Dozens of Highland trauma clinicians pen open letter to NHS Highland over service cuts that would reduce the hours of the Pre-Hospital Immediate Care & Trauma (PICT) team as the health board argues it needs to invest in its under-staffed Emergency Department
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Thirty healthcare professionals working on the Pre-Hospital Immediate Care & Trauma (PICT) team have written an open letter to NHS Highland calling for the life-saving service to be maintained in the face of major cuts.
The risk of cuts to the service was first revealed in the Inverness Courier in January amid rising concerns within the team that they faced a bleak future despite providing what one medical academic called a “world class” service.
The PICT team has been operational since 2016 but recently moved to a seven day a week service but the board wants more cash in its Emergency Department and if that happens service hours will be cut to just 44 hours a week from the current 84 hours a week.
According to the authors who include GPs, advanced practitioners, anaesthetists, and consultants that would be the return of an “inequity” for the Highland population.
They wrote: “If you suffer trauma or critical medical illness in the Scottish Highlands, you will be disadvantaged by comparison to your urban counterparts.
“Established doctor and advanced practitioner teams provide pre-hospital emergency medicine to patient populations surrounding Glasgow, Edinburgh, Dundee, and Aberdeen.
“Access to similar core services is now available across the United Kingdom. Clinical presentations in the Highlands compare to elsewhere in the country; however, they are often in remote and rural areas, with significant delays prior to definitive care.”
They argue that such a service is already available to patients around the UK but could now decline in the Highlands.
They continued: “Enhanced pre-hospital care includes, for example, complex medical decisions, major incident response, advanced analgesia, trauma, cardiac arrest and paediatric emergencies.
“Additionally, we help to reduce pressure on our Ambulance and Emergency Department colleagues by discharging at scene where appropriate, redirecting to existing healthcare services or facilitating direct hospital speciality admission if required.
“The PICT service has now been established and operates with due clinical governance: access to training; resources; and a roster of staff with the freedom to immediately respond to tasking.
“Moreover, many of these clinicians continue to use their own time to provide undergraduate education and nurture the future of pre-hospital emergency medicine in the Highlands.”
Earlier a NHS Highland spokesman said: “The PICT service in NHS Highland provides prehospital care for a range of medical conditions including trauma care. This service works alongside and in addition to our nationally networked trauma services, our emergency departments, primary care partners and the Scottish Ambulance Service.
“The PICT service is not available on a 24/7 basis but was temporarily able to increase provision from an agreed baseline of four half days per week up to seven half days by accessing funding from the Scottish Trauma Network (STN) on a non-recurring basis.
“It was proposed that recurrent funding for a seven-day PICT could be identified by diverting STNfunding away from planned enhancements in emergency medicine services from 2023/24. NHS Highland seeks to use this investment to address a substantial short fall in Emergency Department (ED) staffing when compared against national standards and we are committed to improving this to benefit all patients requiring urgent care across the region.
“Investing in emergency medicine services will enhance trauma care to patients brought to hospital, including thedevelopment of clinical and professional support to the three rural general hospitals in NHS Highland, further strengthening our trauma care equitably across NHS Highland.
“NHS Highland continuously review both funding and service models for emergency medicine to ensure our services are safe, effective, and optimise care to all trauma patients.
“The PICT service has been extremely successful in providing a high level of trauma care in the prehospital setting, and will remain part of trauma care provision in the Highlands, integrated with national and regional trauma services, hospital emergency department, partners in Scottish Ambulance Service and with primary care colleagues across the region.
“NHS Highland values the role of the PICT service but needs to review how to integrate the PICT service with other trauma and major illness services across NHS Highland's population and hospitals. This review will include those currently working in and delivering the service as we reshape our services to meet the need of patients and service users.”
For more on the story see tomorrow's Inverness Courier.
