Patient campaigner blasts 'horrendous' GP out-of-hours service

A pharmacist advised her to contact NHS 24, who in turn said she should attend the nearest out-of-hours GP service.

READ MORE: Secrecy and defensiveness can only backfire on the NHS 

The Queen Elizabeth University Hospital, Gartnavel Hospital and Easterhouse-based services were all closed due to staff shortages so Ms Hughes, who had to give up working as a nurse due to a number of chronic health conditions, paid for a taxi to the RAH.

She arrived, along with her 76-year-old mother Anne, shortly before 9pm for what she describes as a "horrendous ordeal".

She said: "There was no water or food available. There were no vending machines in the out-of-hours area where you could even get a cup of tea.

"There weren't enough seats so people were standing or lying on the floor. The department was freezing because of a broken door that was letting cold air in.

"You wouldn't be allowed to treat animals like that. There were children and very young babies waiting to be seen - one baby wasn't even a week old.

"There was only one doctor on duty and everyone was getting irate with her. She was due to finish at midnight but stayed on an extra hour until they managed to get a second doctor to come in at 1am, when they closed the department to new patients.

"Some patients were shipped off to the Victoria hospital in Glasgow, but I think some just went to A&E or gave up and went home. I waited more than eight hours.

"I've got no issue with the care I received - the doctor was lovely and she was doing her best. But she said that would be last shift she would be doing for out-of-hours as seemingly the week before had been even worse.

"The week previously she said that she'd been totally on her own and hadn't even had a nurse to be able help triage patients safely.

"She said her friend, who was working in the Victoria out of hours service, had been on the phone crying before her shift as she didn't want to go to her work."

READ MORE: Freeman takes swipe at NHS Glasgow over whistleblower criticism and 'obstacles' faced by infection control medics 

Ms Hughes, who previously campaigned against the closure of inpatient beds at Glasgow's Centre for Integrative Care, said she was so exhausted when she finally arrived home at 5.30am on November 11 - her 51st birthday - that she slept for the rest of the day.

She added that both her mother and herself have since fallen ill with respiratory infections which she believes they picked up from other sick patients during their wait in the out-of-hours unit.

It comes nearly a year after a similar delay involving Ms Hughes mother was raised in the Scottish Parliament by Glasgow Conservative MSP, Annie Wells.

Staff shortages on December 1 2018 had closed the out-of-hours GP service at the QEUH and overcrowding in its A&E department meant that Anne Hughes - then 75 and suffering an acute kidney infection - was sent to the RAH instead. She finally arrived home 10 hours after first seeking help.

At the time, Health Secretary Jeane Freeman told MSPs that "the length of time that it took to be treated and the additional travel are completely unacceptable".

Figures later revealed that staff shortages had forced GP out-of-hours services across the region to close 250 times in 2017 and 2018.

The problems have persisted, however, with senior Scottish Government officials calling a meeting with health board bosses in June when all but one of the five services were closed one weekend because doctors were not "willing to work".

Ms Hughes, who suffers from a number of conditions including chronic pain, chronic fatigue, arthritis, and Crohn's disease, said her quality of life has deteriorated so much since inpatient care ceased at the CIC - formerly known as the Glasgow Homeopathic Hospital - that she even consulted her GP earlier this year about ending her life at the Swiss assisted suicide clinic, Dignitas.

In further blow, Ms Hughes said her next appointment with her gastroenterologist, scheduled for February 27, was cancelled this week and has been pushed back until August 20 2020.

She said it brought back memories of her father's death in 2004 after his return hospital appointments were repeatedly cancelled.

She said: "My Dad had multiple long-term conditions too including Crohn's disease, arthritis and a history of TIA's [mini strokes]. Had he been seen at his clinic appointment instead of it being cancelled several times he would in all likelihood have lived longer and may well still be alive today.

"However, he developed complications due to Crohn's disease and a sub-phrenic abscess. He developed sepsis and was eventually admitted into intensive care for two and half weeks, but they asked us to switch his life support machines off. He was 65 years old."

READ MORE: Man died within weeks of cancer diagnosis after tumour missed in CT scan 

It comes after NHS Greater Glasgow and Clyde was escalated to Level 4 status on Friday amid concerns over its handling of infection crises at the QEUH and Royal Hospital for Children.

The decision follows revelations over the deaths of 10-year-old Milly Main and Mason Djemat, three, within weeks of each other in 2017 while they were being treated in paediatric cancer wards 2A and 2B.

The unit was eventually closed in September 2018 following a string of infections linked to the water supply.

The Crown Office is already investigating the deaths in December 2018 and January this year of two cancer patients - a 10-year-old boy and a woman, aged 73 - who had contracted infections linked to pigeon droppings during treatment at the QEUH.

Responding to Ms Hughes experience at the RAH, Annie Wells MSP said: "Not only are the terrible conditions stopping people from receiving the care they deserve, the conditions are also driving away doctors from wanting to do these difficult shifts.

“People deserve a lot better than this horrendous treatment. This doesn’t even meet the most basic level of care. And it looks like things are only going to get worse now that winter is about to kick in."

Dr Alasdair Forbes, deputy chair of the Royal College of GPs Scotland, said out-of-hours services across the country are "under huge pressure which is showing no signs of easing".

He said many GPs feel so stressed and overwhelmed by the daily workloads in their practices that they cannot cope with the additional pressure of covering clinics at night or weekends.

"We are experiencing significant workforce challenges across general practice, with a lack of GPs coming into the profession and challenges retaining GPs within the service," said Dr Forbes.

"We know that these challenges are felt acutely in the out-of-hours service, where we have seen a concerning decrease in the number of GPs working over recent years.

"We have consistently called for solutions to the challenges facing out-of-hours across Scotland to be prioritised by policy makers and we must ensure that those GPs working in the out-of-hours service feel supported and valued, if we are to continue providing around the clock general practice to patients when they need it most.”

Earlier this month, a report by the Royal College of Emergency Medicine (RCEM) Scotland, warned that hospitals needed "at least" an extra 320 beds to prevent patients languishing on A&E trolleys or wards becoming dangerously overcrowded.

Since 2009/10 NHS Scotland has lost more than1000 staffed beds across all acute specialities, despite increasing admissions from emergency departments.

Dr David Chung, vice-president of RCEM Scotland, said there had been a spike in people turning up at A&E but that the real problem was a shortage of available beds.

"There are issues with getting people out of the emergency department into the hospital, so there are people waiting a long time on trolleys," said Dr Chung.

"We need to increase capacity in the community as much as anywhere else to free up beds. It's about getting people out of hospital and into care homes or back home with a care package. That's a big problem in some areas.

"In other areas that might be working quite well, but there simply aren't the number of beds needed to cope with demand.

"Everywhere is seeing an increase in activity - NHS 24, out-of-hours GP services, everywhere is feeling the strain. There's no doubt about that.

"Everybody definitely feels that winter has arrived, and once you get to Christmas it all becomes much more problematic."

In a statement, NHS GGC said it is currently recruiting GPs specifically for the out-of-hours service.

It said: "Every patient across NHS GGC who requires GP out of hours care needs to contact NHS 24 who will direct them to the nearest out of hours facility.

"The majority of shifts at all our GP out-of-hours centres are filled but when we don’t fill all our shifts we need to allocate staff to ensure adequate geographical cover is provided and that demand is met.

"When a GP out-of-hours centre is closed, our GP home visiting service is available as normal for patients who are assessed by NHS 24 as requiring this. There is always transport available for patients who do not have access to their own transport.

"Unfortunately, patients turn up without having called NHS 24 first and this puts pressure on the service leading to delays for those patients who have accessed the service correctly.

"We can only apologise to patients for any additional delays when this happens. If waiting times do increase we advise patients of alternative centres that they can access if they are able to do so.

"There are a number of developments underway in primary and community services which will offer people a wider range of choice in terms of getting the support they need out of hours.

"We are currently advertising to recruit a number of salaried GPs specifically for the out-of-hours service. This model is available in other NHS boards across Scotland and we hope this will offer us more flexibility for staffing our GP out-of-hours service."