EMERGENCY consultations via a video link may be introduced in the remotest area of Richmondshire for patients facing a drive of nearly 30 miles to see a doctor.

Training is under way with a view to setting up equipment at Bainbridge Ambulance Station to link patients with GPs at the Catterick Garrison Primary Care Centre.

The idea, designed to improve out-of-hours cover, was put forward at a review meeting in Hawes on Tuesday by Richmondshire District Council community and environment overview and scrutiny committee.

Chris Long, chief executive of Hambleton and Richmondshire Primary Care Trust, disputed claims that Dales people were at risk because of changes to the service, but agreed that certain measures could ease the pressure on the emergency doctor service.

These included the possible use of a room at Bainbridge Ambulance Station where trained nurses and emergency practitioners could assess patients and decide whether they required a doctor. These practitioners could also be asked to make home visits where it was felt a GP was not needed.

Training was under way, he said, and the first practitioners should be in post within the next three to six months, and discussions had begun with paramedics based at Bainbridge about using the ambulance station. However, additional training was required and this would take time.

Iain Robertson, chief executive of North Yorkshire Emergency Doctors, which provides cover at weekends, overnight and on bank holidays, said a general shortage of GPs had caused some problems in availability.

Discussions had begun with a German locum agency about the possibility of flying GPs from Germany to cover weekend rotas in North Yorkshire.

He agreed the use of a room at Bainbridge to assess patients was a possibility. "The upper dales area is unique in North Yorkshire because it has the biggest centre of population the furthest away from a primary care centre," said Mr Robertson.

David Bolam, of the Patient and Public Involvement Forum, which represents patients' interests in the health system, backed the idea. He agreed with residents that the reinstigation of a Saturday surgery would help, particularly at bank holidays.

"It is also important that patients from the upper dales are not discharged from hospital on a Friday afternoon," he said. "This means more out-of-hours cover is needed if something goes wrong over the weekend."

Coun John Blackie, county councillor for the upper dales and chairman of the county council health scrutiny committee, wanted to see four improvements to the out-of-hours system - more use of Aysgarth surgery, the reintroduction of Saturday surgeries, a doctor based at Aysgarth over bank holiday weekends and a guarantee that an ambulance would be stationed at Bainbridge overnight and at weekends.

Mr Long said demand for and the benefits of Saturday surgeries at Easter and Christmas were being assessed. A decision could be made by the end of the year.

Suggestions that the primary care centre for Richmondshire should be moved from Catterick to Aysgarth, the geographical centre of the district, would leave 13 times as many people with long distances to travel. The PCC had to be near the largest centres of population.

He produced figures to show that if the Richmondshire PCC had been stationed at Aysgarth, the geographical centre of the district, 650 inhabitants would have been phoning Aysgarth.

For most of the population, home visits would take significantly longer from Aysgarth.

Dr Vicky Pleydell, a Catterick GP, stressed that doctors would not be part of a system which they considered dangerous to residents' health. "As doctors, we wouldn't want to be part of a rota that we didn't feel was safe," she said.

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