Health centre to extend area it covers

The Scalloway Health Centre will take on more patients over a wider area when the new practice opens in the former primary school building later this year.

Medical staff will cater for up to 600 new patients in an area stretching as far as Gulberwick. Scalloway’s current boundary extends to Whiteness and Weisdale, the Tingwall valley and Burra and Trondra, as well as East Voe. Some patients in Wester Quarff also go to Scalloway – historically, because the GP used to go there by boat.

The latest move, due around May, should give the village practice responsibility for 4,000 patients. It has been made possible by the deal brokered between the NHS and Shetland Islands Council, which has already seen Scalloway school pupils move into the old junior high school building that had been vacant since 2011.

Gulberwick patients will be given the choice of being registered in either Lerwick or Scalloway. Those in Gulberwick who are registered in the town will have the option to transfer to Scalloway should they wish to do so. Letters will be sent in the near future to help keep folk informed.

The news emerged at last night’s meeting of the Lerwick Community Council, where health officials outlined plans for four new advanced nurse practitioners, or ANPs, to begin in the town practice from next month.

Primary care service manager, Lisa Watt, was accompanied by community health and social care director, Simon Bokor-Ingram and serving ANP Joan Sandison. Medical director, Roger Diggle, was also present at the meeting.

The appointment of more ANPs were largely welcomed by members.

But SIC convener Malcolm Bell questioned whether problems lay in having one GP surgery – Lerwick – covering half the population.

Ms Watt said Scalloway would soon be getting a bigger health centre, which would help spread the numbers.
“From today, we’re looking at expanding the Scalloway practice boundary, which will give capacity of up to four thousand.”

She said the decision to appoint another four ANPs followed long-running difficulties, mirrored nationwide, to fill GP vacancies. The town practice should have 7.2 GPs on its books, but has been saddled with a 1.7 full time equivalent vacancy for almost two years.

Dr Diggle said a number of Shetlanders were going through GP training, giving Shetland a slightly more positive picture than the nationwide shortage. Across the UK, more than half of GPs were aged between 50 and 65. Most of those training, he said, were women who wanted to work part time.

Ms Watt said appointing ANPs was within the health board’s budget and would help the NHS offer more appointments to those in need.
Responding to questions from town councillor Michael Stout, she said ANPs would be on hand to deal with acute

patient care. That would leave GPs able to tend to other patients with long-term needs, which would help maintain a continuity of care.

Mr Bokor-Ingram stressed ANPs were people who were “highly experienced and educated members of the care team.”

The meeting heard Ms Sandison had been in the Lerwick Health Centre for 26 years, and had a key involvement in the walk-in clinics at the Gilbert Bain Hospital on Saturday mornings.

The four new recruits will be less experienced, said Dr Diggle, but would be supported by two GPs, who would make themselves available to see any patient if requested by the ANPs.

“I think it will be a huge step forward,” he said.

Questions were also asked about the number of GPs working in Lerwick. SIC member Jonathan Wills queried how

GP figures in Lerwick now compared with 10 or 20 years ago.

The health experts worked out an historical figure of six. But that had to be seen against a backdrop of growing demand among more patients, with 4,000 appointments being seen now compared with 2,000 in previous years.

Dr Wills said there was a need for a third or half as many more GPs.
“Or you use other members of the team, and that’s effectively what we’re doing?” Dr Diggle interjected. “It is a way of creating capacity.”

Speaking after the meeting, Ms Watt stressed the change of Scalloway’s boundary had not come about in order to help the Lerwick practice.

“It’s because Scalloway are getting a bigger health centre and can take more patients,” she said.

“This move has come about to aid the growth and viability of the Scalloway practice, as opposed to any permanent change in GP practice boundaries.”