The midlands out-of-hours GP service that covers Laois, Offaly, Longford, and Westmeath has been downsized with the HSE saying doctors believe the move will improve services.
A decision has been taken to close two satellites services in the busy Offaly towns of Birr and Endenderry. The change replicates Laois which has just one centre in Portlaoise.
A HSE spokesperson confirmed the move and explained why reason for the change.
"A decision to close the two satellite part-time cells in Birr and Edenderry, with effect from Monday 2nd April 2018, has been made after "a full review and assessment of the service provision for the entire county."
"Participating GPs and HSE in Offaly believe a better out-of-hours service can be delivered to patients by reorganising the current structures in Midoc Offaly, which will increase availability of call outs and home visits to elderly patients unable to travel to the centre," the spokesperson said.
The HSE added that the service has had, for "historical reasons", three treatment centres in Offaly - one full time in Tullamore and two part-time centres in Edenderry and Birr.
"The intention is now to operate one fully functioning Treatment Centre based in Tullamore on the campus of Midland Regional Hospital Tullamore for the entire Offaly population. This is in line with the other Midoc centres across the Midlands."
The HSE said an iindependent review was undertaken in 2017 which identified concerns in the areas of clinical risk, medical emergencies, and lone worker.
"These concerns relate specifically to locum doctors on duty working with no clinical support, the ability to manage independently when presented with a medical emergency and the personal safety of the doctor while working alone in Birr and Edenderry.
"Service Provision in Birr and Edenderry is also limited, as both satellite centres provide a part-time service only with no call outs/home visits being provided. Outside of the limited operational hours of both satellite centres, patients already have to attend Tullamore treatment centre," said the HSE.
A full review and assessment of the service provision for the entire county was undertaken recently to assess quality, risk, safety, population, activity levels and viability.
"The participating GPs in conjunction with the GPs have taken the decision to close the two satellite part-time cells in Birr and Edenderry, with effect from Monday 2nd April 2018. These changes were already piloted over the Christmas period and on several other weekends and have worked well.
"When the services in Birr and Edenderry merge into Tullamore, to enhance the current service provision in Tullamore and to take into account the additional patients travelling from Birr and Edenderry, an additional doctor will be on duty in Tullamore, during weekends and public holidays, from 12midday to 8pm. This will facilitate the more effective management of call outs and home visits to the entire county, including Birr and Edenderry," the HSE spokesperson said.
The HSE spokesperson said the Tullamore centre has the capacity to absorb the extra patients.
"A review of the current monthly activity levels indicates that Tullamore will be more than capable of absorbing the patients from Birr and Edenderry centres and will in fact bring it in line with Longford, Mullingar and Portlaoise centres."
"Additional administration support will also be provided by the Offaly cell to free up doctor’s time, resulting in more patient contact, and a more-effective out-of-hours service for all," they concluded.
The closure of Midoc services in Birr and Edenderry has caused outrage across Offaly, with a number of local councillors and residents expressing dismay at the news.
Cllr Peter Ormond claimed the service in Birr was closed "without warning" and that it means patients in all of Offaly relying solely on the Midoc service in Tullamore.
The Midoc Service was established in the West Offaly region in December, 2002. At that time GPs in East Offaly, such as in Tullamore and Edenderry, were not participating in the service. These GPs subsequently joined Midoc in December 2011.