CUTS to the number of medical secretaries in Scotland's largest health board are jeopardising patient care with nearly one-quarter of clinical letters taking more than two weeks to type up, a report has warned.
Consultants have raised concerns with management at NHS Greater Glasgow and Clyde (NHSGGC) after finding the backlog meant many patients were arriving for follow-up appointments before letters from their previous consultations were available. The letters are vital in communicating a patient's condition as they are referred between health professionals or back to their own GP.
The consultants are also frustrated by what they claim has been a deterioration in the quality and accuracy of the letters being produced after the ratio of secretaries to consultants was halved last year.
The Herald revealed last April doctors in the health board were opposed to plans to slash the allocation of Band 4 medical secretaries, warning the changes would result in a reduction in the quality and safety of patient care.
At the time, each consultant surgeon worked with a medical secretary on a one-to-one basis, but under the proposals this would change to two consultants sharing one secretary, with each consultant allocated a typist for additional work.
The health board pressed ahead with a pilot from June to September last year in the general surgery and orthopaedics departments at Glasgow Royal Infirmary (GRI) and the urology department at the Southern General. A subsequent evaluation by the Surgery and Anaesthetic Directorate reported the cuts "can provide a safe and effective administrative model for the service" – contrary to the views of 89.5% of consultants surveyed.
The model was approved in November, but consultants at the GRI who have carried out their own audit claim the management report was flawed and the new system has resulted in huge delays.
Their findings were discussed with Jane Grant, chief operating officer for acute hospitals in NHSGGC, during a heated sub-committee meeting last month.
According to the consultants' analysis, 40% of clinical letters were taking more than seven days to type up during the 2012 pilot period compared to 13% during the same 13-week period in 2011.
By December 2012 and January of this year it had deteriorated further, with 81% taking more than seven days to turn around and 24% of these taking more than two weeks.
Their report concluded: "The New Admin Model has been associated with a substantial increase in the typing turn-around time. Many patients are attending for subsequent episodes at which time the letters from prior clinic appointments have not been available due to the typing delay."
One doctor said: "The surgeons applied proper statistics and have showed conclusively and objectively that the service has deteriorated significantly.
"Our management have not listened to or addressed our concerns at all."
A spokeswoman for NHSGGC said: "Implementing new electronic systems and a new model of administrative support across such a vast organisation inevitably takes time to embed. Some of our consultants have raised issues with us regarding the new model. We take these concerns seriously and have committed to develop an action plan to ensure that the issues they have raised are fully addressed."
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