Due to increasing and ongoing challenges in providing sufficient medical cover for the three existing Primacy Care Out-of-Hours Centres in Forth Valley, a number of changes are being made to the way services are provided on an interim basis.

These changes, which will be put in place from 24^th July 2017 to 30^th September 2017, are designed to provide greater stability and reduce the need for unplanned contingency arrangements (which often have to be put in place at very short notice). They will also ensure that people across Forth Valley continue to have access to GP advice, treatment and home visits for urgent healthcare issues during evenings, weekends and public holidays.

During the week Primary Care Out-of-Hours services will continue to be provided from the three existing Out-of-Hours centres in Larbert (Forth Valley Royal Hospital), Stirling (Stirling Community Hospital) and Clackmannanshire (Clackmannanshire Community Healthcare Centre) up until midnight. After midnight, they will be provided from one Out-of-Hours centre in Larbert (rather than from two centres in Larbert and Stirling).

At weekends and public holidays services will be provided from two centres in Larbert and Stirling up until midnight (rather than three centres in Larbert, Stirling and Clackmannanshire) and from one centre at Larbert after midnight (rather than two centres in Larbert and Stirling).  Services will continue to be accessed via NHS 24 who will arrange for people to attend a Primary Care Out-of-Hour centre, speak to a health professional for advice or receive a home visit from a GP, if appropriate.

Andrew Murray, NHS Forth Valley’s Medical Director, said: “Over the last few months, like many other parts of Scotland, we have experienced significant challenges in filling our GP Out-of-Hours rotas. These problems were becoming more frequent and while, we have tried to put in place contingency arrangements, we knew that it would become increasingly difficult to adequately staff our Out-of-Hours centres over the summer holiday period. A number of GPs have also raised concerns about working in isolation when shifts have not been able to be filled and have told me that they would prefer to work alongside other colleagues on a single site to help manage demand more effectively.

“We have therefore taken the decision to move from two centres to one centre after midnight and from three centres to two centres at the weekend on a temporary basis. This planned approach will ensure that we are able to maintain Out-of-Hours services while we work to recruit additional staff and carry out a wider review of the service as a whole.”

Consolidating services during the quieter over night period and at weekends will also make best use of the staffing resources available as the majority of calls and attendances at Primary Care Out-of-Hour centres occur before midnight. The Primary Care Out-of-Hours centre at Forth Valley Royal Hospital is also the busiest of the three sites and local patients already travel to different Out-of-Hours centres in the Forth Valley area, depending on demand and the availability of appointments.

Over the next few months, a wider review of Out-of-Hours activity across Forth Valley will also be undertaken in partnership with Integration Joint Board colleagues to identify how safe, sustainable services Primary Care Out-of-Hours services can best be delivered in the future. This will look at how services can be delivered by a wider multi-disciplinary team, in line with the recommendations of the National Review of Primary Care Out-of-Hours Services undertaken by Professor Sir Lewis Ritchie. As part of this work, there are plans to gather feedback, ideas and suggestions from local service users and carers, GPs, nursing, AHPs, social care colleagues and support staff on how Primary Care Out-of-Hours services can best be designed and delivered in the future. In addition, work will also be undertaken to try to recruit a number of clinical staff (including GPs and Advanced Nurse Practitioners) to work within NHS Forth Valley’s Primary Care Out-of-Hours services.