“Progress is being made in the development of a pioneering and innovative model for the provision of Unscheduled Care in the Borders”. That is the message from NHS Borders Medical Director, Dr Sheena MacDonald.
The health board, in common with others across Scotland faces significant challenges in the provision of unscheduled, out of hours and emergency care. This is largely due to workforce challenges including a national shortage of GPs who are willing to work during the out of hours period, as well as limited numbers of specialty grade staff to work in the emergency department especially in the  overnight period. 
However a highly skilled team of NHS Borders clinicians and senior managers, as well as representatives from partner agencies including the Scottish Ambulance Service (SAS) are working together to redesign services to ensure that they continue to deliver safe, effective and high quality patient centred care as close to patient’s homes as possible, which will avoid unnecessary hospital attendance and admissions.
Executive Programme Lead, Dr MacDonald says “Workforce challenges have actually presented us with an opportunity within NHS Borders to develop a redesigned unscheduled care service that is sustainable and is underpinned by a skilled multidisciplinary workforce who possess core, transferable skills.
“By developing a new nurse led service delivery model we will gradually move away from the traditional doctor led models. This gives our nurses the opportunity to up-skill, training to become Nurse or Advanced Nurse Practitioners. Once this model is in place it will enable us to deliver a high quality service, improve patient experience, reduce delays and deliver a more efficient service, within affordable means which is not dependant on the limited resource of doctors available to us.”
Day to day management of the Unscheduled Care Programme sits with NHS Borders Service Manager Mr Kirk Lakie, who adds: “this is a wide reaching programme which is looking at a number of workstreams including nursing practice development, the redesign of the Emergency Department at the Borders General Hospital (BGH) and the professional development of paramedics. An overview of the programme is included as an appendix withi NHS Borders Clinical Strategy, which is currently out for consultation. Changes will be introduced gradually and the programme is scheduled to complete during 2015.”