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      Uist and Benbecula News

A special board meeting on Thursday morning (July 11) will discuss the inter-island air service postponed by NHS Western Isles due to the General Election.

A report by Debbie Bozkurt, the Director of Finance and Procurement, being presented to meetings highlights that the award of the Stornoway/Benbecula Public Service Obligation contract to Highland Air Service will have a seriously detrimental effect on healthcare services in Stornoway and the Southern Isles.

Among the concerns are loss of plane capacity, flight schedules and aircraft accessibility issues for people with impaired mobility.

Equally important, the inter-island link’s flight scheduling reduces the number of visiting services clinics from Raigmore Hospital and cuts the number of outpatient clinics.

NHS Western Isles is therefore concerned that the loss of services and flight connections could affect their ability to “provide safe and effective services as close to home as possible for the residents of the Western Isles and to pursue and deliver the best possible outcomes and experience.”

A new 22-page impact assessment coming before the board notes that NHS Western Isles was not involved in developing the pre-tender specification, issuing the tender invitation, assessing, or awarding the contract as it has no remit in the provision of public transport.

The assessment states, “In relation to capacity, we understand that the tender specification for the recent PSO procurement stated, ‘The Comhairle will not score the proposed aircraft capacity.’  

“We understand that the procurement documentation did not state the overall passenger numbers to be provided, and we understand that the procurement documentation did not provide detail of the numbers typically using the service to attend a medical appointment or using the service to attend, as a medical professional, clinics or appointments.”

The assessment report points out that the Western Isles’ geography means patients may have to travel extensive distances to access specialist diagnostics, care, or treatment. 

Despite the wide and expanding range of quality services available in the Western Isles, the increasing specialisation in medicine and the continuing advances in sophisticated equipment and technology have resulted in some services only being available in specialist and large hospitals on the mainland.

Not only is the new inter-island link affecting patients, but it also has major implications for visiting clinical staff.

The assessment report suspects that the 7 am flight from Inverness to Stornoway, used by visiting clinical staff to connect with the Benbecula flight, was dropped as a direct consequence of the new Public Service Obligation.

NHS Western Isles was notified in April that Loganair would continue to provide three 7 am flights on Mondays, Tuesdays, and Thursdays between Inverness and Stornoway. This summer timetable enabled consultants from Raigmore to travel on a return trip to and from the Western Isles Hospital in Stornoway.

“NHS Western Isles has been advised that this change in timetable is only possible owing to a change in provision on another route initially scheduled for the period in question. These early morning flights will, we are told, stop in August, reverting to the immediate changes that Loganair made post award of the PSO to another operator,” the assessment report discloses.

The timetabling will impact what the Western Isles Hospital can provide for patients across the islands as it is heavily dependent on visiting clinicians from other NHS boards, particularly NHS Highland.

Thanks to these visiting healthcare professionals, the Stornoway hospital can annually provide 24,510 outpatient appointments, 1,287 theatre procedures and 1,033 endoscopy procedures. 

Comments the assessment report’s author: “Of the above activity, 7,528 procedures or appointments are provided by NHS Highland-based consultants, 28% of all NHS Western Isles activity. If morning flights from Inverness to Stornoway are not provided post-August, then up to 40% of the activity generated by visiting consultants is at risk of being lost, approximately 3,011 procedures or outpatient clinic appointments.”

It is a similar picture at Uist and Barra Hospital in Balivanich.

Says the impact assessment: “The provision under the previous PSO included flights running two days a week, Tuesday and Thursday, linking Inverness and Benbecula. 

“This not only aided members of the public and patients travelling to Inverness but also linked NHS Highland Consultants to Benbecula to provide care and clinics. 

“The two returns on Tuesday and Thursday worked well and accommodated NHS Western Isles service plans given that the scheduled flights worked well with NHS Western Isles and NHS Highland Consultants and clinicians’ job plans and established theatre schedules.”

However, the new inter-island flight schedule does not permit many of the current services to continue.

“Uist and Barra Hospital is wholly dependent on capacity provided by visiting clinicians, particularly from NHS Highland and clinicians from the Western Isles Hospital. This capacity helps to generate annual activity of 2,837 outpatient appointments and positive patient experiences in terms of local access and short waiting times,” states the impact assessment.

While NHS Western Isles is negotiating workarounds to keep healthcare services going at both the Western Isles and Uist and Barra hospitals, they concede this has not been possible in many instances. One example cited is the cancellation of this month’s Ear, Nose and Throat appointments at Uist and Barra Hospital due to flight timetabling necessitating more than one overnight stay for visiting clinicians.

The assessment concludes: “In summary, provision under the new PSO contract is likely to have a significant and detrimental impact on members of the public who would normally choose air travel to access health care. In addition, longer wait, service retraction, and in some cases cessation may be an unavoidable consequence, as a result of the impact on clinical staff travel options.”

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The meeting papers are downloadable.