Brechin patient safety “top priority”

Brechin Health Centre
Brechin Health Centre

NHS Tayside has issued an update on health services in Brechin, after the health board took over management of Brechin Health Centre on October 1, following the dissolution of the GP partnership.

NHS Tayside’s Dr Michelle Watts said: “As patients of the GP practice at Brechin Health Centre will be aware, NHS Tayside took over the management of Brechin Health Centre from October 1, following the decision of the previous partnership to dissolve the partnership.

“I am pleased to say that the handover has gone smoothly and the GPs are continuing to see patients routinely. The remaining GPs are now salaried doctors which means they are directly employed by NHS Tayside to provide primary care services at the health centre. This has been supplemented by locum doctors while NHS Tayside continues to recruit more salaried doctors.

“The decision to dissolve the partnership was difficult for the practice but they had struggled to recruit GPs, despite their best efforts. In fact, the issues facing the Brechin practice reflect the GP recruitment difficulties being experienced across the UK.

“This shortage of GPs nationally means that we need to find new ways of delivering care in all of our communities across Tayside, be that in a city, in smaller towns or in our more rural areas.

“In north-east Angus, we are already establishing new models of care and the GP practice in Brechin is leading the way with the introduction of some innovative solutions including:

an open access surgery operating between 8.30am to 10.30am Monday to Friday where patients can be seen by a GP or a Nurse Practitioner on a ‘come and wait’ basis without the need to call to make an appointment. This has had a lot of positive feedback from patients and has already reduced the number of appointments wasted due to patients not attending. It also means that patients can have a quick assessment for acute problems, like earache or tonsillitis, freeing up bookable appointments for those who need continuity of care and for those with complex or long term conditions which require ongoing monitoring.

in addition to the salaried GPs who now provide day-to-day services, there is a small group of experienced locum GPs who work to support the team, alongside an expanded nursing team.

increasing the pharmacy input, thus allowing more support for medication issues and freeing up more GP time.

doctors and nurses from old age psychiatry, community nursing, medicine for the elderly (MFE) and mental health services more closely involved in the care at the practice to develop a more coordinated approach to support the health and wellbeing of the community.

“As the way in which we deliver Primary Care, including General Practice is changing for the communities in and around Brechin, we also have to look at the future role of Brechin Infirmary. Our primary focus at this time is to make sure we have enough GPs and nurses to manage the everyday demand for appointments at the GP practice, which runs into hundreds of appointments every week.

“The practical outcome of this is that at the present time we simply do not have enough GPs to also run the GP ward at Brechin Infirmary.

“Currently, there are no patients in Brechin Infirmary and none requiring to be admitted. However, the medical staffing situation makes it clear that we cannot admit into the infirmary at this time as we would not be able to deliver safe care for our patients. Patient safety will always be our top priority and therefore we have looked to our Medicine for the Elderly consultants, doctors and nurses to provide the continuity of care for our patients in and around Brechin.

“This means that, with immediate effect, patients who require to be admitted locally, be it a direct GP referral or step-down care from an acute hospital, will be cared for in Stracathro Ward 2. There is sufficient capacity in this ward to cope with the small number of patients who require to be admitted.

“Brechin patients will be looked after under the care of an MFE consultant and medical and nursing team. This will ensure rapid access to 24-hour medical and nursing care, investigations and ongoing treatment. The team will then follow the patient back home into the community, working together with the GP practice in Brechin to ensure good continuity of care.

“We understand that people are naturally attached to their local hospital and we are fortunate that many people in North Angus also view Stracathro as one of their local health facilities. We hope that patients and their families understand the reasons behind why we have had to make changes so quickly to the way we deliver inpatient care in the area and can see that we have tried to keep that care as local as possible in Stracathro.

“Although we are now going to admit patients to Stracathro when required, the introduction in the coming months of the Enhanced Community Support Model, a new community-based model of care for elderly patients, will provide improved care to support people in community and at home. This involves a multi-disciplinary team of health professionals working together in partnership with social care and voluntary sector colleagues to support individual patients and their families.

“By introducing this Enhanced Community Service (ECS) approach to north-east Angus frail, elderly people in the community can be better supported as the team can anticipate problems at a much earlier stage, offer comprehensive assessment, and provide support early enough to maintain people at home, where possible.

“This model is already working well in South Angus in Monifieth, Carnoustie and, most recently, in Arbroath where it has been very much welcomed by patients, their carers and the teams who work with them.

“In order to develop this with our local community we are already working with a patient group in the GP practice in Brechin and we are keen to get more people involved in shaping the future services in north-east Angus. We are arranging a local community event in the next few weeks, details of which will be advertised soon please come along and get involved.

“Health and care services must change and this is an opportunity for the north-east Angus population to lead the way in developing person-centred, tailored services for their communities now and into the future.”