Shannodoc service to be examined as part of wider GP review

THE provision of out-of-hours GP services in the Mid-West will be examined as part of a wider strategic review of general practice, Minister of State for Mental Health and Older People, Mary Butler has announced.

Responding to questions in the Seanad from Senator Martin Conway, Minister Butler stated preparatory work for this review has already started this year.

Since the emergence of Covid-19, the HSE provided out-of-hours co-operatives with a support grant to ensure continuity of care.

Minister Butler confirmed funding for Shannondoc was increased to over €6.8 million in 2020.

“Where there is increased demand in certain areas, Shannondoc can provide support from other treatment centres, to ensure services are provided where needed most,” said Minister Butler.

“The service is demand-led, and the HSE has advised that Shannondoc has continued to meet the targets for urgent and routine calls set out under its service level agreement.

“The Government is committed to increasing the number of GPs working nationwide and therefore improving access to GP and GP out-of-hours services across the country.”

The minister outlined there is an agreement to provide an initial €2 million support fund nationally for GPs in areas of urban deprivation and increases in the existing support funding for rural GP practices.

Senator Conway stated the experience of Shannondoc in his area has been mixed.

“The doctors who work in it when they are available are very committed and do a very good job. They can take the pressure off our emergency departments. The problem is that the Shannondoc service has been consolidated and it has been curtailed and cut back to such a degree that there are real challenges to the provision of services.”

“There was a time when there was a Shannondoc facility just outside the towns of Ennistymon and of Kilrush and in other areas. However, I believe that Miltown Malbay is the only facility that Shannondoc is providing in West Clare,” he added.

He pointed out when someone is injured late at night, they can panic and worry.

“The out-of-hours doctor service is one which can give them reassurance and provide necessary medical interventions and maybe calm the situation, ensuring that people do not present at the emergency department’s front door in Limerick. We want to avoid that where possible.

“The problem with Shannondoc is that on many occasions there has been no cover.

“That was simply down to the fact that GPs could not be got and were not available, as was the case for locums and so on.

“That is always a problem because the public needs to have confidence that once GPs sign off on their practices, surgeries and so on, the Shannondoc out-of-hours co-operative service will kick in.”

He noted that University Hospital Limerick, (UHL) is the most overcrowded emergency department in the country and regularly has had up to 100 people on trolleys on a number of occasions.

“Many, or at least some of them could be diverted from hospital if they were to present to a ShannonDoc-type facility,” he said.

Senator Conway asked what is the timeline for this review and recommendations on how the out-of-hours GP service can be improved.

Councillor Tony O’Brien, meanwhile, has renewed his call for Shannondoc management to outline and answer questions about its provision of services at a meeting of Clare County Council after councillors backed this proposal at its February meeting.

In view of Shannondoc’s surplus of €742,082 for 2020 and state funding of more than €5 million, he said it would be beneficial for management to outline where public money is spent.

In reply to a Dáil question from Sinn Féin Deputy Martin Browne, the HSE stated the operating hours for the Ennis treatment centre are 6pm to 8am from Monday to Friday, with an extended opening to 9am on Bank Holidays and Public Holidays.

Shannon is scheduled to be open from 6pm to 11pm from Monday to Thursdays and 9am to 10pm on Fridays, weekends and public holidays.

Miltown Malbay is scheduled to run from 6pmm to 8am Monday to Thursday, 6pm to 9am on Friday, Saturday 7pm to 9am Sunday and Sunday 7pm to 8am Monday.

A doctor may not always on site in Shannon or Miltown Malbay, but the HSE outlined there is a doctor on duty available to see patients when and if required.

The HSE confirmed a team of doctors and patient assistants are on duty midweek from 6pm to 8am Monday to Thursday, while 24-hour cover at weekends and public holidays is provided from 6pm Friday to 8am Monday.

If deemed clinically appropriate by the triage nurse, the patient will be given either a face-to-face appointment at one of the Shannondoc treatment centres, a virtual consultation or the doctor will see the patient in their own home.

“In short, every single patient that needs to be seen, is seen and the delivery of a quality clinical care remains the priority.”

“The introduction of mobile doctors, remote doctors and Core Treatment Centre doctors, all centrally co-ordinated by dispatchers and nurses ensure that all areas are covered.”