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Uneven allocation of resources leaves Lerwick patients waiting longer to see GPs

Lerwick South councillor Amanda Westlake said the lengthy wait time for GP appointments was "not acceptable".

FRESH calls have been made for NHS Shetland to ensure its GP resources are allocated more evenly as Lerwick Health Centre patients continue to face a lengthy wait in order to get a GP appointment.

Lerwick South member Amanda Westlake told a meeting of the Full Council yesterday that she had waited 28 days for an appointment, while other patients sometimes wait as long as six weeks.

She said it was “not acceptable” and was seeking assurances that something would be done about an issue that was “the largest area of concern for my constituents.

“It seems like groundhog day,” she said. “I don’t see any improvement – I see things deteriorating.”

SIC and NHS director of community health and social care Simon Bokor-Ingram acknowledged that the health board’s GP resources were “not spread proportionately”, while recruiting GPs continued to be an issue.

Director of community health Simon Bokor-Ingram acknowledged that resources are not being allocated in the most efficient way.

The number of full-time equivalent (FTE) GPs in Lerwick is currently 6.2 to serve 8,759 registered patients.

That works out at 1,413 patients per doctor, which is not the highest ratio in the isles – Brae and Scalloway health centres have a greater number of patients for each GP – but it is exacerbated by there currently being two vacancies in the town.

Smaller remote practices have much lower ratios – there are 1.3 FTE GPs in Hillswick serving 779 patients, while surgeries in Unst, Walls and Whalsay also have similar ratios, albeit posts are currently sitting vacant in those areas too.

Some of those practices have a higher allocation to enable them to provide their own out-of-hours cover, while an NHS Shetland spokeswoman said the allocation of practice GPs was “historical” and “not therefore necessarily representative of demand or size of population”.

Bokor-Ingram told councillors in Lerwick Town Hall on Wednesday that Lerwick Health Centre possessed an “extremely hard-working and dedicated group of staff”, but accepted the health board needed to look at “how we use our resources more effectively”.

He said more use needed to be made of nurse practitioners, pharmacists and other health professionals, while there are currently four trainee GPs working in Lerwick some of whom may be able to work as GPs once their training is complete.

That also has to be balanced against the challenges presented by an ageing workforce, with a number of GPs not far from retirement age.

North Mainland member Alastair Cooper was keen to ensure any measures to resolve the situation in Lerwick were not to the detriment of rural practices.

South Mainland councillor Robbie McGregor said that, as a lifelong pharmacist, hearing that his profession was to be utilised more fully was “music to my ears”, but he wondered whether “perhaps a PR job with the public” was necessary.

Council leader Cecil Smith pointed out that the shortage of GPs was a national issue, adding that it was not always a solution to “throw good money after bad”.

North Mainland member Alastair Cooper – whose ward includes the Brae and Hillswick surgeries – said it was important to “protect those practices that are performing well” and he didn’t want to see them “brought down to the lowest level” as a side-effect of resolving Lerwick’s shortcomings.

At present Lerwick serves 38 per cent of the 23,078 isles patients while a further nine GP practices serve the remainder.

One source suggested that a solution would be to have a single GP service with a number of satellite surgeries at the existing locations, with a single manager then able to ensure GP resources are allocated in the most efficient manner possible.