DOCTORS in West Devon have expressed their concerns over the news that the GP out-of-hours service at Tavistock Hospital will be cut later in the year.

The NHS Northern Eastern and Western Devon Clinical Commissioning Group (CCG) has confirmed that there will no longer be local GPs based at Tavistock Hospital during evenings and weekends, meaning people needing the service will have to contact a central call centre in Exeter for advice or travel to Derriford Hospital or Okehampton Hospital for face-to-face appointments.

The current service, provided by Devon Doctors Ltd contracted by NHS Northern Eastern and Western Devon CCG, sees a GP based at the hospital every evening from 7pm to 11pm and two GPs at the weekend from 8am to 1pm then one from 1pm to 11pm.

They provide advice and consultations over the phone, face-to-face consultations at the hospital and support the minor injuries unit and the hospital ward. There is also a car and a driver for GPs to carry out home visits for people who are housebound.

From October, however, there will no longer be any GPs out-of-hours based at the hospital, there will be no car or driver based in Tavistock and a number of the support staff will be made redundant. Cars and drivers based in Plymouth and Okehampton will cover the home visits.

GPs at Abbey Surgery in Tavistock have expressed concerns that the reduced service will cause delays and increase pressure on other services.

A spokesperson for the surgery said: ‘In 2004 local GPs stopped providing services for local patients through their surgeries when a new national contract was introduced.’

‘Responsibility passed to the then primary care trusts, now CCGs, to provide a service for patients requiring a GP when their surgery was closed. Since this time the service has been provided by Devon Doctors On Call, a mutually-owned, not for profit organisation, staffed mainly by local GPs. Locally they have been based at Tavistock Hospital. This service across the county has long been noted as one of the best performing out-of-hours providers in the country, with consistently good results on various measures such as safety, performance and feedback from patients.

‘CCGs have recently been directed nationally to incorporate 111 services with their GP out-of-hours services. This has resulted in a contract renegotiation locally, with less money available for GP services.

‘Sadly for the people of Tavistock this means they will lose their GPs from Tavistock Hospital during the evenings and weekends. The service will now be provided by a remote call centre in Exeter, supported by another in Newcastle. Patients who need a face-to-face appointment will need to travel to Derriford or potentially Okehampton, but Okehampton will only be available for reduced hours and only at weekends.

‘Provision for home visiting will be via the existing cars at these bases, with no additional capacity being provided. There is no agreement for support for MIU and the hospital ward.

‘We are afraid this will mean remote operatives offering advice about situations without local knowledge, increased travel for mobile patients and significant delays for home visiting. We are also concerned regarding the safety of a lack of medical input at the hospital during evenings and weekends. Many local doctors with significant out of hours experience will no longer be available to local people who need their expertise.

‘The effectiveness of this service is based on the assumption that a new, more efficient 111 service will significantly reduce demand. Our view is that demand is likely to be delayed — longer waits for care, deferred — increasing pressure on local practices, or diverted — increasing pressure on the ambulance and Derriford A&E services. This doesn’t represent the intended cost saving across the service for tax payers, while providing a poorer service for patients.’

Dr David Hopes from Abbey Surgery added: ‘In my opinion Tavistock is getting a raw deal and we’ve lost our local service. There will still be a service but it is being spread very thinly, which is a shame. It is a very well-used service — last Saturday morning we had two doctors working solidly. We want people to be aware that this is happening and that it is not the GPs that have made this decision and to put pressure on the CCG not to forget the rural communities.

‘It’s very sad for the people of Tavistock that we won’t have the coverage that we have had.’

A spokesperson for NHS Northern, Eastern and Western Devon CCG said: ‘Tavistock will no longer be a GP out-of- hours treatment centre, which means it won’t have a GP based there in the evenings or at weekends.  The other NHS services provided at Tavistock Hospital are not part of this procurement and will continue to be provided as they are now. 

‘People living in Tavistock who contact the out-of-hours GP through the 111 service, will be directed to use the Plymouth treatment centre and they will be given a booked appointment at a time that suits them, so they won’t have to wait for a GP to become available. Where people are unable to travel to a treatment centre, the out-of-hours service will arrange home visits from a GP.

‘If a patient has difficulty getting to Plymouth and an out-of-hours GP is in the vicinity there will be an option for an appointment to be booked at Tavistock Hospital.

‘As part of the new model, there will be an additional and separate group of GPs available to visit people in their own home. Appointments will also be available over the phone for the home visits, with doctors visiting at a time most suitable to the patient. Devon currently has a higher number of treatment centres when compared to other CCG areas across the country, so this system brings the number in line with demand.

‘The proposed changes have been presented to the Devon Scrutiny Committee and have the support of this committee.’

The CCG said the new system would be more efficient and flexible with an increased number of doctors working in the out-of-hours treatment centres, to ensure that there were not long waiting times to see a GP out-of-hours. 

The new model also stipulated that the majority of people would not have to travel more than 30 minutes to get to a treatment centre.