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Home / Northland Age

After-hours doctors calls will divert to helpline

Northland Age
2 Sep, 2015 08:53 PM4 mins to read

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Northland DHB chief executive Nick Chamberlain (left), Te Tai Tokerau PHO chief executive Rose Lightfoot and Manaia Health PHO Chris Farrelly. PHOTO/MICHAEL CUNNINGHAM

Northland DHB chief executive Nick Chamberlain (left), Te Tai Tokerau PHO chief executive Rose Lightfoot and Manaia Health PHO Chris Farrelly. PHOTO/MICHAEL CUNNINGHAM

After-hours visits to the doctors are in for a change as major provider Te Tai Tokerau Primary Health Organisation introduces a telephone helpline to support rostered on-call general practitioners.

From October 1, about 19,000 people in and around Kaitaia who currently have after-hours access to a general practitioner (GP) will be directed to a "triage" nurse on a phone who will decide whether care is needed immediately or whether the matter can wait until normal practice hours.

Te Tai Tokerau PHO chief executive Rose Lightfoot said change was needed as the 10 GPs who currently shared after-hours duties were under immense pressure.

"It's taking its toll on our GPs. That's the motivation for doing this.

"It's not a cut so much as it's a strategy - support for our health practices which are quite stretched."

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Ms Lightfoot said she expected the overhaul may worry some people but the service provided by Homecare had been introduced with very good results in other areas.

"It's going to be quite a change.

"All GPs are contracted to provide 24-7 services and so there has to be an after-hours service. They have been doing this with a roster. There's still a great demand for GPs' clinical services after hours and it's very hard to predict how much will be needed. Often they are called out of bed for things that don't quite require a GP being called out of bed for.

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"So what we are looking at doing is an initial phone triage service.

"What people will do in the community is, if they have concerns, they can talk directly with a registered nurse who can offer some trained advice.

"People can ring their usual GP on the same number they always have but the line will be diverted to the service automatically.

"The nurse who answers the phone will have all the information they need to know to give advice about what that person needs to do. One option may be to contact the GP, another thing may require the nurse to call for an ambulance, which they can do. Or they may decide that the matter can wait until the morning."

Ms Lightfoot said the nurses would be on call seven days a week and 24 hours a day: "They already provide this service to a number of significant areas such as the Mid North, covering the Bay of Islands, and Dargaville."

She said the phone service had been operating for about five years in Northland with no major incidents or wrong decisions. It also came with significant benefits to both the overworked GPs and the community.

"It doesn't cost the person anything to ring. It's no cost to the patient and it decreases the demands on our GP services.

"If people are assessed as needing to see a practitioner at that time, then they will go up to the hospital and the nurse on the phone will arrange for the person to see the GP there and then. There is no confusion about where they have to go, all after-hours GP visits will be at the hospital."

Ms Lightfoot said, as in all cases when a GP visit is required, there would be a cost, apart from children under 13: "GPs are private practitioners and they run as private businesses.

"We encourage people to go see their GP during normal business hours, that is the most cost-effective approach.

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"But in cases when they would have called for their after-hours GP, we are just asking them to ring first on the direct line. Potentially, it will be a saving for them and once they have been assessed, they can put their minds at rest while staying in the warmth of their homes."

Dr Tim Malloy, President of the Royal New Zealand College of General Practitioners, told the Northland Age many patients were already served by after-hours phone triage services around New Zealand and these seem to be working well.

"The main advantage of an after-hours phone triage service is that it gives the opportunity for two-way communication, where the patient can get advice to manage the problem they are dealing with, and the triage service can identify the level of urgency needed for treatment.

"The triage service is also successful when it is backed up by clinical services in urgent situations, where deemed necessary.

"We envisage that ultimately the ideal would be the person taking the triage calls will have access to the patients' electronic medical record. While this is not currently the case, it is the direction primary care is moving in and it will provide an improvement to the current triage services."

-After October 1, call your usual practice. For a health emergency, call 111.

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