FERMANAGH’S Out of Hours GP service has been without a doctor at its Enniskillen base on nine occasions since the beginning of April this year.
The news comes as the daughter of an 81-year-old Kinawley pensioner, has described how she had phoned the Out of Hours service last Thursday evening, for her “violently sick” mother, only to be told she may have to make her way to Omagh for medical attention.
Christine Gilleece says she was surprised to be told that there was no doctor on call available in Fermanagh, and even more so to learn that the situation wasn’t “a one-off”.
“My mother hadn’t been well the whole day,” she told The Impartial Reporter, “But by the evening she practically passed out. She was violently sick - and she is a woman who is never sick.
“When I rang I explained the situation to the lady on the other end of the phone and she said there was no doctor.
“I though the doctor was maybe out of call or something - but no, there was no doctor at all.
“The lady told us that if we wanted to bring her to Out of Hours there was a doctor in Omagh.
“There was no way she was fit to travel from Kinawley to Omagh in a car at that point to Omagh.
“We told the lady my mother needed either an ambulance or a home visit. She spoke to her supervisor and rang back and said that if we couldn’t get her to Omagh, the best she could do was get an ambulance out to us within two hours. 
“She told us that if my mother got any worse before they arrived to ring 999 for an emergency ambulance.”
The ambulance arrived within an hour.
“She was taken straight to A and E and is still in hospital now (Tuesday).
“The doctors said it was a kidney infection which could have turned to sepsis.”
Praising the care her mother has received at South West Acute Hospital, Christine says she was “gobsmacked” that the Out of Hours service does not run all the time from Enniskillen.
“People are under the illusion that the service is there, but it is not all the time.
“And given the size of the hospital in Enniskillen, and the size of Fermanagh, it is just ridiculous.”
A spokesperson for the Health and Social Care Board (HSCB) said: “Out of Hours cover has always been available in Fermanagh, however there have been some periods where a GP has not been physically based in the Fermanagh centre.  
“Since April 1, 2018 there have been nine occasions when there was no GP booked to work at the Enniskillen centre. Six of these were what are referred to as red-eye shifts which operate from 12 midnight to 8.30am. On one occasion a Saturday afternoon shift was unfilled however GPs were available on shifts either side of that empty shift. 
“Two recent occasions occurred on an evening shift, i.e. 6pm to 12 midnight; one of these was the evening in question. The base remained open to receive any patients who are booked to see a GP and to arrange for any prescriptions etc to be collected by patients.
The spokesperson said summer time proves difficult period to arrange GPs for all bases every day.
“There have been doctors on call but they may not have been physically based in Fermanagh.  As we have entered into the summer holiday period Out of Hours GPs are taking their annual leave and sustaining their own work-life balance therefore Western Urgent Care (WUC) have had increased difficulties with arranging GPs for all bases every day. 
“Whilst WUC try to offer enhancements to attract GPs to work all shifts there are times when they are unable to do so. WUC therefore manage capacity to meet the anticipated demand. It is an unfortunate situation but one which is experienced by all GP Out of Hours providers in the province at present.
“WUC monitor capacity and availability of GPs in each base on a daily basis. They offer enhancements to the rates of pay for OOHs work. When WUC know they have fewer doctors available at a specific base they arrange for a GP to work at that base which differs from where the GP will have originally been booked to work at. WUC arrange additional Nurse Advisors to triage patients and assist in clinically prioritising patients who need to been seen by a doctor,” said the spokesperson.
 A media campaign is planned to remind patients that GP Out of Hours Services are here to support patients with their urgent medical needs. 
The HSCB say GP Out of Hours should not be used for certain health conditions or for arranging repeat prescriptions; these are best managed by the patient’s own GP. WUC are recruiting a number of Advanced Nurse Practitioners to work at some Western centres and are supporting the training of a number of others so that WUC can manage their longer term workforce plans.
“If WUC have been unable to book a GP to work at a base eg Enniskillen, and several patients need to be seen in that area, WUC will arrange for a GP from another site such as Omagh to attend and undertake blocked bookings for a period of time at the Enniskillen OOHs centre. 
“The GP will also undertake any home visits needed for patients in that area before returning to their original booked clinic base. 
“There is also the option that a patient will be offered an appointment in their local base with the GP working the next available shift in their area. 
“This would be suitable for patients who are not as urgent and are fit to travel to the base,” the statement added.