GP out-of-hours service 'not safe' in north Wales, say staff
The GP out-of-hours service in north Wales is understaffed and has a number of management issues, according to a report seen by BBC Wales.
The leaked document includes responses from 117 staff and 84% said at times they felt the service was "not safe".
The health board said it commissioned the report as the basis of an action plan which was being implemented.
However the report also identified "a clear sense of pride" in the service and the dedication of staff.
The report by a team of consultants in March compared the north Wales service against recognised Welsh standards.
All "very urgent cases" should have a face-to-face consultation within an hour but, last year, that was achieved only half the time in north Wales.
The standards say 100% of urgent calls should have a definitive assessment in 20 minutes. The service managed 80%.
Concern was raised about unfilled shifts resulting in long waits for help on the phone and lack of leadership.
The out of hours service, which operates when GP practices are closed, is delivered from three centres at the district hospitals in Wrexham, Bodelwyddan and Bangor.
The service at Ysbyty Gwynedd in Bangor is said to be the most effective.
Prestatyn GP Dr Eamonn Jessup, who is on the out-of-hours GP rota based at Glan Clwyd Hospital, Bodelwyddan, said staffing was a key issue.
"The report is very heavy on the management and how management can be improved but I do concern myself that you can get as many managers in as you would wish but, at the end of the day, they can't magically make up that number of nurse practitioners and doctors," he said.
"The problem is down to recruitment."
In a statement, Betsi Cadwaladr University Health Board said it had commissioned the study and that "the process was transparent" with staff having had sight of the final report.
It said: "We welcome the report which has made a number of recommendations. These formed the basis of an action plan which is currently being implemented."
Clwyd West AM Darren Millar, shadow health spokesman, said he had not seen any proof that action was being taken.
"You can see that these problems go back a long time and have not been addressed," he said, while studying the report.
The Welsh government said it did not comment on leaked reports.
"There was an almost total lack of understanding regarding performance amongst all staff members in the survey and clinicians in both the interviews and site visits.
"Performance is perceived as a management issue, not a clinical one," the report said.
Full report on BBC Wales Today on Tuesday 12 May from 18:30 BST