Rural Yorkshire facing drastic cuts in doctors' night service

A radical change to arrangements in North Yorkshire will be tested at Catterick first, with less dramatic changes introduced in the Skipton and Selby areas, in a plan that one family doctor has already described as "concerning".

The proposed pilot, revealed in a letter from NHS and North Yorkshire Community and Mental Health Services to local GPs, would see on-call doctors sleep at home during overnight shifts rather than being on duty at the primary care centre which serves the garrison town and a large area of rural North Yorkshire.

Anyone seeking medical care would have to ring the out-of- hours number, the calls going to Northallerton Friarage Hospital where doctors would decide if the situation merited waking up the on-call GP.

Coun John Blackie, who has already raised his concerns at the changes with the North Yorkshire County Council scrutiny of health committee, said: "This is a major change, we are not just talking about a vast rural hinterland of the Yorkshire Dales, but also soldiers fighting for their country out in Afghanistan, and they should not have to be worried about whether their loved ones would be able to get access to a doctor in the middle of the night.

"There are 51,000 people in Richmondshire of which some 19,000 are connected with the military. This is a cut that affects a very specialised population within the garrison and a huge rural area outside of it – Catterick primary care centre serves us all in the upper Dales, I can't believe the primary care trust (PCT) would risk that.

"This is not a trial but a closure by stealth approach."

It is not yet been decided when the pilot will take place, but in the letter, sent out on November 22, it says it will be "carried out in one locality initially" and the results will be published thereafter.

In the meantime, from next week changes to out-of-hours services – 11pm to 8am – in Catterick, Selby and Skipton will see GPs who are currently on duty at primary care centres throughout the night being switched to sleeping shifts. This will mean their pay is slashed by 40 per cent and patient calls will be prioritised (triaged) by doctors at hospitals in Northallerton, Harrogate and York instead.

The sleeping shifts mean GPs will be allowed to sleep at the primary care centres while on duty, although it is claimed they will still be available for patients either at the centre or at their homes where required.

It is hoped the changes, which are due to come in on December 1, will help address a projected budget overspend of nearly 1m by March 2011.

A rural GP who works in the area affected by the pilot, but wishes to remain anonymous, said: "This will make rural communities lose touch with local doctors. Even in a best case scenario it will take longer if a out of hours patient does want to see a doctor face to face.

"They will save some money but they are just cutting everything at the moment."

It is also claimed a minor injuries centre in Richmond, near Catterick, is to be shut down at the end of the year. One of the reasons given by North Yorkshire and York Primary Care Trust was that patients could use the out of hours service at the garrison.

A spokesman for North Yorkshire and York Community and Mental Health Services, said: "The main reason we are doing this trial in Catterick is because the doctors suggested it themselves. It is going to happen but it needs further discussion.

"We will not go ahead with anything that is detrimental to our patients' health."

The trust's clinical director of unscheduled care services, Dr Mike Holmes, said: "As we are all aware the NHS, like all public sector organisations, is facing huge financial challenges.

"We are looking very carefully at our services to see how we can operate them more cost effectively."

Dr Holmes added: "We have reviewed the number of patients who access the out- of-hours service in the Catterick Garrison, Selby and Skipton areas. Following this we feel able to make the proposed changes to the overnight service.

"This is not about a reduction in clinical provision or making any change to the way patients are seen or treated, as the local GP at Catterick Garrison, Selby and Skipton would still be available if a patient needs to be examined.

"We would be offering a much more efficient and cost effective service."