NHS Highland is relying on four other Scottish health boards to provide potentially lifesaving treatment for its patients amid a deepening crisis in its vascular service.
The health board confirmed that since the last vascular surgeon, Bernhard Wolf, resigned earlier this year citing the “unacceptable” state of the service, emergency measures have had to be put in place.
Health boards are working together to treat Highland patients. Picture: iStock / Kayode Fashola
The latest updates from chief executive Fiona Davies and medical director Dr Boyd Peters in reports to the area’s health board painted a dire picture that outlined risks to the service.
What is currently in place is a system that is surviving off locums and one vascular nurse and those with vascular conditions must travel far from home.
Dr Peters reported that mutual aid arrangements – where one health board does the work of another whose service has been disrupted – are in operation.
That signifies the seriousness of the situation as mutual aid agreements are used to “prepare for emergencies” according to the Scottish Government.
The health board is still developing what he calls “pathways” for Highland patients who need interventions – usually a surgical procedure – which are “maturing”.
While “patient outcomes and associated adverse events were being actively monitored and investigated, in association with partner NHS boards”.
And work nationally and regionally is “being taken forward with a view to seeking an improved interim and longer-term solution”.
The updates also revealed that locum cover is in place but more is being sought.
Ms Davies summed up: “We continue to face significant challenges with our vascular service provision due to a national shortage of vascular surgeons and interventional radiologists – two specialist groups we have been unable to recruit in recent years.
“I am deeply grateful for the support provided to our vascular patients by larger centres across Scotland, as well as our locum surgeons who are seeing and assessing patients at Raigmore [Hospital in Inverness] alongside our vascular specialist nurse.
“I would like to pay special tribute to our former vascular surgeons, particularly Bernhard Wolf, who recently retired after providing unstinting service for several decades in the Highlands as both a general surgeon and vascular specialist.
“The current arrangements are not a permanent solution. Active discussions are ongoing at regional and national level to create a sustainable long-term solution which will give NHS Highland the service which our population needs. The medical director and I remain actively engaged in these discussions.”
Remarks accompanying NHS Highland’s corporate risk register, presented to its board, stated: “The distribution of this risk is variable with services such as vascular surgery, oncology, general practice, dental being examples of our highest sustainability risks.”
Highland MSP Edward Mountain said: “These comments echo what I have been raising in parliament since March, when it was first announced that Bernhard Wolf would resign his post as vascular surgeon due to the danger NHS Highland’s service was posing to patients.
“I am therefore glad that the CEO of NHS Highland has finally conceded that the current arrangements cannot be seen as a permanent solution. We need local and reliable vascular care, or people will lose their lives as they wait for, or travel to, help.
“Highlanders are being persecuted for where they live by the ever-falling standards of healthcare they receive, and this cannot continue.
“I hope that NHS Highland’s reliance on other health boards to provide adequate care will come to an end following the ‘active discussions’ currently ongoing to find ‘a sustainable long-term solution’.”
Earlier, the government said the health secretary Neil Gray is “confident” that work under way will result in the “long-term sustainability of the service”.
That work is to ensure “equity of access” and “the best possible outcomes” while “delivering the best possible outcomes with a strong emphasis on quality and safety.”
But it added that “there may be instances where patients need to travel to another health board” – something health campaigners say is not “equity of access”.
A Scottish Government spokesperson said: “Mr Gray fully supports the work that has been undertaken to develop a new model for vascular care and is confident it will result in the long-term sustainability of the service in both NHS Highland and across the north of Scotland.
“This work is focused on ensuring equity of access and delivering the best possible outcomes with a strong emphasis on quality and safety.
“We want to ensure patients are treated as close to home as possible. However, in order to receive the best possible care, there may be instances where patients need to travel to another health board.”
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