GPs' Christmas holidays causing "genuine concern"

The College of Emergency Medicine Scotland has warned patients are likely to face longer waits for treatment in overcrowded hospitals as practices close their doors for the two bank holiday weekends.

One mainland health board, NHS Grampian, contacted all GP surgeries and asked them to consider offering some appointments during the festive breaks. One agreed.

NHS Lanarkshire had a better response, with almost a third of practices agreeing to see patients during the mornings of Saturday December 27 and Saturday January 3 in return for payment of £350 per day, plus 10 pence per registered patient.

It is two years since Christmas and New Year have fallen directly beside a weekend, resulting in the closure of GP surgeries for four days in a row, two weeks in succession. In the intervening period hospitals appear to have come under greater pressure, with more complex elderly patients needing ward beds.

Dr Martin McKechnie, chair of the College of Emergency Medicine Scotland, said: "We have genuine concerns about the lack of alternative healthcare available to the population over these four-day periods.

"The reason for that is people will, as usual, vote with their feet and turn up at A&E as the only available healthcare to them."

He predicted out-of-hours GP services would become fully booked, resulting in patients using casualties instead and adding to queues. It came as figures out yesterday showed more than 100,000 patients had already waited more than four hours in A&E departments this year.

Dr McKechnie said: "The quality of care provided to all the patients will have the potential to be reduced because waiting and crowding in hospitals is associated with mortality."

He also warned some patients who become unwell tend to try to wait until their GP surgery re-opens before seeking treatment, leading to a deterioration in their condition over four days to the point they need hospital treatment.

A study in Scotland, which was published last year, found patients admitted to hospital on bank holidays are more likely to die than those admitted the rest of the time.

Matt McLaughlin, organiser for trade union Unison in the Greater Glasgow and Clyde area, said: "We know that death rates in hospitals appear to go up after a bank holiday. We know that when GPs are closed for extended periods attendances at A&E front doors increase, we know this has an impact on waiting times and bed occupancy and boarding (patients being in the wrong department for their condition).

"The trick is to try to ensure that only people who genuinely need A&E care attend hospital emergency departments."

A spokeswoman for NHS Grampian said they had contacted surgeries and asked them to consider offering a service during the bank holiday weekends and one, in Banchory, agreed to open on Saturday December 27.

Discussing the impact of the two bank holiday weekends, the NHS Grampian spokeswoman said: "It means everything else gets a lot busier, whether that is NHS 24 or the out-of-hours GP service or people turning up at A&E departments and often that's not the place they need to be."

NHS Lanarkshire said 28 practices would open on December 27 and 32 on January 3. The board added: "We typically see a surge in the numbers of people using the (out-of-hours GP) service on the Saturdays following both Christmas Day and New Year.

"The additional Saturday opening times will improve access to GP services for patients on these days and help to reduce the pressure on the out-of-hours service."

Mainland health boards around the rest of the country confirmed all GP surgeries would shut for the full four days at both Christmas and New Year. Out-of-hours medical centres, accessed through helpline NHS 24, will be in operation.

NHS 24 expects to handle more than 80,000 calls over the two festive weekends and has recruited extra nurses and call handlers.

Dr Andrew Buist, deputy chair of the British Medical Association's Scottish GP Committee, said: "Whilst some health boards may have put extra local arrangements in place, patients across Scotland can be reassured that if clinically necessary they will be able to see a GP at all times throughout the festive season."

A spokeswoman for the Scottish Government said it is ensuring the NHS is ready for winter and an extra £8.2 million is being used to put robust plans in place across the country.

She added: ??NHS boards have each been allocated a proportion of the funding, in addition to their local targeted funding, to put in place local solutions which will ease pressures across the winter months, including the festive period. "