Concern grows for Ross-shire chronic pain health unit

FEARS for the future of a cherished Ross-shire unit providing a "life-changing" service to patients suffering chronic pain are being raised amidst a storm of protest over the "commandeering" of beds there.

The North Star last week revealed demands for a u-turn over NHS Highland's decision - without consultation - to earmark five out of 10 beds in the Highland Rheumatology Unit (HRU) in Dingwall to ease increased pressure on services over winter.

Highlands and Islands MSP Rhoda Grant has called for NHS Highland to review the decision and now a string of patients who have benefited from the service down the years are also demanding a rethink, warning of devastating knock-on impacts.

Jane MacLennan, from Gairloch, said: "I was an inpatient at the HRU last year at the time NHS management first commandeered some of the beds in the unit as 'an emergency'. Not once was it mentioned it was 'a pilot' or that they would be doing it again .To take so much away from such a well-used and invaluable specialised centre is horrific.

"At this time of year, with cold and damp weather more prevalent, patients with rheumatoid arthritis and its associated conditions struggle a lot with stiffness and pain. This time of year is especially when rheumatoid arthritis patients need to have full access to this specialised unit for the intensive therapy there. Who knows the needs of those with rheumatoid arthritis better than those within in the HRU and trained to treat the condition?"

To put other general medicine patients amongst those with suppressed immune systems "is asking for trouble". She said: "We are already very susceptible to bugs and viruses so to potentially put at-risk patients at even more risk is not only going to put more pressure on the NHS when we do get seriously ill as a result, it is, quite frankly, downright dangerous and extremely short-sighted."

She said: "I am very concerned that the future of the HRU may be in jeopardy. What will the NHS management decide next? To take more beds? To shut off the unit from actual rheumatology patients in favour of others? This cannot be allowed to happen."

She said: "I was diagnosed in my mid-twenties - I am now in my late 30s. I potentially have years and years of living with RA ahead of me. Without being able to easily access this specialised unit will make living with this incurable disease so much harder and will mean longer waits for intensive treatment when it is badly needed. In short, I am much more likely to be a drain and a burden on the NHS in the future without specialised care now."

Brian Stuart of West Way, Muir of Ord voiced "shock, anger and dismay" at the lack of consultation. As a sufferer of ankylosing spondylitis for over twenty years he was admitted two years ago after a bad flare-up. he said : "It is no exaggeration to say that this was life-changing in a very positive way. I had input from the rheumatologists, specialist physiotherapists, occupational therapists and nurses who all work together to come up with the best treatment plan for each patient. This is something that simply could not happen with outpatient appointments.

"The two weeks as an inpatient helped my acute pain but also helped me deal with the other mental and physical difficulties that come with having a lifelong, incurable rheumatic disease. Since my first admission I have had a further two spells as an inpatient when my disease has flared up, these have helped me get back to a point where I can manage to do daily tasks.

"This is extremely important for me as I am also the main carer for my disabled wife who requires round the clock care. Without the rehabilitation and treatment from all at the HRU I would have been unable to carry on caring for my wife and she would have had to go into permanent residential care.

"To deny five patients a week this treatment, at a time of year when they are likely to be suffering more than usual, is disgraceful in my opinion and goes against everything the NHS should stand for."

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NHS Highland issued a statement to the North Star in response to the concerns.

"We are using five of the Highland Rheumatology Unit beds as part of the Highland-wide response to increased pressure on services during the winter months. This measure will ensure patient safety for the anticipated numbers of elderly admissions and increased community hospital capacity will be required to meet this demand. This is a temporary measure and the unit will revert to the previous service configuration as scheduled in early spring 2019.

"NHS Highland does not routinely consult as we manage resources to meet demand fluctuations across services and ensure patient safety within our services. We prioritise emergency flows over elected and planned activity if we see clinical services coming under increased pressure.

"An evaluation of last year’s use of five rheumatology beds for community hospital patients highlighted that the changes were well managed and the quality of care to all patients was maintained.

"We have learnt from the evaluation and are now establishing updated patient transfer criteria and also working to rearrange clinical cover requirements to provide greater Allied Healthcare Professional (AHP) support to the service.

"The specialist physiotherapists, occupational therapists and specialist nurses are supporting rheumatology patients both in the hospital and the community. The ward nursing team is being supported by additional staff including the advanced nurse practitioner who leads the general ward. This will enable us to manage waiting times and give patients appropriate access to treatment.

"We are very proud of the history of rheumatology specialism in Highland and proud to host one of the only dedicated inpatient services for rheumatology in the UK, which provides specialist services for those with long-term chronic conditions. Acutely unwell rheumatology patients will continue to be seen by our rheumatology consultants at Raigmore Hospital."