RESIDENTS in Tavistock have spoken out about their dismay at the cuts to the out of hours GP service at Tavistock Hospital and are calling for those in charge to stop the implementation of the cuts until a ‘full and meaningful’ consultation with GPs and the public has been undertaken.

A number of residents have written to the chair of the NEW Devon Clinical Commissioning Group and the chair of the Devon Doctors’ Board expressing how ‘greatly alarmed’ they were after reading about the planned cuts in the Times (Thursday, July 7).

The letter states: ‘As residents of Tavistock and neighbouring areas we are greatly alarmed by the news reported in our local newspaper that the new contract for Devon Doctors to provide the NHS 111 and out of hours GP service will mean the withdrawal of GPs from Tavistock Hospital during evenings and weekends. Most of us have used this service for ourselves or for family members. It is greatly valued by the community and we believe the proposals represent a threat to the health and wellbeing of the local population.’

They highlighted that the Government created the Clinical Commissioning Groups in 2013 to ‘take responsibility for NHS resourcing decisions from remote bureaucrats’ and put it into the hands of ‘local clinicians and GPs’.

The residents said: ‘However, it is quite clear from the statements made by the doctors of Tavistock’s Abbey Surgery, as quoted in the newspaper article, that they believe the changes will mean a poorer service for patients, longer waits for care and that they are not supported by our GPs.’

The residents said they assumed the changes were part of the ‘efficiency savings’ the Government claimed would save the NHS ‘£20-billion by 2020’ and that the CCG’s press release announcing the contract stated that proposals would make more efficient use of GP time.

‘If doctors attending home visits in the Tavistock area have to travel from Plymouth or Okehampton this does not suggest a more efficient use of GP time,’ the residents said. ‘Also, the CCG’s own website currently advises people to visit minor injuries units instead of A&E departments whenever possible but inevitably, as the public becomes more aware that the Tavistock MIU is not supported by out of hours GPs on site, increasing numbers will instead go straight to Derriford’s A&E, a service already under immense pressure.’

The residents also highlighted concerns regarding the impact the removal of doctors from the hospital would have on the long term viability of its other services. They said they were aware that community hospitals were under threat due to the cuts the Government was asking CCGs to make but said even if the CCG claimed the planned changes would not jeopardise the future of Tavistock Hospital, they would find it ‘hard to accept such reassurance’.

They said: ‘From what we have been able to ascertain, there has been no consultation with local GP practices or the public regarding the changes. The CCG states that it will operate with sufficient transparency about NHS activities to promote confidence between the CCG and the public. We do not believe it has done so in this case.

‘There is nothing in the CCG’s press release, previously referred to, which would alert the Tavistock community to the planned changes to our local NHS service. It appears the matter has only been made public as a result of the actions of concerned GPs.’

Signing the letter off, the residents asked both chairs to publish details of the current costs of NHS 111 and out of hours GP services in Devon and the proposed budget for the new service, details of all planned changes and how bosses determine where cuts in services should be made and to publish the impact and risk assessments associated with the planned changes. They also asked for them to stop the implementation of the service cuts until there has been a full and meaningful consultation with local GPs and the public.

In response to the letter, a spokesperson for NHS Northern, Eastern and Western Devon CCG said the integration of the NHS 111 telephone service and the out of hours GP service in Devon was as a result of national guidance from NHS England on how these services should be delivered in the future and that public representatives worked with South Devon and Torbay and NEW Devon CCGs’ commissioners on the design of the new service and how it would be delivered. They said the new specification recognised Devon currently had a higher number of treatment centres compared to other CCGs with low utilisation rates, which provided scope for the new provider, Devon Doctors Ltd, to maximise service efficiency while maintaining local access.

The spokesperson said: ‘As part of the decision making process, a review of the current usage of the out of hours service and the NHS 111 service was undertaken. The data showed that an average of less than one patient accessed the Tavistock treatment centre per weeknight evening and an average of less than eight patients a day accessed the centre at weekends. With this information it was decided that Tavistock would be one of the current locations which will cease to be an out of hours treatment centre from October 2016. Other NHS services at Tavistock Hospital are not part of this procurement.

‘People living in the Tavistock area will be directed to use the Plymouth treatment centre and will be given a booked appointment. Where people are unable to travel to a centre and there is a clinical need for the patient to be seen, the out of hours service will, as per the current practise, arrange a home visit.

‘There are no reductions to the budget for these services and the same level of finance maintained. This is £44-million for three years for both South Devon and Torbay CCG and NEW Devon CCG combined.’

The CCG said in order to ensure itself and the public that all possible impacts had been considered and either eliminated or managed, an equality impact assessment was carried out which showed overall positive impacts in clinical safety, patient experience and effectiveness. Some protected and other groups were identified as needing greater consideration and the mitigation for this was included. It said rurally isolated people were identified as a group which could be disadvantaged by the location of the centres but this was mitigated by the continued ability to use all sites to meet with people, the use of increased telephone-based clinical advice could reduce the need to travel to be seen and the increase in home visiting would benefit this group.

The CCG said the integration of the two services would result in a ‘more joined up service’ for patients and would mean shorter waiting times at out of hours treatment centres as well as increased home visiting capacity. It said people would benefit from a number of service innovations when the new service launches, such as interactive voice response technology to help callers to NHS 111 obtain answers more quickly.

The CCG spokesperson added that the Devon Scrutiny Committee was provided with information about the proposed changes in a closed briefing in June and the committee has determined to put it on its work programme. It will form part of the agenda for the next Devon Scrutiny Committee on September 19.