Following concerns raised during the recent Fermanagh and Omagh District Council Policy and Resources Committee around GP Out-of-Hours (OOH) cover in Enniskillen and Omagh over the Easter weekend, the Department of Health has insisted clinical cover was provided throughout.

This was with one exception over an eight-hour period on Sunday, April 17 when no GP was on site, but available remotely, and the shift was covered by other medical staff.

However, Western Health and Social Care Trust figures for Emergency Departments (ED) over the same timeframe were “unprecedented, [with staff] under pressure to deliver in an already stretched system [with] patients waiting longer to be seen, treated, admitted or discharged”.

A Departmental spokesperson insisted it was “incorrect to state there was no GP OOH cover” as it was available at all times in each base.

This comprised a combination of GPs, Advanced Nurse Practitioners (ANPs) and prescribing pharmacists, with experienced Nurse Advisors undertaking most patient telephone triaging.

The spokesperson continued: “The majority of patients don’t need to be seen face-to-face and will receive advice or support to contact alternative services such as pharmacies, District Nursing teams, dental services or their GP.

“The introduction of video consultations have facilitated triaging and seeing a clinician without travelling, [thus] enabling efficient use of clinicians and providing an appropriate service.”

In relation to the impact on hospital pressures as patients seeking assistance were claimed to have been diverted to EDs, the spokesperson replied: “OOH providers are acutely aware of ED pressures and will only refer in an emergency.

“Many patients contact OOH due to injuries and other trauma, or with symptoms suggesting heart attack or stroke who will be appropriately referred to the ED.”

The response continued: “OOH at Omagh Hospital and Primary Care Complex houses two important 24/7 services, complementing provision – the Minor Injuries Unit, including X-Ray facilities, and the Cardiac Assessment Unit – both operating throughout the year.

“The South Western Area Hospital [sic] OOH operates alongside the ED and includes a Minor Injuries Unit.

“The combination intends to provide the full range necessary to meet population need, 24 hours a day, 365 days a year.”

Asked if clinical cover included GPs, the spokesperson repeated: “OOH was covered throughout by clinicians providing care or referral.

“Even during normal hours, this would be by staff combination, not exclusively by GPs.

“For clarity, GPs were situated in bases across the Trust [area] at all the times.

“This included GPs or a combination of GPs and others who were on shift, with one exception between 4pm and midnight on Sunday, April 17.

“This was covered by a combination of ANPs with access to GPs at other Trust sites to undertake remote consultations if required.”

Meanwhile, a Western Trust spokesperson advised: “The South West Acute Hospital ED was extremely busy over the Easter period and under pressure to deliver an effective service in an already stretched system.

“The level of patients accommodated was unprecedented, with 88 on the evening of April 20. Patients were waiting longer to be seen, treated, admitted or discharged.”

Figures for the Easter 2022 period shows increases in a range of areas compared to the same period in 2021.

For example, from April 14 to 22, there were 959 ED attendances, compared to 824 patients from Easter 2021 – 135 more patients.

Some 157 patients were admitted this year against 134 during Easter 2021, marking an increase of 23.

Patients waiting more than 12 hours increased, peaking at 29 waiting more than 12 hours within a 24-hour period, compared to a peak of 10 people over Easter 2021.