Highland Healthvoices Network News

Inside this issue:

1. NHS Highland Board 6th December summary update

2. Get involved and have your say

3. Improving access to dental service

4. Planning for Integration

5. Review and re-design of local services

6. North Highland Community Health Partnership

7. Mid Highland

8. Raigmore Hospital, Inverness

9. Impact of Industrial Action – 30th November 2011

10. Newsletters, Reports and Links

11. Forthcoming NHS Board and Governance Committee meetings

NHS Highland is now using Twitter - You can receive regular updates on news stories and health promotion campaigns by following us on twitter

Make your voice count

You will notice the format of our newsletter has changed but we want to do more to make this a two-way communication. To help us keep up to date with your news please let us have any articles or items you feel should be included in future editions throughout 2012.

The deadline for articles for the next issue is Monday, 10th January.

If you would like to influence the content, design or distribution, please contact Maimie Thompson, 01463 70 4722

Contact details of Governance Committees

1.NHS Highland Board 6th December summary update

Review of governance and senior operational management

The Board agreed to replace the existing Community Health Partnerships (CHPs) in the operating units covered by the Highland Council area (North, Mid, South East and Raigmore), with a single CHP from April, subject to the approval by the Cabinet Secretary. The corresponding review of senior operational management was also agreed as outlined in the paper tabled. The timing of the changes were designed to coincide with the integration of health and social services between NHS Highland and the Highland Council.

Members emphasised the opportunity to strengthen public involvement at a local level through proper support and engagement with partnerships at nine district level. The new committee will continue to be made up of council representatives, patient groups, voluntary sector as well as senior staff from health and social care. Committee meetings will be open to the public.

Finance recovery plan for Raigmore Hospital

While NHS Highland is on course to break even for 2011/122, work is ongoing across Raigmore to bring down current projected overspend of £4.4 million. Some of the growing financial pressure include year on year increase on drugs costs (up by £1.1 million per year since April 2009). The Board has raised concerns that many of the proposals in the savings plans relate to one off costs (non recurring) where as the focus needs to be how recurring savings can be made.

Part of the recovery plan includes reducing referrals to Raigmore by using up spare theatre capacity at Caithness General Hospital and Belford. The logical extension of this is to bring the clinical networks together under a single hospital operating on three sites, with unified management and budget, and clinical networks providing greater consistency in terms of quality and efficiency. This aligns with the removal of boundaries between CHPs and opens up potential opportunities for the rural general hospitals and overall improved ways of working across Highland. A full review and forward plan for the next two financial years will be brought to the Board in April 2012.

Healthy Weight Strategy

Discussion and support for the Board's healthy weight strategy and the importance of changing public perceptions about what is "normal" and what is over weight / obese.

Infection Control

Strong performance across NHS Highland means 100 people fewer a year, compared to three years ago, are being infected while in our care.

For further information contact Kenny Oliver, Performance Manager on 01463 706776 or email .

Four steps to get ready for winter

Step 1 - Know when your GP surgery will be open
Your local doctor’s surgery will be open on Friday 23rd December, then closed for four days during the Christmas period opening again on Wednesday 28th December.

The surgery will be shut again from December 31st through until 3rd January. It will reopen on Wednesday 4th January, 2012.

Step 2 - Restock your winter medicine cabinet
Common winter ailments such as a cold or flu-like illness can often be effectively treated at home with readily available medicine. So check your medicine cabinet and re-stock if you need to.

Step 3 - Use your local pharmacy

Your pharmacist can offer advice or help if you have run out of any prescribed medication. You can also collect medicine for minor ailments or illnesses.

Step 4 - Make sure you have repeat prescriptions
If you or someone you care for requires medicines regularly, make sure you order and collect repeat prescriptions to last over the holiday period.

While it is important to be prepared all emergency services are available as normal. Anyone experiencing health problems during the holidays should contact NHS 24 for advice.

General advice and information on how to stay healthy this winter can be found at or contact NHS inform on 0800 22 44 88

2.Get involved and have your say

Want to join the Food, Fluid and Nutritional Care Steering Group?

The group is responsible setting and overseeing food services and nutritional standards for patients. If you are interested in this position please get in touch with Judith Catherwood, Associate Director (Allied Health Professionals) on 01463 706731 or on email . The closing date for this post is 7th January, 2012.

The group meets quarterly and video conferencing is available for all meetings. Travel expenses will be paid as necessary.

Pharmaceutical Care Services Plan: April 2012/13

The draft plan is currently out for public consultation. We are looking for views on whether the plan meets requirements for pharmaceutical services. Responses are sought by the end of February 2012 at the latest to be returned to:

The plan can be found on the NHS Highland website at the following link: Click here

For further information or to obtain a hard copy of the Pharmaceutical Care Services Plan contact –Mary Morton, Head of Community Pharmaceutical Services, NHS Highland on 01463 706809 or e mail

Have your say on Palliative Care Information

The Highland Hospice are running a three month survey on the provision of palliative care information to patients, their families and carers. Part of the proposal is to identify if the information is easy to understand and relevant. You can contribute to this process in a variety of formats, either:

Complete the online survey at Click here

Or contact / phone 01463 246470 for a form or to share your views and share your experience of the palliative care information.

The survey will run from 1st December 2011 until 29th February 2012.

3.Improving access to dental service

NHS Highland was delighted to hear that a Fort William dental practice has won the best NHS practice category in the Dentistry Scotland Awards. The NHS committed dental practice M&S Dental Care, of Glen Nevis Place also won the best practice award for North Region.

The M&S team has been key in improving access to NHS dental services in Lochaber, where there are now no waiting lists of patients seeking NHS registration.

In 2009, the practice purchased the Fort William Community Clinic from NHS Highland following the transfer of the Salaried Dental Team to the Camaghael Health Centre in Fort William. The conditions of purchase included the registration of a minimum of an additional 3,000 NHS patients. As a consequence of this, all people on the waiting list for NHS registration in the Lochaber area were offered NHS dental registration by the end of 2009.

4.Planning for Integration

The Highland Council and NHS Highland have given formal notice of their plans to integrate health and social services. As part of this process public meetings were held in Helmsdale, Inverness and Fort William. Jan Baird, Planning for Integration, Transitions Director explained how, from 1st April 2012, staff are being brought together into integrated teams to work with children and families and with people who use community care services.

For further information about the development of planning for integration please telephone 01463 706751 email: or visit Click here

5.Review and re-design of local services

There a number of reasons why it makes sense to review local services. People are living longer and are telling us they want to be safe and independent in their own homes for as long as possible. This links with our plans to integrate health and social services.

Another reason is that parts of our hospital buildings are now very old and not fit to run safe and modern services. More generally health services are always changing to reflect changing needs, clinical evidence, standards of care, new interventions, drugs and technologies.

But any re-design of services should be able to show that the standard of care is maintained or improved and without detriment to another part of the service.

Sometimes it is about changing the way we work. Other times further investment may be required to develop or improve services. NHS Highland works within a budget set by the Scottish Government. Any costs to changes to services need to balance out.

If local people want more home care in the community then the money has to come from spending less in some other area of local work. This means that the decisions – on hospital beds, out patient services, use of drugs, access to services and community services – are clearly linked, and that decisions on one service affect the resources available to be spent on other services. So there are choices to consider and decisions to be taken. Not easy but necessary.

6.North Highland Community Health Partnership

New Tele-health Clinic piloted in Thurso

Caithness patients with diabetes have been involved in trials of a new tele-health clinic that will speed up their access to specialists. The clinic which has been set up in the Dunbar Hospital will reduce the travel time of Consultants allowing them to see more patients, thus reducing the length of time patients have to wait for return appointments. It will also reduce the need for some patients to travel to Raigmore Hospital in Inverness. It is not intended to replace face to face consultations but to be used in conjunction with appointments with consultants.

Consultant Diabetologist, Professor Sandra MacRury, explained that the first clinic was held on 4th November. The patients involved were comfortable with the technology and felt that Video Conferencing (VC) worked well. A formal evaluation of the clinic will be carried out within the next month and we are hoping they will be implemented in January of next year.

Other North Highland projects include the tele-dialysis VC link between Caithness General Hospital and Raigmore Hospital and the speech therapy tele-health project, which is using VC links at Caithness General Hospital in Wick and the Lawson Memorial Hospital in Golspie. Further VC units are being put in across North West Sutherland (Kinlochbervie, Durness and Bettyhill), with a view to expanding the services being delivered by VC. These are additional to the units already in place at Armadale and Lochinver.

West Caithness review of hospital and community services

NHS Highland is currently re-evaluating a number of possible options for changes to local health services in the area including changes to some services which are delivered on the Dunbar Hospital site (Thurso) as well as services provided in the community.

While many of the proposed changes have broad support from local people, some are considered more controversial. There has been considerable concern expressed by some people about the option to close 12 inpatient beds and in particular the provision of local palliative care. To further discuss the options an open event was held on 6th December, and was attended by around 50 people.

The feedback, together with the findings of the petition from local people, will be written up and included as part of the additional evidence to be fed into an extraordinary meeting of the North Highland CHP Governance Committee. This meeting has been arranged specifically to discuss the West Caithness redesign proposals and will be held in public at the Weigh Inn, Thurso, on Tuesday, 20th December at 2pm.

For further information contact, Kay Oswald, on 01955 880246 or by email at

East Sutherland - Lawson Memorial Hospital (Golspie)

Discussions are underway to look at possible improvements to how the Lawson Memorial Hospital site is used. Recent NHS Highland Property Condition Survey identified a backlog for maintenance is £3.3 million with £1.85 million of work required in the next five years. The Lawson site currently provides a range of inpatient, outpatient and rehabilitation services in two units.

The Lawson Community Group, which includes representatives of the Lawson Memorial Hospital League of Friends, the Friends of the Cambusavie Unit, Brora and Golspie Community Councils, The Highland Council, Sutherland Access Panel and local NHS Highland staff, met for the first on 6th December.

The group will develop options to improve the condition and efficiency of the buildings and will also link in with other relevant service developments in East Sutherland and elsewhere in Highland. It is hoped that work on the options will be completed by early next year and will then go forward to the North Highland Management Team for consideration.

National Recognition for Migdale Hospital Bonar Bridge

The new Migdale Hospital at Bonar Bridge in Sutherland has been highly commended in the annual NHSScotland Environment, Estates and Facilities Awards.

A local support group has been instrumental in designing and fundraising to design the garden for patients.

7.Mid Highland

Ross Memorial, Dingwall

A second event giving people living in Dingwall and the surrounding area a chance to be involved in designing health services for older people in their area was held in Dingwall on 9th December.

Part of the reasons services are being looked at is that it will cost £2.6 million to bring it up the building up to minimum standard. More generally, across Highland work is ongoing to improve the quality of services, with a focus on prevention, anticipation of needs and supported self management. This supports the ambition of helping people to live longer healthier lives at home or in the community for as long as possible.

The event, which was attended by 60 people was run by the Ross Memorial Hospital Designing Services for the Future Steering Group. The steering group is chaired by Highland Councillor Margaret Paterson, who is also a member of the Mid Highland Community Health Partnership (CHP) Committee.

Emerging from this process will be a shortlist of possible options. These will then be subject to closer review including risk assessment; financial assessment; clinical assessment.

Glenelg

One of the local GP’s in Glenelg applied for and has been granted a secondment with the Scottish Government for the next two years. There is local concern regarding the future arrangements and in particular emergency cover. To date there has been no change to service provision.

An update was discussed as part of Mid-Highland Management Team Meeting on 2nd November. At the meeting it was agreed to undertake the following work.

• Develop the further detail of the potential options
• Undertake a non financial benefit scoring exercise with stakeholders in January
• Further work on the risk and impact assessment
• Liaison with the development manager for Out of Hours
• Further work describing costs in relation to other areas
• Exploring the potential of ‘twinning’ with another practice

This work will be reported to the CHP Management team meeting to be held on 1st February, 2012.

West Ardnamurchan

NHS Highland and the Scottish Ambulance Service (SAS) held a further Open Event on Tuesday 6th December. In advance of the meeting a leaflet summarising the proposed new Emergency Responder model has been prepared and has been distributed to every household on the peninsula. The meeting was attended by 10 people.

The current arrangements are strongly reliant on an immediate response provided by two Community Nurses working 24/7 service 365 days a year; which is no longer an acceptable model.

The emergency responder model that is proposed will build on the skills of existing healthcare professionals who live in the areas. They will receive additional training, equipment and access to a vehicle. Road and air ambulance back-up will be immediately dispatched. They will have contact through airwave radio to paramedic advisors, GPs and where necessary, accident and emergency support. Modern technology will also be introduced to support all of this. A robust evaluation will be put in place and can be refined and improved in response to feedback.