loss of RURAL doctors.

[MuckleJoannie]

NHS Shetland fund surgeries, based on national guidelines. Some idea of how the funding is worked out can be found in this document.

 

http://www.sehd.scot.nhs.uk/pca/PCA2008%28M%2909SFE.pdf

[paulb]

lerwick and whalsay are run by the nhs. others are fundholders.

 

the gps in england don't or did not employ district nurses. some have been moved from community trusts to over organizations. whatever the budget for district nursing does not come from the gps.

[oddtablet]

Interesting letter from Dr Gerald Freshwater in this week's Shetland Times.

 

[Silvercloud]

Paulb in England I said they employed practice nurses and the District nurses were emplyoed by the Trust as in case of our old surgery .

[Silvercloud]

Why have only Lerwick and whalsay run by NHS and the others fund holding ?

[MuckleJoannie]

Because the NHS haven't been able to recruit contractors I would think.

[Uncle_Monty]

Cuts are grim all round. The rural ones have it bad, and it probably won't help when I mention that several friends and colleagues of mine, all of whom have moved to Lerwick over the years, still use the Brae GP, purely because it's a way better one-to-one service.

 

It speaks volumes about the provision in Lerwick when folk would sooner drive to Brae to get checked out...

[paulb]

it does seem strange that lerwick struggles so much. are the gps there all permanent or are some temps.

 

you really should be able to see a GP within the day if you think its urgent. Obviously none urgent appointments should be able to be booked in advance.

 

What could help the hospital is if they turned the 4 beds on ronas that they have closed into an assessment observation unit. this would take the stress off the other wards and would in the end save money.

 

the 1/3 cut of the mental health service provision by the SIC. is really not going to help the hospital. it is not equipped or the staff trained to care for mentally ill folks going through acute events. they can offer a place of safety but that's all.

 

lastly using bank staff to prop up shifts can not make financial or staffing sense. it would be better to employ a few more staff as permant staff: so the wards can cope with sickness holidays ect.

[Stug]

it does seem strange that lerwick struggles so much. are the gps there all permanent or are some temps.

 

you really should be able to see a GP within the day if you think its urgent. Obviously none urgent appointments should be able to be booked in

 

The problem with that is everyone thinks their need is urgent. I know of someone who went to the doctor last week thinking they needed antibiotics because they had sore throat for two days and were not pleased when the doctor refused and advised self management and if their condition got worse to come back. It is exactly this sort of patient that makes it difficult for genuine patients to see a doctor.

 

 

lastly using bank staff to prop up shifts can not make financial or staffing sense. it would be better to employ a few more staff as permant staff: so the wards can cope with sickness holidays ect.

 

The problem with employing permanent staff is that it will cost more in the long run. They will be contracted for a certain number of hours per week whether you need those hours covered or not. By using bank you are only in incurring costs for the shifts you need covered.

[Silvercloud]

Using the nurse bank only works if it run properly. Okay, I'm using south as an example here when if a member of staff is booked and they are not then needed they are used elsewhere in the hopsital thus honouring the shift.

Here on Shetland they book the shifts and then cancel the shift(s) just hours before it starts this demoralising the nurse bank staff and leaving staff out of pocket as they could have made other arrangements.

 

Once a shift has been accepted it should be honoured .

[paulb]

I agree with you there Stug that that was a waste of time to go to a doctor with a sore throat for just two days! I know someone who has had far more than that and probably does need antibiotics and will not go to their doctor and has not been able for work because of it and will wait to get better without going to the doctor.

 

oh i agree the patient needs to have some common sense. it getting the balance right that is important. maybe its not even the persons fault. it could have been that they were not taught simple cures for common aches and pains. maybe that should be a topic in schools.

 

yes the bank is an important resource but what it should not be doing is replacing permanent staff. its meant to fill unexpected shortages. doing other than that weakens the care provision. It should also sound alarm bells if bank staff out number the permanent staff on a shift.

[Uncle_Monty]

I think we'd all agree that some people would do well to avoid rushing to their GP and cluttering up the hospitals unnecessarily with minor ailments that could be treated with a few paracetamol.

 

However, I don't think that the eagerness of some people to rush to their GP is a new phenomenon. It doesn't explain why so many people are having difficulty with the current setup, especially in Lerwick.

 

My concern lies with the folk at the other end of the spectrum - the elderly Shetland man, for example, who may be reluctant to go to the clinic and, when he finally gets around to it, he's told that there's no appointments for several days.

 

I witnessed this myself when I was in for a blood test, I could see the old guy was in a bad way, but didn't want to be any bother.

 

I just wonder what's wrong with the old system of coming in and simply waiting your turn?

[Silvercloud]

If you had the old system back some elderly folk could be waiting a long time to be seen, some maybe using a bus service , others might have children pick up from nursery/school etc .

[Stug]

Stug, an NHS Manager goes on this forum and abuses patients though, I gather because of her inefficiency of how she works, otherwise she would not have to try to defend what she has done in her position, but evidence proves the truth.

 

 

Vitalite, who complains about being abused on Shetlink, seems to think it is okay to abuse me. Although I should not lower myself to respond I feel I should set the records straight. I am neither female nor an NHS manager! I am a male who has several chronic health conditions that makes it necessary for me to frequent both my GP and hospital so, unfortunately, have an insight into how things work. I was not abusing patients I was simply stating that some attend when it is not necessary and Vitalite agreed!

 

I agree with you there Stug that that was a waste of time to go to a doctor with a sore throat for just two days! I know someone who has had far more than that and probably does need antibiotics and will not go to their doctor and has not been able for work because of it and will wait to get better without going to the doctor.

 

 

So why the completely inaccurate abuse now? For someone who complains about people on Shetlink I think you should look in the mirror.

[Uncle_Monty]

@silvercloud - true enough, but surely there's a better way than the current system. I was more thinking for people that were so ill they had to actually be off work to be honest. Take your point regarding kids etc.