TWO ANGUS minor injuries units are to be closed overnight, Tayside health bosses agreed yesterday, writes Marjory Inglis, health reporter.

The units at Whitehills Hospital, Forfar, and the Links Health Centre, Montrose, will be closed overnight from 10pm-8am.

Patients with non life-threatening conditions will be treated in their own homes by a paramedic and a nurse, attending in a specially-equipped car provided by the Scottish Ambulance Service.

The service is expected to be up and running by the summer.

There is interest in spreading the mobile unit model for out-of-hours care to other areas of Tayside, if the Angus service proves successful.

One aim of the new service is to reduce the numbers of people taken by ambulance to Ninewells Hospital, treated and then left to make their own way home during the night.

Members of NHS Tayside’s delivery unit committee, meeting in Murray Royal Hospital, Perth, yesterday approved the setting up of the new “see and treat” service in Angus.

Members were generally very supportive of the new service.

However, Dr Andrew Russell, NHS Tayside’s director of primary care and a part-time GP at Arthurstone Medical Centre in Dundee, was cautious in his comments.

He pointed out that experienced GPs were reluctant to make diagnoses in patient’s own homes, as it was not always the most appropriate place. They did not have access to the full range of diagnostic equipment, particularly desirable when a patient’s condition was deteriorating.

“When doctors have got into trouble, they have got into trouble when they have failed to make a diagnosis in a patient’s own home,” said Dr Russell.

“Most experienced diagnosticians are moving away from diagnosing people in their own homes. Now we are suggesting people with less diagnostic experience should be diagnosing in people’s own homes.”

Minor injury and illness units (MIIUs) were set up in Tayside as part of the out-of-hours arrangements put in place when GPs opted out of their round-the-clock responsibility for patients.

When GP surgeries shut at night, over the weekend and during public holidays, NHS Tayside took over responsibility for delivering the service to patients, working closely with NHS 24 and ambulance service.

Patients fit enough to travel were encouraged to attend out-of-hours primary care centres or MIIUs.

Seeking approval for the new “see and treat” service, Angus general manager Susan Wilson told members of the committee that only a handful of patients used the MIIUs in Angus during the night.

“We have highly skilled nurses who man these units and quite frankly we could be using their skills at other points in the day when we are busier,” said Ms Wilson.

She pointed out that hundreds of patients every year were taken to Ninewells Hospital by ambulance from their homes in Angus.

The vast majority were seen very quickly and then had to be “repatriated” back to Angus.

“The ambulance service has an obligation to take people to Ninewells, but it doesn’t have an obligation to bring them back,” said Ms Wilson. “That can be a problem for some patients.”

Ms Wilson said there was support from the public in Angus for the “see and treat” service.

Committee member John Angus said there were “similar problems” in the MIIUs in Perth and Kinross district.

“I look at this with great interest,” he said. “I think it is a great idea.”