Annual Report 2015/16 contents

Chairman and Chief Executive Foreword 2 Progress

Service Developments and Improvement 6 Improving Health 11 Locality health improvement 14 Health Protection and Screening 23 Patient Experience 29 Quality and Patient Safety 34 Achievements Volunteers & Involvement, 38 Fund Raising & Donations 40 Staff Awards and Achievements 45 Celebrating Excellence 49 Our Year in Pictures 50 Staff Retirements and New Starts 57 Performance HEAT Targets and Standards 62 Board Members 64 Annual Review Letter 65 The Future Tech advances and innovations 70 Integration 72 New hospital 74

Scottish Ambulance Service

1 Chairman’s Foreword Chief Executive and

Jeff Ace Chief Executive Chief Executive

As Chief Executive of NHS Dumfries and Galloway, Jeff and Chairman’s Ace is accountable to the Board and to the Scottish Government for delivery of safe, effective, person centred care within the Foreword Board’s financial allocation. He leads a team of Directors with responsibility for all aspects of health services NHS Dumfries and Galloway has successfully NHS Dumfries and Galloway’s Medical Director, navigated another busy and challenging Dr Angus Cameron, was seconded on a half- in the region and has been year. There is a great deal to report and this time basis to work with Scottish Government on NHS Board Chief Executive document highlights the main achievements a new National Clinical Strategy. This involved and developments of 2015 / 16. Thanks identifying an achievable strategy for dealing since February 2012. to the hard work and dedication of the with the significant pressures faced by NHS people who make up our workforce we Boards in Scotland in a way that produced have delivered on the targets and standards better outcomes for our patients. The strategy set by the Scottish Government and was produced in February and well received made significant progress on a number of nationally; we are proud of Dr Cameron’s landmark projects. contribution to such an important piece of work. Each region in Scotland will now produce In March work began on the new District a delivery plan to put its recommendations into General Hospital in Dumfries and we welcomed practice. Shona Robison, Scottish Cabinet Secretary for Health, Wellbeing and Sport to the We have maintained our focus on improving groundbreaking ceremony. She also visited the quality and safety of our services through Dumfries and Galloway Royal Infirmary in a number of developments and initiatives and August when she met staff and issued guidance throughout 2015 / 16. The commitment of staff to health boards for winter 2015 / 16. and quality of our services has been recognised in a number of ways, including the Celebrating Chief Operating Officer Julie White was Excellence Awards in September. We would appointed Chief Officer for the Integrated Joint like to take this opportunity to once again Board and Katy Lewis, our Director of Finance, thank all staff who contributed to our culture of was appointed as Chief Finance Officer. We continuous improvement. Your hard work is our are making good progress on the integration success. of health and social care and you can find an update from Julie later in this report. Finally, we wish to assure people in Dumfries and Galloway that we will continue to work Last year also marked the departure of Director hard to ensure we deliver quality and safety of Nursing, Professor Hazel Borland, who took improvements in the coming year so that up a new post with NHS Ayrshire and Arran. We they can rely on excellent care that is person- welcomed her replacement, Eddie Docherty, in centred, effective, efficient and reliable. time for him to attend his first Board meeting in February.

Philip N Jones Jeff Ace Chairman Chief Executive 2 3 and Improvement Service Developments

Philip N Jones Chairman of the Board

Appointed to his post by

the Scottish Government, Improving Health Philip N Jones has been NHS Dumfries and Galloway’s Chairman since May 2014. His duties include promoting the Progress highest standards of integrity and corporate governance across the organisation and demonstrating visible and ethical personal leadership by Screening Health Protection and modelling the highest standards of professional behaviour. He Service Developments and Improvement 6 also leads the Board’s decision- making processes, acts as Improving Health 11 a guardian of due process and exercises independent Locality Health Improvement 14 judgement on the Board’s

policies. Nationally Philip Patient Experience Health Protection and Screening 23 contributes to development and implementation of strategy and policy through membership Patient Experience 29 of the Scottish Chairs Group and at a regional level is a core Quality and Patient Safety 34 member of the multi agency Regional Strategic Partnership. Safety Quality and Patient

4 5 Service Developments Improving Health Health Protection and Patient Experience Quality and Patient and Improvement Screening Safety 7 Docherty Eddie Nurse Director Nurse Docherty joined Eddie and NHS Dumfries as Nurse Galloway 2016. in February Director and has strategic He leadership operational making for responsibility person deliver we sure and effective safe centred, and services nursing This clinical practice. includes providing and guidance direction issues, on professional policy and developing staff nursing keeping and skilled, inspired represents He motivated. level, national at the Board groups leading national when required. processes before an event an event before processes if it happens – particularly be high risk to is recognised know we that a process testing in our is a challenge now sure make to hospital, current and, can cope hospital’ the ‘new to can be used Simulation how Some teaching. objective deliver Simulation how examples are response, arrest cardiac can test transfer patient handover, patient Clinical with the • Confirm staffing the nurse Educators, / rotation / education training the to as they apply programmes whole hospital a timeframe will include This and testing. implementation for include the measuring and To on skills 1 Care Level sustaining of the Wards. Since its introduction in 2014 its introduction Since 20 out to has been rolled E-Roster has in within DGRI and now areas 4 are There 1300 users. of excess be implemented, to further areas by which should be completed 2017. Once the Jan the end of Nursing workforce workforce Nursing ensuring sustainability of services local ERostering their new model of care/ their new model of workstream Additionally, service. each attended have members describe how to meetings other’s will be delivered, their services impact on the and the subsequent areas. clinical/non-clinical other have planning groups Workforce the each of been established for directorates operational three and Galloway Dumfries at Acute (DGRI) i.e. Infirmary Royal Women’s and Diagnostics, and Facilities and Children’s take to Directorates Management planning the workforce forward areas. their appropriate agenda for the planning groups, Each of the Workforce which all link into is Workstream, and Transition Manager. the General by chaired Next steps Next of Implementation / Care of Models New and / Education Simulation Training plan an implementation • Develop focussed care new models of for Unit, Care on Critical initially Assessment and Combined Wards Unit plan, to a simulation • Develop example, testing for at, look

The Clinical and Service Change and Service Clinical The was established not Programme are our staff that ensure to only to the move for prepared fully the new hospital in December and 2017, but also as a response altering to approach pro-active due working of ways our current demand on our the increased to system. and social care health is change programme The and supporting the development new models of implementation working of and new ways care of our new hospital and our for services. community 15 clinical and non- are There working clinical workstreams and community acute both across with a wide- each services, including membership, ranging and medical, nursing, from staff Professionals, Allied Healthcare Resources, Human management, side. and staff finance in the last 15 workstreams The been focussed have months few their of on the development policies outlining operational Acute and Diagnostic and Diagnostic Acute 2016 improvements and Service Clinical Programme Change and Improvement and Developments Developments Service Service 6 and Improvement Service Developments

completed further consideration efficiencies delivered through eRostering system. will need to be made as to achievement of rostering There is an on-going recruitment whether the benefits and roll-out standards. programme for both Band 2 and Dr Angus should be extended to Maternity, 5 Bank staff, and a new process Community and Mental Health. • Improved allocation and has been put in-place to create Cameron management of annual leave a more efficient recruitment The benefits and process for our substantive staff. Medical Director efficiencies achieved • Improved reporting and visibility Currently, we have a total of 255 of staff working practices has led Bank staff: through the to better staff management of Improving Health implementation of training and unavailability. Grade Substantive Bank Only Total

As NHS Dumfries and E-Rostering Band 5 71 57 128 • Improved visibility of staff Galloway’s Medical Director Band 2 97 30 127 Increased visibility, accountability shortfalls and management of Dr Angus Cameron is and auditability of staff rosters: temporary staffing with Bank fill- Additional education and training responsible for the strategy The E-Rostering system rates increasing from 65% - 75%. sessions have been developed for which delivers high quality automatically generates regular our ‘Bank only’ workers to ensure reports, with additional reports Efficiencies their clinical skills and values and healthcare to the region’s circulated by the E-Rostering behaviours meet the needs of the population in accordance Team as required. The information • Reduction in ‘over rostering’ – hospital now, and in the future, as produced looks at the following staff rostered and shifts filled in- we undertake the transition to the

with local, regional and Screening Health Protection and areas of rostering: line with establishment budgets new build. national initiatives. He and agreed staffing templates. leads, motivates and Safety – do we have the right Processes have also been staff, with the right skills, in the • Better use and management of introduced to obtain feedback inspires medical, dental right place and at the right time? staff hours due to more accurate and improve the service we and pharmaceutical staff recording and monitoring provide. In addition, new Fairness – are we managing our to deliver clinical strategies processes have also been staff fairly, e.g. is everyone getting • Regular roster and template developed to closely monitor and achieve corporate the same amount of requests/ reviews with finance have staff availability and utilisation. goals. Dr Cameron provides time off and/or share of shifts. Are delivered improved efficiencies The Quality Rostering Policy we meeting EWTD? through changes to shift times, and Regional Nurse Bank Policy professional leadership and patterns and working restrictions. have recently been updated and Patient Experience acts as the bridge between Effectiveness – are we using the approved, reflecting changes staff resource effectively e.g. are staff and the Board. He is also • Greater accountability through to services and wider regional we utilising all staff contracted new formal roster review and working. working closely with Scottish hours before authorising approval processes. overtime. Are we using the correct Government to develop New Hospital and grade of staff for each shift • Improved management of ‘Nurse a new National Clinical requirement? Bank’ through integration of Recruitment Strategy and, acts as the systems and creation of a regional Unavailability – are staff available Nurse Bank incorporating DGRI, Workforce planning is progressing Board’s Caldicott Guardian to work the full range of clinical GCH and community. well. Nurse staffing numbers and and Senior Risk Information shifts, how many are on mat skill mix are being finalised, with leave, study leave or sickness, and • Creation of a KPI data-set the majority of nursing staff now Officer. Safety Quality and Patient are we confident we don’t have to monitor performance and matched to their posts within the too many staff in one area with drive quality and efficiency new hospital. working restrictions? improvements Education and training continues for all staff in-line with the Band Establishment – Do we have Nurse Bank enough staff to deliver the 5 Skills Passport and HCSW service? Is there enough budget in Standards. Training and simulation The DGRI and Community are now being developed to help the establishment and do we have Nurse Bank have now been sufficient staff in post? facilitate nursing transition and amalgamated into 1 team to migration plans. provide consistency in systems Fairness and Safety and processes, as well as greater Recruitment is on-going. flexibility and management of this Additional ‘Rotational’ posts • Standardisation and closer temporary workforce. Efficiency monitoring of rostering practices are also being created; this will has been delivered through the facilitate the development of through the development of introduction of an electronic a ‘Rostering Policy’, as well as staff who have a wide range of booking system linked to the experience and skills.

8 9 and Improvement Service Developments

identified as one of the Six Care of Older People in As part of this work there are Essential Actions for improving Hospitals Tests of Change being undertaken patient flow and safety. focussing on key areas in patient Since August 2015, the Leading flow, Unscheduled Care and There is an established Improving Better Care/Releasing Time To Outpatients. multidisciplinary team now Care Coordinator focused on available at the weekend. enhancing care for older people The first Test of Change focussed This team includes Doctors, in hospitals, as part of Health on the medical patient pathway Pharmacists, Social Workers, and from the Emergency Department Allied Health Care Professionals

Improvement Scotland (Health Improving Health Improvement Scotland) initiative to the Medical Assessment which supports the patient flow Unit and onto downstream consistently over seven-days. This Health to drive up quality of care for older people along with two other wards. A flow co-ordinator has all improves the patient safety and health boards as part of a one year been situated on the Medical experience. pilot. Assessment Unit and is working closely with the medical and Health and Social Care Within Dumfries and Galloway nursing staff to promote patient Integration Improving and protecting Strengthening individual Improving mental health flow. Royal Infirmary (DGRI), Ward 16 the health of local people and community resilience and wellbeing an orthopaedic / gynaecological There is a good working and reducing health ward, was chosen as the initial Early indications demonstrate that relationship between Acute and patient flow has improved since inequalities remains Much of the work focuses on Creating an environment where pilot ward where staff were Community colleagues. A good enabling people and communities concerns about mental health and

commencing the test of change. Screening Health Protection and given base line questionnaires example is that in order to support central to the work of NHS to find a solution and address wellbeing can be appropriately to complete to assess staff The second Test of Change is the Respiratory pathway, the Dumfries and Galloway. linked to flow variability and their own needs, and also to help addressed is vital. Taking account knowledge on; delirium, acute team and GP colleagues DG Health and Wellbeing them access services when these of local need, as identified by dementia, pressure ulcers, falls proactive discharging which worked together on a pilot for initially will focus on testing the is a partnership between are needed. Promoting social the community, available data and sepsis. Chronic Obstructive Pulmonary inclusion and increasing personal and a review of the evidence Discharge Criteria on ward 9 at Disease patients to self-manage the Council and NHS DGRI. The purpose of this test and community resilience is key. has enabled effective work to be Following completion of the their condition at home. which provides strategic We achieve this by helping people supported. This includes social questionnaires, education of change is to use criteria set by Preliminary results of this pilot leadership for improving the lead clinicians with the aim of to access group activities, build prescribing, mindfulness, arts and sessions were offered for the highlight a decrease in hospital population health and their own capacity, and engage dementia work. All these initiatives staff to attend over a 3 month encouraging proactive dynamic admissions for these patients. discharging by junior doctors wellbeing. in learning and development seek to reduce social isolation and period which concentrated on; opportunities throughout their promote mental wellbeing. Falls, Pressure ulcer prevention, and senior nursing staff. This will An alternative model of “step – up be evaluated by measuring the Improving population health is lives. Patient Experience Continence, Sepsis, Adults with / step down” is being tested in the achieved by working in partnership Work with children and young incapacity, Dementia, Delirium, length of stay of patients and Nithsdale area which is the largest obtaining feedback from staff. with a wide range of people and Building Healthy Communities people to improve their mental Nutrition, Datix, Effective Team catchment area for DGRI and organisations all of whom have a (BHC) is Dumfries and Galloway’s and emotional wellbeing includes working. should reduce delayed discharges role to play and contributions to region-wide community working with the curriculum and The next steps are to ensure from the acute hospital. In sustainability of this improvement make. As some have greater need development project. It focuses teachers, developing programmes Ward 16 staff are now enhancing addition, we are assessing how to for action and services to support on promoting resilience, so that to improve confidence and older people’s care by working on across the whole of the medical develop an acute care/enhanced inpatient pathway. improved health and wellbeing, a people and communities are resilience among young people, various improvement initiatives care at home model in our key aspect is effort which seeks to able to respond positively to and implementing a whole school such as, flexible visiting for Nithsdale locality (closest to DGRI) reduce health inequalities. challenging health, social and nurture project. The nurture carers, what matters to you and Seven-day Services to reduce admissions and keep financial circumstances, in order project is being taken forward early detection of delirium. The patients safe within their own The prioritised work programme to support improved health and in three primary schools with a staff have just commenced the Seven-day services have been homes. is to: wellbeing. Beginning with the specific focus on attachment, Safety Quality and Patient new Scottish Patient Safety assets that exist in communities, mindfulness, homework and Programme Falls audit which the • Strengthen individual and interventions seek to encourage play and outdoor learning / Releasing Time To Care Facilitator community resilience and enable people to take control playgrounds. has been supporting the ward of their lives by putting the staff, along with the Pressure • Improve mental health and person at the centre and meeting Ulcer Prevention. wellbeing their needs. Building resilience in people, families and across Service Developments and • Improve physical activity communities is known to be Improvements effective in improving health and • Promote food and health wellbeing outcomes. The Directorate is involved in three National Improvement • Create environments supportive The aim is that this work underpins Programmes, Unscheduled Care, of health and wellbeing and supports action for improved Flow Variability and Developing health and wellbeing. Outpatient Integration Together (DOIT)

10 11 Service Developments Improving Health Health Protection and Patient Experience Quality and Patient and Improvement Screening Safety 13 Obesity and overweight is an issue and overweight Obesity on the effects with wide-ranging as increasing such health, public’s approach The diabetes. of rates and in Dumfries being taken centred family a offers Galloway support provides which approach, and sustainable realistic for change. behaviour Creating environments environments Creating and health of supportive wellbeing in which people environment The on their has a huge impact live Work and wellbeing. health the of some address to continues people living by issues being faced including ensuring in poverty, advice the appropriate to access work, For those in finance. around aims to Lives Working Healthy by environment, the work improve maintain to supporting workplaces and mental and address safety, health. physical Improving physical activity physical Improving alliance strategic A region-wide bring key established to has been and progress together partners in the National noted the actions Implementation Activity Physical will focus Alliance Plan. The activity physical on developing the population opportunities for approach course a life which take in successful as this has proved in physical changing participation capacity as building as well activity, literacy. and physical and health food Promoting and Dumfries ambition is for The be a sustainable food to Galloway means taking into This region. health, the environment, account concerns social and economic also It food. when producing with strategic working requires the most effective find to partners positive promoting of ways food. to and behaviour attitudes

individual resilience and physical • improve and wellbeing health mental in partnership • work environments create to and health of supportive wellbeing. Michele and her colleague colleague and her Michele lead the Carnon Andrew local for responsible teams improve protect, action to and health and maintain and reduce wellbeing and inequalities in Dumfries Galloway. in challenges faced The many are ill health preventing require They and complex. the NHS, social action across and Independent Third care, and in partnership sectors with people, communities and the wider population. a takes work this of Much impact to any time for long fruition and requires to come priorities The ongoing focus. to: action are for and community • strengthen Joint Interim Interim Joint Public of Director Health Michele McCoy Michele 12 and Improvement Service Developments

Timebanking Annandale and Eskdale Time Lockerbie and Bank please contact Mia Lochmaben Men’s Timebanking is a way for people Glendinning by email at mia. and organisations to share [email protected]. Shed Locality resources, skills and knowledge and be rewarded for it – in time. Day Opportunities For every hour of time you give, providing a service for another Annandale and Eskdale Safe member of the Timebank, and Healthy Action Partnership

you receive one-time credit (SHAP) Day Opportunities Fund Improving Health health – one hour = one time credit. has supported the development Members can spend their credits of over 40 community-based on services provided by other services and activities for members. So if you provide three older people and their Carers. hours of child care you can claim The principle aim of this fund three hours of gardening, or was to reduce loneliness and something else you need. social isolation and promote improvement independence and the below: Timebankers with Timebroker development of new skills. Mia Glendinning and Community Link Worker Julie Robertson, celebrating Timebanking’s second birthday The fund was intended as a way of supporting the setting up of Screening Health Protection and NHS Dumfries and Community Link Worker, Michelle new groups and activities which would be self-sustaining or able Galloway is committed to Annandale Wilkie, works as part of the Health Improvement Team in Annandale to attract funding from other improving and protecting sources for the longer-term. The Lockerbie and Lochmaben Men’s and Eskdale. She said: “Linking Shed is a thriving group which the health of local people people to local sources of support following examples show where and Eskdale this funding has been used to provides opportunities for people and reducing health is crucial in ensuring good health, to work on various projects inequalities. Each locality Community Link Workers independent living and peace of support people across Annandale and Eskdale. including wood turning and has a dedicated team mind. I work with people to help making small garden furniture working with local people The development of Community them realise their own potential pieces like trugs and bird houses. Link Workers resulted from finding and to set realistic goals. Tea and Tennis

to support optimum health Patient Experience out what really matters to people Members are involved in some and wellbeing through the in relation to living the way “Sometimes it’s just about asking This group used its grant for Time Banking is proving to be a restoration work including creation of environments they want to, keeping well and the right questions. If we ask What coaching fees, hiring the hall real success; it reduces loneliness a spinning wheel. Thanks to which support healthy managing their own health. matters to you? instead of What is in poor weather, equipment increased membership the group the matter with you? we often find and supports people to live and promoting the group to choices and build independently in their homes. is currently looking for new They work closely with people to out that what matters is something encourage new members. This It is one of the activities that the premises. For further information community resilience. help them identify their priorities small, simple and easy to fix. This group is now an integral part Community Link Workers find about the group please contact Activities are wide-ranging and support them in planning how can have a dramatic impact on of the Seaforth Tennis Club really benefits people, a simple Colin Howe on 01387 810 009 or and the following section they will achieve their goals, for people’s health and happiness and in Annan; members sit on the concept that can make incredible Ken Harvey on 07511 024 394 example putting them in touch can help them feel in control of committee and play active describes some of the work changes. undertaken in 2015 / 16. with local groups or activities. their lives and health.” roles in fundraising. Members pay towards coaching fees –

Mia Glendinning is the Annandale Safety Quality and Patient Practitioners and partners, To find out more about which helps sustain the group and Eskdale Time broker including GPs, social workers, the Annandale and Eskdale – and organise who supports people and district nurses, mental health Community Link Programme sessions organisations that want to take workers and those involved in please contact Elaine Lamont by without the part in this valuable scheme. planning hospital discharge now email at [email protected]. coach. She said: “Timebanking is a realise the benefits of this person- way of valuing everyone and centred approach which focuses The people recognising that we all have on positive outcomes and the who take part in something useful to share. By whole person rather than trying to this group have bringing people together to fix one problem at a time. learned a new share experience and skills we sport, made help them develop friendships new friends and that in turn enrich their lives and really enjoy the build resilience in people and physical activity communities.” followed by a chat over tea. To find out more about the

14 15 and Improvement Service Developments

Devil’s Porridge Langholm Information The Jills of All Trades Phoenix Club in Stranraer. Heartstart Museum Cordite Club Hub Monday Club Heartstart is an initiative This club aims to build members’ This project which provides coordinated by the British Heart Foundation to teach the simple confidence in a safe, welcoming tourist and other local Members of the Monday Club skills needed in a life-threatening environment and offer older information supported by 24 have access to a wide range emergency which can help keep people at risk of exclusion a volunteers was piloted in July of activities including Tai Chi, someone alive until professional place to make new friends. with no initial budget. It far cooking, arts and crafts, day trips helps arrives. The certificated exceeded expectations with and singing. They have also

two hour Emergency Life Skills Improving Health over 800 enquiries in just three heard talks on topics ranging (ELS) Course is aimed at the months. from benefits and health advice public and anyone from the age to Alzheimers and hearing issues. The Day Opportunity Fund In a workshop in Whithorn of ten can attend to learn the supported the group to continue women off all ages are complete range of ELS skills. operating a popular local asset developing DIY skills which over the winter months. are building their confidence Building Healthy Communities and enabling them to tackle volunteers David and Anne Hirst projects at home. As well as have trained over 1500 people in providing structured learning Dumfries and Galloway over the Machars sessions the group includes last nine years. time for socialising, support and The VOICE Mid mentoring. David who is the Heartstart Screening Health Protection and The funding has supported 18 coordinator, also became a Galloway Project Group members decide what training supervisor in 2015, fortnightly sessions which begin Building Healthy Communities skills they need to learn. They which means he delivers Train with lunch followed by games provides the volunteers with then use those skills to help the Trainers courses. He has and ending with a talk from a support in a number of areas other community groups, people co-ordinated the training across guest speaker or crafting led including organising their in need and themselves with DIY 34 schools in Dumfries and by a local artist. People have programme of events, marketing, jobs they might not otherwise Galloway to ensure that every made new friends thanks to refreshments and practical have taken on. pupil in these schools will receive taking part in this group and support to organise the group ELS training at least three times some participants now car pool which meets two mornings a during their time in school. This to make sure those without Tai Chi for Health month. is achieved using DVDs and by transport don’t miss out. Patient Experience Thanks to Building Healthy training teachers to deliver the The organisers are often told that Communities the people Art Groups course. the club is a highlight for many of west Wigtownshire are The Arts Group forms part of and that people would otherwise developing an interest in the In conjunction with Police the Self Help Management be stuck in the house. People health and wellbeing benefits of Scotland, Heartstart volunteers programme run by Building also report learning new things Tai Chi. The Tai Chi for Health have also trained 20 police Healthy Communities in West by taking part in craft activities programme is delivered through volunteers to become Wigtownshire. The group is and listening to guest speakers. two projects – one at North West made up of beginners and Castle in Stranraer and the other more advanced artists who help in the Portpatrick Community Canonbie Matters each other to develop their Hall. skills with occasional help from Funding helped cover some of Partners and Volunteers from Services VOICE Mid Galloway professional artists. Last year Safety Quality and Patient Tai Chi for Health now has the start-up costs for a multi- the VOICE Mid Galloway project started out with 30 volunteers. they held a public exhibition of six qualified Building Healthy agency project to develop celebrated their achievements The project attracted a further their work at Stranraer Library. Canonbie Matters, a community during National Volunteers Week 107 volunteers, all of whom Communities volunteer facilitators which has resulted café for Canonbie and district. As in June, a year after its launch. benefitted from a wide range As part of the Machars Building in an expanded programme well as being open to the whole Funded by the Volunteer Action of training opportunities, which Healthy Communities Self including an eight week instructors. They will deliver community Canonbie Matters Fund Scotland and supported by were sourced and delivered Management Programme introduction to Tai Chi for Health the course to peers at Stranraer aims to attract and engage with the Machars Area Partnership the locally. members of the Isle of Whithorn with Parks Primary school in Academy and four primary older residents, and provide project aimed to provide support Art Group meets every Stranraer when 16 children schools to ensure there are low-level opportunities for and training opportunities for The volunteers were then Wednesday afternoon and were introduced to Tai Chi. enough instructors to deliver the community participation. volunteers across Mid Galloway. supported to use their newly membership has grown over the The facilitators also supported course to pupils in all of these developed skills to run groups year. Members have also taken students at Stranraer Academy schools. The Silver Surfers Beginners class Led by staff from Building and clubs. They contribute over part in local arts fairs to promote providing Tai Chi as relaxation has proved popular with older Healthy Communities (Machars), 330 voluntary hours every week the group and exhibit their work. A total of 113 people were trained people; several participants are in Dumfries and Galloway which is helping build resilience before the exams. The group also delivered an introduction to to deliver the Heartstart course their 80s and two are in their 90s. Council’s Community Learning in the local community. last year. and Development and Social Tai Chi to the members of the 16 17 and Improvement Service Developments

Isle of Whithorn Art • Induce relaxation and mood Stranraer Wheelchair enhancement Group Curling Group Stewartry The group which meets every Initially funded by Putting You Wednesday afternoon has grown The Stranraer Wheelchair Curling Teenage MOTs First and set up as part of the over the year. Members have also Group has had a successful In partnership with two of Building Healthy Communities taken part in local arts fairs to year with teams in the Scottish the local GP practices in Self-Management Programme promote the group and exhibit Curling Championship. the Stewartry, the Health their work. Glenluce Boccia and Improvement Team delivers Teenage MOT Clinics as a form Improving Health Dancercise (Isle of Boccia and New Age New Age Curling of preventative care for young Whithorn) Group people in the locality. Curling Clinics generally run twice a Tobacco Control This initiative was set up at the The group is delivered by trained month at both Castle Douglas Both of these activities are same time as the Art Group Building Healthy Communities Medical Group and Craignair Smoking Matters has taken Paralympic target games and was initially advertised as a volunteers and runs every Health Centre, where 15 and 16 forward new projects to teach designed to be played either Gentle Chair-Based Exercise to Thursday from the Glenluce year-olds are invited to come young people about smoking seated or standing and are great Music group but it quickly turned Bowling Club. It provides a social in and meet with the Health prevention. We are in our first ways for people of all abilities the members of the Isle of into a Dancercise at the request setting so people aged over 50 Improvement Officer. year of delivering the Decipher to get exercise while having Whithorn Art Group now of the members. The group with reduced mobility can stay - ASSIST programme which is a contribute to the cost of the hall fun. Members of the Glenluce The Clinic provides an

active and have some fun. peer led programme in tobacco Screening Health Protection and Boccia Club join members of and provide their own materials. opportunity for young people involving 12- to 13 year-old the Newton Stewart Activity and The Machars Area Partnership for The group has developed to talk in a safe and confidential pupils. Through a selection Resource Centre every week for Building Healthy Communities relationships with another Boccia environment about any worries process influential pupils are some friendly competition. has also helped with funding to and New Age Curling group in or concerns they have about nominated by their peers help sustain this activity. Newton Stewart and members their health and wellbeing. and trained to become peer Healthy Eating hope to build a network Topics generally covered can supporters in smoking cessation. include; exam stress, sexual The group is run by a Building to support friendship and There are three pilots running in health and relationships, Healthy Communities volunteer We advise groups in schools participation. Scotland and NHS Dumfries and problems at home, family and aims to provide local people and the local community of the Galloway is contributing to a bereavement and a range with the chance to take part benefits of eating balanced and growing evidence base in this of health issues such as skin in a new activity while having meets every Tuesday morning nutritional meals. Groups learn area.

fun and meeting new people. and has gone from strength to about how to eat healthily on problems. Patient Experience strength. a budget with a range of fresh Along with the provision of stop As of 2016 the Teenage MOT produce and alternative foods smoking services across the Clinics now also offer basic as well as how to reduce food region, other prevention work Glenluce Chair-Based sexual health services including waste. has included a wide programme C-Card (a confidential scheme Exercise Group of activities through primary to provide teenagers with free The activities are delivered as and secondary schools. More condoms), condom distribution Building Healthy Communities workshops and this year 173 recently we have added nursery and a pick up point for postal West Wigtownshire worked people took part. Building education which focuses on sexually transmitted infection Dumfries and Galloway Council’s Healthy Communities volunteers reducing the harm caused by (STI) testing kits. Leisure and Sport team to who have successfully second-hand smoke to children develop chair-based exercises completed their Elementary through our Home Sweet Home for the over 50s as part of its Food Hygiene course regularly programme. Safety Quality and Patient supporting rural communities assist with these popular sessions Group members gain confidence Self Help Management from developing new skills programme. while experiencing art in a relaxed, welcoming and friendly Three volunteers took the environment. opportunity to train as facilitators on low impact sitting exercises Taking up a craft can have many to support and maintain the benefits including: group so older people can stay generally healthy and enjoy a • Improve self-confidence social gathering in Glenluce. • Promote a sense of achievement • Self development • Reduce isolation

18 19 Service Developments Improving Health Health Protection and Patient Experience Quality and Patient and Improvement Screening Safety 21 Charles Jencks, Charles Jencks, Multiverse Crawick is a stunning of representation discoveries exciting the and theories of universe. world-class This landscape art design links the themes of and astronomy space, creating cosmology, inspiring a truly will landmark that everyone appeal to art enthusiasts from the to and scientists wider community. Crawick Multiverse Crawick is a major Multiverse Crawick and art project land restoration Landscape art has in Sanquhar. open cast a former transformed an outdoor space mine into coal future by can be enjoyed that generations. Communities Building Healthy was Nithsdale (BHC) in Upper part in the launch take to invited The in June. the Multiverse of with Sleeping worked team design people to and local Giants ship complete and build a rocket and aliens as part with astronaut the launch event. of BHC also supported the of members Chi networks Tai Nithsdale in Upper to and Dumfries their skills display in this wonderful environment. funded Privately of the Duke by and Buccleuch designed by globally-renowned landscape artist The new path was officially was officially path new The with an event in August launched Hepburn Jamie by attended Health Sport, for Minister MSP, Health and Mental Improvement Minister MSP, McLeod and Aileen Change Climate Environment, for also event This and Land Reform. the to improvements showcased Park Car Wood Town changes to improve their health their health improve changes to also Students and wellbeing.” nutritional their client’s at looked on how advice and gave intake diet a healthier adjust to to options, eating including healthy styles and portion cooking control. a received volunteers “The and fitness plan food bespoke them increase help designed to their their fitness and improve also were They life. quality of suitable and realistic given changes and lifestyle exercise keep be able to they would that the programme going after great got students ended. The with real working of experience of people with a wide range they that medical conditions when account into take had to the programmes.” developing The partnership used the used the partnership The 20 as a path existing core Dalbeattie connect means to and Colvend with Barnbarroch the to easy access while giving and Kippford villages of Coastal and travel both for Rockcliffe purposes. recreation and wellbeing health Promoting opportunities accessible through in the project was prominent as development was encouraging promotion through the world class outdoor at environment Forest Dalbeattie has which research is under-used shown residents. local by Programme Worker Helen Helen Worker Programme those helped identify Mackintosh part in the programme. who took committed are said: “We Sheila the health improving to people in of and wellbeing and this and Galloway Dumfries way is an excellent programme together bringing students of benefit with people who would their skills and knowledge.” from people who added: “The Helen 50 and all over part were took conditions health of a range have which can be improved all of and regular with good diet and each student exercise to up with a participant teamed regime and fitness design a food for them.” specifically and Dumfries from tutor Sports McMinn Paula College, Galloway with the HND closely works and Exercise Health Fitness, people said: “The She students. a through taking part went tests fitness and health of range the the students which gave plan they needed to information fitness programme. a six-week suitable also given were They and lifestyle exercise and realistic

Active Dalbeattie is a Dalbeattie Active partnership community-led and health improve aiming to increasing through wellbeing cycling. walking, jogging and consulted partnership The what on community the local support they need to resources active more become them to a of and the development Dalbeattie from path coastal as was identified Colvend to Dalbeattie Active a priority. carry out £187,000 to secured and support works infrastructure and wellbeing health community activities. Active Dalbeattie Dalbeattie Active - Core Event Launch 20 Path The Heart and Soul and Heart The volunteers and students Twelve a healthy, for together got and Dumfries nutritious lunch at training Zest College’s Galloway celebrate to in March restaurant and Soul the Heart completing programme. and Soul is a collaboration Heart and NHS Dumfries between Building Healthy Galloway’s and HND team Communities and Exercise Health Fitness, and Dumfries from students students The College. Galloway people aged with twelve worked a design and deliver 50 to over fitness and six-week bespoke nutrition programme. Communities’ Building Healthy Sheila Manager, Operational and Self-management Campbell Dumfries Dumfries and Lower Nithsdale 20 and Improvement Service Developments

Kelloholm and Kelloholm and Kirkconnel Gala Day Kirkconnel Xmas Light Switch-on The costumes for the Crawick Health event had a successful second Building Healthy Communities outing in June when they won volunteers were also responsible first place it the Kelloholm and for the Kelloholm Santa’s Kirkconnel Gala Day fancy dress Grotto where Mr and Mrs Claus competition. gave all the local children a Improving Health little present. A bingo night in The team also served specially October attracted more than 40 Protection and blended alcohol-free cocktails, participants and raised over £300 free fruit and information to decorate the Grotto. on what BHC does in Upper Nithsdale. Although the weather wasn’t ideal the team retreated indoors It was a great opportunity for to continue the fun with face local people to find out what Screening painting and refreshments. the team does and how to get involved. The team put the skills they

learned at Crawick to good Screening Health Protection and the age of 18 girls will have had meningitis (inflammation of the use with a number of lantern Health protection is a 17 separate injections and boys lining of the brain) and septicaemia making workshops to local multi-agency, multi- will have had 15. These injections (blood poisoning). There are five people throughout October and disciplinary activity. In protect children from a number main groups of meningococcal November. The results of these Dumfries and Galloway we of potentially life threatening bacteria that can cause meningitis workshops were showcased in work with key stakeholders illnesses including diphtheria, and septicaemia- A,B,C,W and a procession, led by Mrs Claus, tetanus, whooping cough, polio, Y. Meningitis B is now the most which proceeded the grand - including Primary Care, haemophilus influenza type B common cause of meningococcal switch-on of the Christmas Scottish Water, Police (Hib), pneumococcal disease, disease in the UK; in Scotland in lights. Scotland and the Council rotavirus, Meningococcal type C 2014 61 out of 73 meningococcal - to ensure we maintain an (Meningitis C), measles, mumps cases were serotyped of which 42 This Christmas event was

integrated approach to the and rubella. (69%) were group B. Unfortunately Patient Experience organized in partnership with Meningitis B is fatal in about one Village Pride which provides the health of the public across in 10 cases. Infants and children Xmas lights, free family activities the region. During 2015 there were aged under five years are mostly and a Xmas market place. two changes to the The term health protection covers affected. With early diagnosis and childhood immunisation antibiotic treatment most make a set of public health activities and programme: involves: a full recovery, around a tenth of survivors experience long-term • From August 2015 the Meningitis • Ensuring the safety and quality health problems (amputation, ACWY vaccine replaced the of food, water, air and the general deafness, epilepsy and/or learning Meningitis C vaccine as part of environment difficulties) and around one-third the routine programme for pupils of cases result in less severe in the third year of secondary • Preventing the transmission of physical and / or neurological Safety Quality and Patient school. In response to an ongoing communicable diseases disabilities. outbreak of Meningococcal W NHS Boards were also asked • Managing outbreaks and the Uptake rates for childhood to deliver a staggered catch up other incidents which threaten the immunisation programmes campaign for all pupils in S4, S5, public health in Dumfries and Galloway are and S6 consistently above the Scottish average. Immunisation • From Tuesday 1 September 2015 the Meningococcal (Meningitis In addition to the core Childhood Immunisation B) vaccination was introduced immunisation programmes Programme into the preschool immunisation targeted vaccinations - Bacillus programme. This programme is Calmette-Guérin (BCG) and Children born in Scotland can now being offered to children born Hepatitis B - are offered to children expect to have eight injections and from Sunday 1 May 2015. and deemed to be at risk of two oral vaccinations in their first tuberculosis. year of life. By the time they reach Meningococcal bacteria can cause

22 23 and Improvement Service Developments

The seasonal influenza The uptake rates for all of these The vaccine is less effective vaccination programme groups, apart from pregnant in older people so it is not women, are above the Scottish recommended for people aged 80 Nigel Calvert From October 2013 the seasonal average. years or older. influenza vaccination programme Public Health was extended to include all two Adult Immunisation For 2015/16 season the uptake and three-year old children and Programme rates for Dumfries and Galloway Consultant pilots were held to include some were: primary school aged children. The shingles immunisation • Age 70 years 55.92% (Scottish As a consultant in public The programme was then further programme commenced Sunday Improving Health extended to include all children 1 September 2013. Shingles is average 50.4%) health medicine, Nigel aged two to five years and all a debilitating condition, which Calvert deals with very primary school children. occurs more frequently and tends • Age 78 years 57.74% (Scottish average 46.7%) complex public health to be more severe in older people. The programme is also offered to It is estimated that around 7,000 issues and he works with adults aged 65 and over, children people aged 70 years and above On Monday 15 October 2012 senior colleagues to plan aged over six months and adults are affected in Scotland each year. a programme to vaccinate with at-risk health conditions and pregnant women against pertussis and deliver interventions to pregnant women. Of these, between 700-1,400 to protect their infants was that aim to influence the develop a very painful and implemented on a temporary The validated uptake figures for the long lasting condition – Post basis. This was because there had

health of the population. Screening Health Protection and influenza vaccination programme Herpetic Neuralgia (PHN). Around been a considerable increase in This includes public are not yet available. Internal 600 hospitalisation episodes pertussis activity in the UK starting health management figures indicate we achieved the are recorded per year, with in mid 2011. The outbreak was the following rates approximately five cases resulting largest seen in the UK for over a of communicable in death each year. decade. disease cases, outbreak • Children aged two to three years management, coordination 61.5% The programme is being offered to adults aged 70 years old to protect of vaccination and • School programme 78.4% against shingles with a phased immunisation programmes, catch-up programme for people • Over 65 year’s group 76% up to aged 79 years. During the coordination of screening 2015 / 16 season the catch-up Patient Experience programmes and • At risk groups 50.5% campaign was aimed at people emergency preparedness aged 78 years. • Pregnant women 48.8% work in relation to floods, chemical incidents and other occurrences.

Laboratory confirmed cases of whooping cough 2000 to 19 Sept 2012 Safety Quality and Patient

1200

1000

800

600

400

Number of cases of Number 200

0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 to 19 Sep Year 24 25 and Improvement Service Developments

Abdominal Aortic Infectious Diseases tracing and the recommendation Board uptake Aneurysm Screening of prophylactic antibiotics for Scotland Uptake E coli O157 close contacts. There are several – a one off ultrasound examination types of meningococcus (most commonly B and C in the UK, but 100% is offered to all men in the region Scotland has the highest rate in their 65th year. This aims to of E coli O157 in the UK and also A, W and Y) and in certain 90% detect bulging of the main artery Dumfries and Galloway is one of circumstances a vaccination will also be offered. Close liaison is 80% in the body because these can the Boards with the highest rates. sometimes burst with severe Scientific studies have shown often required with colleagues in education if the case is a pupil or 70% consequences. Surgery is offered that the primary host for E coli is Improving Health student. 60% where appropriate. The uptake in cows and so living in a rural area the region is around 89%. characterised by cattle farming 50% is associated with a higher risk of Tuberculosis infection. uptake % uptake Pregnancy and Newborn 40% Human tuberculosis is caused Screening 30% There is a focus within the health by infection with bacteria of the Mycobacterium tuberculosis - In May 2015 the UK National protection team on working 20% complex (MTB). Whilst MTB Screening Committee announced proactively with partner agencies commonly causes infection of 10% its recommendation to screen to raise awareness of the risk and the lungs (60%), it can involve every newborn baby in the UK to promote strategies to reduce 0% any organ in the body. Early for an additional four genetic it. Team members attended symptoms of active disease can Screening Health Protection and disorders: various agricultural shows over 2012 / 102012 / 201312 / 201302 / 201304 / 201306 / 082013 / 102013 /2014 12 / 201402 / 201404 / 201406 / 082014 / 201410 / 201512 / 201502 / 201504 / 201506 / 082015 / 102015 /2016 12 / 02 the summer in order to raise include weight loss, fever, night sweats, loss of appetite as well as • Homocysteinuria (HCU) awareness among farming Year / month communities. symptoms from the specific organ or system that is infected; for • Maple Syrup Urine Disease example an enlarged lymph node (MSUD) Meningococcal Infections or bone pain if the bacteria have invaded the bones. • Glutaric aciduria type 1 (GA1) Neisseria meningitidis (also known Immunisation with a single dose are administered through GP people take up the offer of a test as meningococcus) is a bacterium A common way to acquire of a pertussis-containing vaccine practices. We also provide advice compared with a Scottish average • Isovaleric acidaemia (IVA). and, although infection is TB is by breathing infected (Repevax®) is offered to all through our website at www. of 56.1%. uncommon, it can be very serious. pregnant women in the period dghps.org/immunisation-and- respiratory droplets from a patient Diabetic Retinopathy It can cause meningitis and/or Patient Experience weeks 28 to 32 (inclusive) of travel. Breast Cancer Screening septicaemia. Anyone who suspects with infectious respiratory TB. pregnancy. Immunisation during Screening meningitis or septicaemia should Transmission is much more likely if the index case has sputum which weeks 28 to 32 of pregnancy Screening – women aged 50 to 70 years seek medical help immediately. – people with type 1 or type 2 is smear positive for the bacillus is likely to maximise transfer old are offered a mammogram diabetes are at higher risk of eye on microscopy, and often after of protective antibodies from Screening refers to the use of every three years. The screening • Meningitis is an inflammation disease. All people with diabetes prolonged contact such as living in the pregnant woman to foetus. simple tests across an apparently programme is managed from the of the lining that covers the brain Pregnant women who are beyond healthy population in order to aged 12 and over in the region are the same household. specialist centre at Ayrshire Central offered an annual eye screen so and spinal cord (the meninges). week 38 of pregnancy are still identify individuals who have risk Hospital in Irvine and utilises Bacterial or viral infection is the that changes can be detected early • Dumfries and Galloway has a offered immunisation up to the factors or early stages of disease, mobile screening units which usual cause. Bacterial meningitis and treated. The uptake rate is 91%. TB rate of 3.4 cases per 100,000 onset of labour. New mothers but do not yet have symptoms. cover the whole of the south west is uncommon but serious. Viral of the population. The rate has who have not previously been Locally, adults are offered of Scotland. meningitis is a fairly common vaccinated against pertussis are NHS Scotland’s ability to consistently remained below screening tests for a number of condition but much less serious Safety Quality and Patient implement this screening the World Health Organisation offered the vaccination up to conditions including the following: than a bacterial cause. when their child receives their first Cervical Cancer Screening programme will depend on the target of fewer than 10 cases per vaccination. changes to National Immunisation 100,000 Bowel Cancer Screening The uptake for cervical screening System (SIRS) currently being • Septicaemia is an infection of is 80% in Dumfries and Galloway. approved and implemented. the blood with bacteria. It is often • Contact tracing identified zero In April 2013 the vaccination – people aged 50 to 74 are Scottish Government, Health called ‘blood poisoning’. If bacteria cases of active TB disease and zero programme was extended and offered a bowel cancer screening remains in place. In 2015 Scottish Government Protection Screening Programmes multiply and release poisons cases of latent infection test every two years. Test announced that the age range Directorate, and NHS Boards are (toxins) into the blood it can cause results are available within two for screening would change supportive of this change. serious illness. • 68% uptake rate of BCG The table above provides uptake weeks and most people have information on the pertussis from between 20 and 60 years to vaccination in referred neonates a negative result. If the result is between 25 and 65 years, bringing Each year in Dumfries and vaccination programme for positive a health professional pregnant women. Scotland into line with the rest Galloway, the health protection contacts the person to offer of the UK. This change will be team deals with the public health them a colonoscopy. This test is effective from June 2016. management of several cases The Health Protection Team offers carried out at a local out-patient advice regarding travel health and of meningococcal infection. appointment. The latest available This includes careful contact recommended immunisations uptake figures show that 59.7% of

26 27 and Improvement Service Developments

Common but less serious Influenza conditions Seasonal Influenza is a highly Norovirus type infections infectious disease caused by a virus. It occurs every year, usually Patient This is a common infection, and in winter, and can make even sometimes causes outbreaks in healthy people feel very unwell. hospitals (which are dealt with Infection usually lasts for about primarily by colleagues in the a week and is characterised by sudden onset of high fever, Infection Control Team) and care Improving Health homes. In 2015 / 16 there were 12 aching muscles, headache and Experience norovirus outbreaks in local care severe malaise, non-productive homes. All received full support cough, sore throat and a runny from the health protection team nose. In the young, the elderly or and there is a regular programme those with other serious medical of training in place. Particularly conditions influenza can bring Late in 2015 / 2016 we developed proactive methods such as surveys intensive support is given to on pneumonia, or other serious NHS Dumfries and an Information Steering Group and focus groups. Information is homes that have experienced complications which can, in Galloway considers which is reviewing and revising our available on the NHS Dumfries multiple outbreaks. extreme cases, result in death. feedback about the information approaches across the and Galloway website. Posters Influenza has an annual attack rate experience of care to organisation. The group aims to and patient information leaflets Salmonella estimated at 5%-10% in adults and be key to improving the develop a range of methodologies about feedback and complaints Screening Health Protection and 20%-30% in children. quality of our patient care. for providing materials to support are readily available in all NHS There were 33 cases of salmonella decision making and inform Dumfries and Galloway hospitals infection that we were made The most effective way to This feedback is obtained from people of their condition and and clinics. All ward and clinic aware of in 2015 / 16. All prevent the disease and/or severe people (patients, families, Carers treatment options. areas have comment cards for were carefully investigated in complications is vaccination. and the public) informally through patients and relatives to provide conjunction with environmental Safe and effective vaccines have a range of methods and formally The NHS Board continues to have feedback about their experience. health colleagues and appropriate been used for over 60 years. through the complaints process. a primary statutory responsibility public health control measures Influenza immunisation has been The information gained from these to involve patients and the public (including exclusion from recommended in the UK since sources helps the Board to ensure across the region including work where necessary) were the late 1960’s, with the aim of that the services we provide are in hard-to-reach groups. This is implemented. protecting those in clinical risk line with our quality ambitions. undertaken in a variety of ways, groups who are at a higher risk of with bespoke groups and is Patient Experience influenza-associated morbidity This approach will continue to evidenced by our commitment and mortality. develop as we work to deliver in our Health and Social Care the approaches within the Integration Scheme for a Person-Centred Health and Care Participation and Engagement Programme (PCHCP). Strategy.

Significant work is being We continue to work in undertaken within services and partnership with all agencies and public partnership volunteers we strive to have a person-centred to identify, plan and implement care model and ethos at the change that will benefit patients forefront of our service delivery. and staff. We continue to Safety Quality and Patient embed the methodology of the Feedback, Comments, PCHC Programme across the Concerns and Complaints organisation with staff becoming increasingly aware of and using Feedback, comments, concerns the Must Do with Me approaches and complaints form a critical part to ensuring that service delivery of NHS Dumfries and Galloway’s is in line with the person’s needs mechanisms for listening, and goals. We are currently testing learning and improving the care the What Matters to Me and delivered to patients, families and Who Matters to Me approaches communities. in Dumfries and Galloway Royal Infirmary and have embedded We seek feedback in a number of What Matters to Me questions in ways for example in writing, by admission documentation. email, by phone, text, social media and face-to-face as well using

28 29 and Improvement Service Developments person-centred Joan Pollard cancer care Associate Director of Allied Health nurses Professionals

service Improving Health Joan Pollard provides strategic direction and professional leadership staff to allied health excellent care excellent Care professionals in Dumfries Care and Galloway. This Care & attention includes physiotherapists, podiatrists, occupational nursing care therapists and speech and nurse Screening Health Protection and language therapists. Joan also collaborates with treatment general managers, allied health professional heads of service, consultants, Patient Opinion develop Wordles. The example Summary Complaints Data lead nurses clinical above is what people told us was directors and professional NHS Dumfries and Galloway good about NHS Dumfries and NHS Dumfries and Galloway seeks recognises that more people Galloway. to learn from complaints and use bodies. Patient Experience can access digital channels, them to improve services. The which offers us an opportunity Patient Surveys table below shows a quarterly to broaden patient and public summary of complaints data for feedback from across the NHS Dumfries and Galloway 2015 / 16. In the past year, NHS region. The Board subscribes to learns a great deal about patient Dumfries and Galloway received Patient Opinion, an electronic experience from patient surveys. a total of 349 complaints, an independent feedback system, In 2014 / 2015 we participated increase of 9% on 2014 / 15 which is open, transparent and in the Scottish Inpatient Patient (321). The number of complaints simple for people to use. Experience Survey. The survey received across all four quarters was undertaken again between has remained consistently higher This service is promoted January and April 2016 with than in previous years.

electronically and through posters results due to be published in the Safety Quality and Patient and leaflets. summer.

Patient Opinion allows people In 2015 / 16 18,049 people to share their experience of local registered with a General health and care services. Stories Practitioner in Dumfries and can be submitted to the website Galloway were asked to provide - www.patientopinion.org.uk, by feedback on their experience of email at [email protected]. their GP practice and local care uk, by phone on 0800 122 3135 or and support organisations, 4,306 by post to Patient Opinion, Patient responses were received. Opinion, Scion House, Stirling University Innovation Park, Stirling You can see the full report here FK9 4NF - http://www.hace15.quality- health.co.uk/index.php/reports/ Using the feedback generated in health-board-reports/2468-nhs- Patient Opinion it is possible to dumfries-galloway-pdf/file

30 31 and Improvement Service Developments

Summary Complaints Data by Quarter and Annual Total Percentage of complaints completed in twenty working (2015 / 16) days 2014 / 2016

Q1 Q2 Q3 Q4 Annual (Apr-Jun 2015) (Jul-Sept 2015) (Oct-Dec 2015) (Jan-Mar 2016) Total 2014 / 15 120% 2015 / 16 Complaints 122 77 68 82 349 110% received 100% Improving Health 100% Complaints 119 (98%) 76 (99%) 66 (97%) 81 (99%) 342 (98%) 89% acknowledged 90% 84% 78% 80% within 3 80% 71% working days 70% 70% 65% 63% 61% Complaints 95 (78%) 57 (74%) 45 (66%) 52 (63%) 249 (70%) 68% 68% 59% 64% completed 60% 60% 56% 57% 45% within 20 50% 54% 55% working days 52% 44% 40% 43% 36% 30% Screening Health Protection and A total of 70% of complaints received a response within the 20 working 20% days. The percentage achieved nationally for 2014 / 15 was 69.9%. Number of cases of Number 10% The tables below provide a more detailed breakdown of the numbers 0% of complaints received and the percentage of complaints responded Jul to within twenty working days across 2014 / 15 and 2015 / 16 for Apr May Jun Aug Sep Oct Nov Dec Jan Feb Mar comparison. The provision of timely responses is taken very seriously. However, the quality of response and complainant satisfaction is prioritised over the speed of resolution. In situations where complaint responses fell outside the twenty-day target these were typically In December 2015 an internal audit The Board has agreed an because the complaint was complicated and often involved meeting of the Board’s complaints handling action plan to address the Patient Experience with the patient (at their convenience). procedure was undertaken. The recommendations. A working scope of the audit was to provide group has been set up to review Number of complaints received and completed in assurance that: the complaints process and ensure twenty working days 2015 / 16 that each recommendation is • there is a robust process in place addressed within the revised to manage patient, carer and complaints process. Ongoing service user complaints 55 The group aims to develop a Not Complete 20 • all identified current guidance has seamless, responsive service 50 Complete 20 been identified and incorporated that reflects NHS Dumfries 45 within local policy and procedure, and Galloway’s commitment

to improve the quality of care Safety Quality and Patient 40 17 • policy and procedure is and the patient experience by 35 4 implemented effectively listening, learning and responding 6 to feedback. We would therefore 30 • all outcomes are appropriately actively encourage people 10 11 4 reported to monitor the quality of to provide feedback via the 25 30 8 performance mechanisms outlined in this 31 20 9 report. NHS Dumfries and 34 4 8 16 The preliminary report indicated Galloway looks forward to hearing 15 23 24 that while we were compliant with from you. 10 21 19 19 our obligations there were some 14 13 12 areas of our process which would 5 9 benefit from review and eighteen 0 recommendations were made.

Jul 2015 Apr 2015May 2015 Jun 2015 Aug 2015 Sep 2015 Oct 2015 Nov 2015 Dec 2015 Jan 2016 Feb 2016 Mar 2016

32 33 and Improvement Service Developments

Maureen Quality and Stevenson Patient Safety and Improvement Patient Safety Manager Improving Health Maureen is a Speech and Language Therapist by Developing a culture of and clarity on how we manage the Maternity Services introduced profession and has worked transitions of care for our patients, earlier scans and worked with safety and reliability is in the areas of Clinical a long term ambition for example between primary expectant mothers to reduce and secondary care and between smoking during pregnancy. This Governance, Risk and for NHS Dumfries and teams. has resulted in a reduction of the Galloway that requires risk of low birth weight babies. Improvement for many us to attend to how we Over the last nine years we have years. Screening Health Protection and manage, plan, how we demonstrated that we can make The Mental Health programme deliver and support staff. improvements in the quality and worked closely with patients to safety of key healthcare processes. reduce personal risk and anxiety As Patient Safety and Spreading improvements through during hospital admissions. They The Scottish Patient Safety Improvement Manager wards, units and services across developed a safety climate survey Programme launched in 2008 the Board has been more for patients which has helped staff Maureen and her team now incorporates work to reduce challenging. and patients to understand the provide programme harm and improve reliability of factors that make patients feel safe care in: management support to Sustaining that improvement in hospital. and embedding it into day to day Patient Safety Programmes • Acute care practice is our ultimate ambition • Maternity and paediatrics across the organisation Patient Experience and we remain committed to this • Mental health process. as well as developing • Primary care improvement capability in Phase two of the Acute Adult Over the last year we have worked the workforce. Safety Programme ended in March to integrate work with medicines and we have made significant management, pressure ulcers, improvements in eradicating falls and infection prevention infections in intensive care. We across all programmes to improve have also improved the way we integration of care processes identify and manage patients around the patients’ journey. whose condition deteriorates. This has contributed to a Weekly leadership walk-rounds Safety Quality and Patient continued reduction in the NHS help keep leaders connected Dumfries and Galloway hospital to frontline staff creating an standardised mortality ratio which atmosphere of understanding has reduced by more than 16% and a commitment to continuous since 2008. improvement. Primary care GP teams have Building the foundations of a improved the processes they safety culture sits alongside the use to manage medicines need for an infrastructure to deliver and they are now focused on real improvement. This includes reducing complications from developing Quality Improvement drug interactions. This means (QI), capacity and capability; an educating patients about what to effective measurement system do if they have a stomach upset to report and monitor progress, which can interfere with how programme management, medicines work. effective communication plans

34 35 Volunteers and Fundraising and Staff Awards and Our Year in Pictures Staff Retirements and Involvement Donations Achievements New Starts 37 Our Year in Pictures 50 in Pictures Our Year Celebrating Excellence 49 Excellence Celebrating Fund Raising & Donations 40 & Donations Raising Fund Volunteers & Involvement 38 & Involvement Volunteers Staff Awards and Achievements 45 Achievements and Awards Staff Staff Retirements and New Starts 57 New and Retirements Staff Achievements 36 Involvement Volunteers and

North West Resource Centre Volunteers Volunteers and Celebration Building Healthy Communities held a Volunteer Celebration Day in December 2015 at the North West Resource Centre in Dumfries. Donations Fundraising and Involvement The event aimed to give volunteers the opportunity to showcase the wide variety of activities they enjoy and to share Local Volunteers on Blood Bikes Funds Boost the positive effect taking part in award winning team them has had on their lives. In February, the Endowment Five local volunteers were part Trustees, granted the life-saving of the team of 300 that won charity, Dumfries and Galloway the British Medical Journal’s Blood Bikes, £22,250 to buy new Creative Communities’ Women’s Health Team of the motorbikes. Artwork Celebrated Achievements Staff Awards and Year Award at the Park Plaza Hotel in London in May. Participants and staff from NHS Building Healthy Communities and Dumfries and Galloway Council’s Community Learning and Development Service gathered at the North West Resource Centre in March to celebrate the installation of five art panels. Our Year in Pictures

Cooking up a Healthier Tomorrow at Wigtown Primary

From January to February, parents and pupils from Wigtown Primary completed a six-week after school programme which combined Go4It! and Let’s Cook. New Starts Staff Retirements and

Inkspirations Book Gallimaufry is a collection of every Wednesday at the North Launch lyrical ramblings produced by West Resource Centre. For six members of Inkspirations, a further information about the November 2015 marked the writing group started by NHS group or how you can join in launch of A Gallimaufry of Dumfries and Galloway’s Building please contact Carolyn Watson, Poems and Short Stories at the Healthy Communities team. Community Health Support North West Resource Centre in Worker on Dumfries 279 279 or Dumfries. The Inkspirations group meets email [email protected].

38 39 Involvement Volunteers and

Caroline Sharp Fundraising and Workforce Director

Caroline Sharp is Donations Fundraising and Donations responsible for the design, development and effective implementation of our workforce strategy covering Human Antenatal Quiet Room Gemma Leadbetter Resource policy and Sands Runs the Marathon practice, Organisation Development, culture Sands funded a complete NHS Dumfries and Achievements Staff Awards and refurbishment and redecoration Galloway’s Senior and values, and staff of the antenatal clinic’s Audiologist Gemma health and wellbeing. As counselling room Leadbetter swapped her blue tunic for trainers a professionally qualified when she tackled the HR practitioner and London Marathon business coach, Caroline to raise funds for the Dumfries and Galloway is highly experienced Hard of Hearing Group in key areas of people strategy, communications, stakeholder engagement, Our Year in Pictures workforce governance, culture and organisation Diabetes Centre Donation development and programme management. The third annual Tommy Rutherford Memorial Snooker Tournament raised over £400 for the Diabetes Centre for the Dose Adjustment For Normal Eating

(DAFNE) New Starts Staff Retirements and Gideon Bible Donation

NHS Dumfries and Galloway’s Spiritual Care Lead Ewan Kelly and Chair Penny Halliday were presented Donation in Memory of with a donation of Gideon Bibles by Donald Boyes Hugh Brewster

Maire Flaherty from Ward 8 recently accepted a donation of £400 from the Solway Vehicle Enthusiasts Club in memory of Donald ‘The Duck’ Boyes.

40 41 Involvement Volunteers and

Midpark Bench Donation

Superheroes raise funds Wendy Jumps for Motor Cycling the John Muir Mrs Judith Pierro (seated), for Cash4Kids Neuron Disease Way her brother and sister in law - who donated a bench to Cree Ward in memory of Staff in the administration In June, Lead Clinical Pharmacist Nurses Ricky Henderson Mrs Pierro’s late husband corridor at Dumfries and Wendy Ackroyd performed an (pictured), Martin McKeown and Ricardo Italo Pierro - with Galloway Royal Infirmary spent 11,000 feet tandem skydive Nigel Wilson cycled 134 miles Senior Charge Nurse, Linda Donations Fundraising and a day dressed as superheroes to raise funds for the Motor from Helensburgh to Dunbar McDougal and Charge in aid of South West Sound FMs Neurone Disease Association along the John Muir Way to raise Nurse Margaret Hollinger. Cash4Kids funds for the Queen Elizabeth Spinal Unit

Speech and Language Run4Health

Staff from Speech and Language took part in the

Run4Health, raising money Achievements Staff Awards and Chest Heart and Stroke Scotland (CHSS)

Hairy Haggis Marathon

Advanced Nurse Practitioners Susan Burnie, Susan Walden, Juliet Forsyth and Martin CASS, STARS and ARC Mckeown ran the Hairy Haggis Our Year in Pictures Mud Rush Marathon in Edinburgh in May to raise money for FEAT, the sepsis awareness charity Staff from Care and Support Service (CASS), Short Term Assessment Reablement Service (STARS) and Activity and Resource Centre (ARC) and their friends and family ran, crawled and climbed around Scotland’s largest mud filled assault course

at Craufurdland Castle New Starts Staff Retirements and

Tough Mudders Raise Funds for Sands

Midwifery staff from Dumfries took the Tough Mudder challenge at Drumlanrig Castle to raise funds for local stillbirth and neonatal death charity, Sands

42 43 Involvement Volunteers and

Painting Donation to Cree Staff awards and Ward

Mrs Myra Crighton, pictured with Dr Fraser Gibb and nurses Linda McDougal and Laura Crosbie,

donated a picture of Cree Basin Donations Fundraising and to Cree Ward Midpark in memory Achievements of her late husband Mansell who was the artist.

UNICEF UK Baby Friendly Accreditation

NHS Dumfries and Galloway Achievements Staff Awards and Health Visiting Service was awarded the prestigious UNICEF UK Baby Friendly Initiative Accreditation and was the latest UK health care facility to win international recognition from UNICEF (United Nations Children’s Fund)

Children in Need Natural Births Highest for

Fundraiser 20 Years Our Year in Pictures Colleen Wins National Ramblers Scotland IPad Caroline Doidge, Lynda Wallace, NHS Dumfries and Galloway’s Mary Little (the retired founder maternity service team Award Winner of the Ward 15 Children in Need celebrated the success of its Day) Janet Crawford and Fiona person-centred approach to the Assistant Management Consultant in Anaesthetics Quinn raising funds for Children care of women and babies which Accountant Colleen Bowthorpe James Neil was the lucky winner in Need resulted in the highest rate of was presented with the national of the Ramblers Scotland Medal spontaneous births in Scotland in prize for the best overall Routes NHS Challenge 20 years performance in the Certificate level of the Audit and Assurance exam New Starts Staff Retirements and Our Caring Hero

Nurse Liz Grieve was named Funds Boost for Walking Our Caring Hero at an awards Away from Diabetes ceremony in Glasgow Programme Eat Safe Award for The Stewartry Diabetes Support Thornhill Hospital Group presented a cheque for £1125 to the Dalbeattie Diabetes Thornhill Hospital was awarded Centre on Friday 15 January. the Eat Safe Award in May

44 45 Involvement Volunteers and

Dr Pete Laboratories Gain first ISO Accreditation in Armstrong Scotland Consultant in Our Haematology and Blood Transfusion was the first

Emergency Medicine Donations Fundraising and of Scotland’s Health Board laboratories gain accreditation and Foundation from International Standards Organisation (ISO) Programme Director

Pete is responsible for Robert Joins Elite foundation trainees in NHS Athletes Club Sheena is a Diabetes Success for Dementia D&G. Nationally, he serves Theatre Nurse Robert Morrow Champion Specialists as a clinical advisor to joined an elite group of the NHS 24 Core Clinical Achievements Staff Awards and endurance athletes when he Sheena MacDonald, Specialist Three senior nurses from took part in the Bob Graham Dietician with the Diabetes and NHS Dumfries and Galloway Group, helping to reshape Round completing a 66 mile, Weight Management Team, is were recently recognised for and streamline the NHS 24 27000 ft circuit of 42 of the one of only 20 Diabetes UK Local completing the prestigious highest peaks in the Lake District Clinical Champions Dementia Specialist clinical contact process. Improvement Leads Programme. He is the lead clinician They received their certificates at a graduation event which in the development and took place during the National implementation of NHS Conference for Dementia D&G’s MeetED campaign, Champions and Dementia encouraging appropriate

Specialist Improvement Leads Our Year in Pictures at Murrayfield in Edinburgh in use of the Emergency March. Department, promoting Specialist Nurse Practitioner, patient education and Lorraine Haining, Senior Charge supporting staff, directing Nurse Linda McDougal and Charge Nurse Donna Tran patients to the most (below: pictured left to right) appropriate source of were among 30 graduates who completed the programme healthcare advice. which is designed specifically for nurses working in specialist New Starts Staff Retirements and mental health services for people with dementia.

Praise for pregnancy mental health

Kirsty McColm and Justina Ritchie championed an initiative aimed at promoting mental wellbeing among pregnant women and new mums. Their efforts were praised in an influential National Society for the Prevention of Cruelty to Children (NSPCC) report.

46 47 Involvement Volunteers and

Important National Role primary and social care despite approach that will reduce clinical for Medical Director the workforce challenges. In variation, avoid waste, explain Angus Cameron order to survive general practice risk and take greater note of will have to become multi- informed patients’ preferences – disciplinary, with collaboration all designed to offer healthcare Celebrating between practices (in clusters) that is of greater value to that will allow for the provision of patients. a greater range of services. The strategy will be implemented The links to social work will be over the 2016 / 17, with probable Donations Fundraising and crucial and should be progressed significant change in the by Integration Joint Boards. configuration of hospital services. Excellence The strategy notes that our Failure to increase resources to acute hospitals contain many primary and community care, patients who do not need to be and failure to progress significant there – and so calls for more change in secondary care, will intermediate care designed result in an extremely expensive to provide health and social healthcare system, supported by support to avert the needs for massive locum spends, which admission, and in particular to will not offer the care quality that assist in eliminating discharge is possible.

delay. Every day approximately Achievements Staff Awards and 1,600 hospital beds across Scotland are occupied by Since April last year, Medical patients who have been Director, Angus Cameron, has assessed as medically fit for been seconded on a half-time discharge. basis to work with Scottish Government on a new National The strategy also calls Clinical Strategy. The remit has Chairman’s Award - John Knox Employee of the Year Education, Team of Year – Ward 6 Surgical for continued progress been a challenging one – to set Mentoring and Support Award - Assessment Unit, Ward 7, Accident in improvement work to out a politically acceptable and Laura Ross and Emergency and Ward 7 make secondary care more achievable strategy that seeks clerkesses efficient – particularly in

to help address the significant Our Year in Pictures relation to theatre usage, pressures that we are facing; out-patients, and the use of namely the demographic change IT. But more controversially from people living longer, the the strategy describes the increased burden of long-term extensive evidence that we conditions, and in the elderly, can get better outcomes the loss of independence that for patients by having fewer follows and results in significant in-patient units, with each frailty. seeing a larger number of patients, and providing Add to that the persisting health more highly specialised Cleanliness and Infection Improvement to Care and Service - Volunteer of the Year Award - Hard inequalities in Scotland, the services. This prompts a new Prevention Winners Laura White Susan Coull of Hearing Group

severe and worsening workforce New Starts Staff Retirements and approach where we should and Intensive Care Unit challenges, the financial be planning on a population constraints, increasing costs of basis rather than a Health new medicines and ever higher Board basis, and aiming to public and political expectations, have clinical networks of and it can be seen that the role hospitals. was a challenging one. And lastly, the Strategy calls After an extensive range of for realistic medicine – an clinical engagement meetings across all parts of Scotland, a strategy was produced and published in February. It calls for a determined push to expand Creativity and Innovation - Dalveen Patients Award - Helen Coles Working Together in Partnership - Enhanced Wing Nursing Team Naloxone Lead Team

48 49 Involvement Volunteers and June Our Year in #Hellomynameis Campaign Comes to Dumfries

Over 150 health professionals and students gathered at Easterbrook Hall in June to hear Donations Fundraising and Pictures Dr Kate Granger MBE talk about her internationally renowned #hellomynameis campaign. April May

HIV Home Test Kit International Nurses Day Queen of the South visit Stranraer Self-test kits for HIV that give an As part of Dumfries’ Guid instant result went on sale legally Senior Charge Nurse Gwen Nychburris, the Queen of the in Scotland for the first time in McGowan from the Galloway South, attendants, cornet and Achievements Staff Awards and April. Community Hospital cut a cornet’s lass visited patients at cake to celebrate International Dumfries and Galloway Royal Nurses’ Day on Tuesday 12 May, Infirmary the anniversary of Florence Nightingale’s birth

Meaningful Integration Event July Our Year in Pictures Physio Upgrade at Over 150 practitioners, Critical Care Handbook Galloway Community volunteers, managers and Hospital leaders from the NHS, Council, Published (August) Third and Independent The physiotherapy treatment room Sectors attended the Building Fanus Dreyer and David Ball at Galloway Community Hospital Valued Relationships: Enabling edited a Critical Care Handbook was been upgraded to reflect the Meaningful Integration which has the potential to quality requirements in patient Conference at Easterbrook Hall transform surgical critical care in care. in May. Sub-Saharan Africa and other low income regions New Starts Staff Retirements and August Hospital Tree Planting Marks Service Success

Planting schemes were carried out in the grounds of local hospitals, including the Galloway Community Hospital in Stranraer, to mark the environmental benefits of a redesigned pattern of home deliveries for patients in Dumfries and Galloway.

50 51 Involvement Volunteers and August November

Health Minister Visits 25 Years of Dialysis in Dumfries and Galloway Dumfries Royal Infirmary Monday 2 November 2015 was Health Secretary Shona Robison an important anniversary in MSP visited Dumfries and the treatment of kidney failure Galloway Royal Infirmary in in Dumfries and Galloway. It Donations Fundraising and August when she met staff and marked exactly 25 years since issued guidance to health boards Dumfries and Galloway Royal for winter 2015 / 16. Infirmary began providing dialysis locally, saving patients the 150 miles round trip to Glasgow or Edinburgh three times a week for treatment.

The Pulmonary Rehab September Team is transforming lives across the region Achievements Staff Awards and Modern Apprentices The team provides a specialised Welcomed assessment and personalised exercise programme designed NHS Dumfries and Galloway to teach people how to manage welcomed 16 young people long term conditions which to its Modern Apprenticeship affect their breathing. programme in September. Our Year in Pictures

October Exercise Basepoint NHS Dumfries and Galloway Infection Control Public staff tested their responses Involvement Group to an emergency situation in November during Exercise Basepoint. Around 80 NHS staff, Anne Dale, a member of supported by colleagues from the Infection Control Public New Starts Staff Retirements and the Council, Police Scotland and Involvement Group, was one Scottish Ambulance Service, took of the volunteers supporting part in the exercise when they International Infection Prevention were called in without warning at Week in October. They provided 8.00 in the morning. information and surveyed visitors on their opinion of infection The Casualty Union provided prevention and cleanliness almost 40 mocked up casualties standards in Dumfries and with extremely realistic injuries Galloway Royal Infirmary. who arrived at the emergency department of Dumfries and Galloway Royal Infirmary over a four hour period to fully test the preparation and resilience of staff and planning arrangements.

52 53 Involvement Volunteers and

Exercise Basepoint - continued December Macmillan feel good morning

The Macmillan Cancer Information and Support Centre at Dumfries and Galloway Royal

Infirmary hosted a free Feel Good Donations Fundraising and morning, for people who have been diagnosed with cancer, in December.

January Achievements Staff Awards and NHS is Carer Positive

NHS Dumfries and Galloway was recognised as an employer that supports Carers in the workplace in January when the Board was awarded Carers’ Scotland’s Engaged Carer Positive status. Our Year in Pictures

February Raising Dementia Awareness at Midpark New Starts Staff Retirements and In February NHS Dumfries and Galloway and University of the West of Scotland (UWS) joined forces to host an event to raise awareness of dementia and the challenges faced by people living with the condition.

54 55 Involvement Volunteers and February Welcome to the New Nurse Staff retirements Director

Eddie Docherty joined NHS Dumfries and Galloway as Nurse Director in February. and new starts Donations Fundraising and

NHS Dumfries and Galloway Kirsteen Paterson welcomed new Nurse Kirsteen joined NHS Dumfries and Director Eddie Docherty in Galloway’s Sexual Health Team as 2016. an administrative support officer in June. Before joining the team

March Achievements Staff Awards and Support National Self-Harm Awareness Day

Local people were asked to support National Self Harm Awareness Day which took place on Tuesday 1 March Our Year in Pictures Eddie started his training in Kirsteen enjoyed a 26 year career Lanarkshire in 1988 and qualified in with Dumfries and Galloway 1991. His career has taken him to Constabulary, now V Division of hospitals across Scotland including a Police Scotland. She joined the secondment to Orkney as Associate force in an administrative role Nurse Director. supporting the force training department and continued In addition to his extensive hands on into recruitment and personnel experience Eddie also has a London roles. Kirsteen also carried out University diploma in nursing, a BA a secondment to the Lockerbie from Strathclyde University, a post Air Disaster Trial Planning Team graduate diploma from Glasgow and a three month posting to the New Starts Staff Retirements and University and an MSc from the Scottish Court at Kamp van Zeist in University of Edinburgh. He has just the Netherlands. In 2001 Kirsteen completed a post graduate certificate joined the Police Area Control in teaching and learning in higher Room as a Controller where she education and he’s a Scottish Patient handled 999 and non-emergency Safety Fellow. calls and assisted operational officers using the Airwave radio Eddie said: “I am very pleased to system. join NHS Dumfries and Galloway and particularly at this time of great When asked about her new role change. The integration of adult with NHS Dumfries and Galloway health and social care is a mammoth Kirsteen said: “My control room task but the strong links between the role was centralised in 2014 and NHS, Council, third and independent I took a temporary post with the sectors in the region means we are project team implementing the starting from a good place.” new National Police Promotion

56 57 Involvement Volunteers and

Process. This was an interesting “I applied to be an MA because Tiffany Copland Natalie Morel “Throughout my career it has been role which encouraged me to it gives me the chance to work really important to me that I work seek a new challenge where I train for a qualification at the same for organisations with a strong could apply my existing skills while time. In Primary Care I work with values based approach to staff, I developing new ones. doctors, dentists, opticians and think it is a great time to be with pharmacists to sort out disclosures NHS Dumfries and Galloway when “I am really pleased to be a part of and their applications to join the it is beginning to embrace CORE the Sexual Health Team who have NHS. It would be great to stay for a values and engage with staff about been very welcoming. The support second year if I get the opportunity how they deliver this in practice of my new colleagues has made but I would consider college and every day. Donations Fundraising and my transition to the NHS very easy I’d still like to be a nurse or maybe which was quite daunting having work on the post mortem side of “In my current role I get to be with worked with the police for such a things.” an amazing group of colleagues long time. The variety of work I who really care about the staff undertake is refreshing and I enjoy Jake Stokoe Former Kirkcudbright Academy pupil, Natalie joined the Workforce I know that has such a positive the challenges it brings.” 18 year old Tiffany Copland works Directorate as Workforce impact on patient care. Being in as part of the administrative team Development Partner in April 2015. Dumfries and Galloway means Modern Apprentices supporting the Nursing Directorate. Before joining NHS Dumfries and I can also indulge my passion She’s on track to achieve a Level 2 Galloway Natalie had a varied for wildlife in a variety of ways One way of starting a career in SVQ in Administration. Tiffany said: “I career which saw her working in from supporting red squirrel the NHS is to join as a Modern work for Alice Wilson (Deputy Nurse London and the Highlands and lots conservation to watching kites

Apprentice (MA). Being an MA Director) answering her phone and of places in between. and ospreys. It is such a great Achievements Staff Awards and means you get a job, a wage and other admin tasks. place to live and work.” a qualification. NHS Dumfries and She’s worked in drug services, Galloway recruits a new cohort of “My job is varied and I help book policy development and equality Farewell to... MAs every year, many of whom training courses for nurses. I also get and diversity so she brings a wide go on to complete a second year to go to the wards with the clinical range of skills to the organisation. Consultant Dermatologist before finding a permanent job educators where I help facilitate In her spare time Natalie enjoys John Norris (right) retired from with the organisation. 20 year old Jake Stokoe already short training sessions for nurses. It’s live music, reading and spending his post in April after 27 years of has a BTEC Level 3 in IT. He works good to get out and about and I’d be quality time with her family, she is treating patients across Dumfries In October 2015, 19 MAs joined in the Payroll Department where happy to stay if I can. Eventually I’d a campaigner for gender equality and Galloway. NHS Dumfries and Galloway to he’s undertaking a Level 2 SVQ in like to be a big boss like Alice.” and supports animal conservation. begin the first year of their Scottish Business Administration. Jake said: Alison Burns, (right) General Our Year in Pictures Vocational Qualification (SVQ), Natalie said: “Working across “My mum works for the NHS in Manager of the Primary and specialising in one of several areas, the UK I have had some great the eye department so I’ve always Community Care Directorate, including Business Administration. opportunities to work in new heard good things about the retired in August 2015 after 28 and innovative ways, and I have organisation.” years service. to say I was really surprised by the incredible art and culture in Mickie Carruthers “I’m enjoying the work and it’s In September, the Workforce Dumfries and Galloway. Spring great to know I am working for a Directorate and colleagues from Fling was a revelation. I am excited Mickie is 18 years old and qualification whilst doing my job. across the Health Board came that the arts are being embraced previously worked in a travel Payroll is a good place to work together to say farewell to and I get to use my computer by the new hospital change agency. She is working towards John Glendinning, (below) skills. The staff have been very project and I’m looking forward to her SVQ Level 2 in Administration who was a familiar face for almost supportive and I would be very being involved. with Primary Care Development. 30 years. New Starts Staff Retirements and Mickie said: “I have always been happy to stay for a second year if interested in the NHS and when I can. My dream job would be to I was about six I wanted to be a have a future working within the nurse. NHS.”

58 59 Standards HEAT Targets and Board Members Performance Annual Review Letter HEAT Targets and Standards 62

Boards Members 64

Annual Review Letter 65

Volunteers & Involvement, Fund Raising & Donations 17

Staff Awards and Achievements 17

Scottish Ambulance Service Our Year in Pictures 17

staff retirements and new starts 17

60 61 Standards HEAT Targets and

Katy Lewis HEAT Targets Director of Finance

In her position as Director Board Members and Standards of Finance Katy Lewis makes the books balance NHS boards are required to monitor and report performance against these key for the whole organisation HEAT targets and standards, and are summarised in the table below. – which is no small challenge in these times Health Improvement Actual Planned Data Date Status of austerity. She provides Smoking Cessation (40% most deprived SIMD) 167 353 14 / 15 Amber professional guidance, leadership and financial

Detect Cancer Early 26.1% 24% 14 / 15 Green Annual Review Letter management on capital Antenatal Access 84.5% 83.50% 15 / 16 Green and revenue investments, Efficiency and Governance Improvements makes sure we make the Financial Performance (£000s) 61 - Mar-16 Green best use of scarce clinical and non-clinical resources 2 Reduce CO2 Emissions (kg CO2/m ) 111.4 116.9 Mar-16 Green and supports other Reduce Energy Consumption (kWh/m2) 448 455.5 Mar-16 Green directors to get maximum health gain and best value Access to Service for money. Faster Access to Mental Health Services 97.7% 90% Jun-16 Green (CAMHS) Katy is a member of the Faster Access to Psychological Therapies 73.40% 90% Jun-16 Red NHS Board’s Management IVF Waiting Times 100% 100% Jun-16 Green Team, supporting decision making processes for the 4 Hour Accident and Emergency 95.1% 95% Aug-16 Green Waiting Times organisation and providing corporate leadership. Treatment Appropriate to Individuals She is also Chief Finance MRSA/MSSA Bacteraemias 0.24 0.24 Mar-15 Green Officer for the Integration Joint Board. C.Difficile Infections ages 15+ 0.37 0.32 Mar-15 Red Emergency Bed Days 4,609 4,274 Mar-16 Amber for 75+ per 1000 population Delayed Discharge (14 days) 23 457 Jun-16 Red

NHS Dumfries and Galloway publishes its full annual accounts on the website at:

http://www.nhsdg.scot.nhs.uk/About_Us/Publications

62 63 Standards HEAT Targets and Board Members Annual Review at 31 March 2016

Letter Board Members

Cabinet Secretary for Health and Sport Shona Robison MSP Chairman, Vice Chair, Chief Executive, Medical Director, T: 0300 244 4000 Philip N Jones Penny Halliday Jeff Ace Dr Angus Cameron E: [email protected] Annual Review Letter

Mr Philip Jones Chair NHS Dumfries and Galloway Crichton Hall Bankend Road Dumfries DG1 4TG Nurse Director, Director of Finance, Local Authority Employee Director, Eddie Docherty Katy Lewis Representative, Jim Beattie 31 October 2016 Councillor Ronnie Nicholson

NHS DUMFRIES & GALLOWAY: 2015/16 ANNUAL REVIEW

1. This letter summarises the main points and actions in relation to NHS Dumfries & Galloway’s Annual Review, held in Dumfries on 28 September. Chair, Area Non Executive, Non Executive, Non Executive, Clinical Forum, Lesley Bryce Robert Allan Grace Cardozo Moira Cossar 2. As you know, I want to ensure the rigorous scrutiny of NHS Boards’ performance whilst encouraging as much direct dialogue and accountability between local communities and their Health Boards as possible. As one of the Boards that did not have a Review chaired by a Minister this year, you conducted the Review meeting in public on 28 September. You clearly outlined progress and challenges in key areas and gave local people the opportunity to question yourself and the Chief Executive. I asked Government officials to attend the Annual Review in an observing role. This letter summarises the main points and actions in terms of NHS Dumfries & Non Executive Non Executive Galloway’s performance in 2015/16. Member, Gillian Member, Laura K Stanyard Douglas

64 65 Standards HEAT Targets and Board Members Introduction and opening comments exercising rigorous management actions to mitigate the risks moving forward and ensure that all stages of the pathway 3. As in previous years , all Boards are expected to are completed as quickly as possible to ensure achievement submit a written report to Ministers on their performance of standards and targets. The Access Support Team will over the previous year, together with plans for the remain in close touch to monitor performance and offer forthcoming year. This self-assessment paper gives a support where necessary. detailed account of the specific progress the Board has made in a number of areas and is available to members of 12. A number of Health Boards across Scotland have the public via the NHS Board’s website, alongside this letter. I struggled to meet and maintain the 4-hour A&E waiting Annual Review Letter understand that the Area Clinical Forum and Area Partnership target over the last 2 years. However, NHS Dumfries & Forum opened the meeting by presenting a helpful summary Galloway is to be commended again for performance of their involvement in Board decision making on key areas in 2015/16 that has consistently been at or above 95%, throughout the year including: the challenges facing the despite an increase in activity over the period. Performance Board in the recruitment and retention of staff across a against patients who are clinically ready for discharge from number of areas, the clinical services change programme, hospital to more appropriate homely settings continues the redesign of mental health services for elderly mentally ill, to be amongst the best in Scotland and I commend the health and social care integration and staff engagement and Board’s commitment to the complete eradication of any development. I am pleased to note of the support from both delays. The Board is also to be commended for its sustained for the National Clinical Strategy and the CMO’s report on achievement against the 31-day and 62-day cancer access Realistic Medicine. standards.

10. The Healthcare Environment Inspectorate (HEI) was Health and Social Care Integration set up by the former Cabinet Secretary for Health and Wellbeing with a remit to undertake a rigorous programme 13. The NHS Dumfries and Galloway Health and of inspection in acute hospitals. During 2015/16, the HEI Social Care Integrated Joint Board went live on 1 April carried out an unannounced inspection at Dumfries & 2016. I understand that the Partnership has established its Galloway Royal Infirmary. The Board has given me the governance committees, approved its regional and locality assurance that all the requirements and recommendations strategies and is now in the process of developing detailed identified as a result of their inspections. implementation plans to support the delivery of strategic priorities identified through the commissioning process, Improving Access - Waiting Times Performance to support the implementation of the Partnership’s key areas of focus over the next three years. I welcome the 11. NHS Dumfries and Galloway has historically positive approach to public and community involvement in performed very well against the suite of elective waiting developing these plans. time standards. During 2015/16, the Board met the 18 weeks Referral to Treatment Target but fell short on the 12 week Finance Treatment Time Guarantee due to capacity pressures during the winter months. The Board has also experienced pressure 14. It is vital that NHS Boards achieve both financial in capacity in diagnostic services and in sustaining the stability and best value for the considerable taxpayer Out Patient 12 week performance. I note that the board is investment made in the NHS. I am therefore pleased to note that NHS Dumfries & Galloway met its financial targets for 2015/16. Clearly, overall economic conditions

66 67 Innovations Tech Advances and Integration mean that public sector budgets will continue to be tight whilst demand for health services will continue to grow. Nonetheless, you confirmed that the Board continues to actively monitor the achievement of all local efficiency The Future programmes and, whilst the position is challenging, NHS Dumfries & Galloway remains fully committed to meeting its financial responsibilities in 2016/17 and beyond.

Tech advances and Innovations 70 New Hospital ANNEX Integration 72 NHS DUMFRIES & GALLOWAY ANNUAL REVIEW 2015/16 MAIN ACTION POINTS New Hospital 74

The Board must:

• Keep the Health Directorates informed of progress with its significant local health improvement activity

• Continue to review, update and maintain robust arrangements for controlling Healthcare Associated Infection

• Continue to deliver on its key responsibilities in terms of clinical governance, risk management, quality of care and patient safety, including a prompt and effective response to the findings of HEI and Older People in Acute Care inspections

• Keep the Health Directorates informed on progress towards achieving all access targets

• Continue to work with planning partners on the critical health and social integration agenda

• Continue to achieve financial in-year and recurring financial balance

• Keep the Health Directorates informed of progress with redesigning local services in line with the Board’s clinical strategy

68 69 Innovations Tech Advances and

Graham Gault Tech advances General Manager Information, Communications Integration and innovations and Technology

Graham Gault has an When it opens in 2017 In conjunction with this important integral part to play in the new District General work we have also managed driving NHS Dumfries and Hospital will be the most a number of eHealth projects designed to reduce inefficiencies Galloway’s digital strategy. technologically advanced and improve patient experience His department manages digital hospital in Scotland. including: a number of eHealth New Hospital The new digital hospital will rely • An electronic ordering system projects designed to reduce on technology as an integral and will support safer, quicker and inefficiencies and improve fundamental part of its business more convenient ways to request strategy enabling NHS Dumfries diagnostic tests. patient experience. In the and Galloway to deliver high last 12 months he has led his quality care in increasingly efficient • The Hospital Electronic ways. By integrating IT, medical, Prescribing and Medicines team to overcome a range communications and building Administration (HEPMA) will ensure of challenges around the technologies we are creating a medicines management is safe development of the new hospital which goes far beyond and manageable. any advanced clinical systems digital hospital. It is thanks to currently in place. • All areas of the new hospital will their hard work that, when it have strong wireless signal offering Over the last year we have secure and public internet access. opens in 2017, NHS Dumfries addressed a number of challenges This will also support good and Galloway will have the to development of the new clinical communication as well as most technically advanced digital hospital including distinctly providing TV and communications different systems with multiple for patients. hospital in Scotland logins and administrative issues such as inefficient data capture • The patient administration Preparations for moving to and significant time spent on system is linked to the emergency the new hospital also meant paperwork. We have created a department system to remove developing a local network that In 2015 alone NHS Dumfries and Galloway digital archive for patient records communications barriers and can securely connect over 3000 can report: and produced electronic forms streamline the patient journey. staff who will be based at the new to replace paper notes. This has hospital, in community hospitals • Electronic referrals to our Hospital 74,000 meant finding new ways to input • A new PORTAL of clinical across the region and at Crichton data more efficiently and more Information where staff will Hall. • Electronic Inpatient Clinical Observations 400,000 efficient ways to present all patient be able to review and update • Electronic discharge letters 14,000 information. Adoption of ePENS, information from a single screen We are already conducting a • Clinical documents created electronically 1.92m tablets, flexible form design from many underlying clinical great deal of day to day business • Electronic x-ray and laboratory results 1.6m software and advanced scanning IT systems, anywhere across using electronic methods as the techniques we are overcoming Dumfries and Galloway. following figures show. • Electronic orders placed 105,000 the age old challenge of capturing • Electronic ePEN forms submitted 840,000 data in real time. • Electronic documents sent to GPs 256,000 • Electronic medical charts created 2305 • Scanned documents (2014-2015) 50m (cumulative) • Accident and emergency 38,000 electronic patent notes created

70 71 Innovations Tech Advances and

Julie White Integration Chief Operating Officer

A new Health and Social to meet local identified needs. who use health and social care Julie White is a creative, Integration Care Partnership for We are the only partnership in services. innovative and very Dumfries and Galloway Scotland which has chosen to integrate the entirety of our Acute It sounds complicated, what’s busy Chief Operating Services alongside primary care, your timescale? Officer who has overall mental health, community based services, social work and social - It is complicated but it certainly responsibility for helping care services within an Integration isn’t impossible, we have a strong staff to deliver the highest Joint Board. A sustainable future record of working in Partnership for health and social care requires in Dumfries and Galloway and levels of operational transformational change. We this new Partnership will build on performance. She believe our chance of success is the foundations which have been

also leads the team New Hospital vastly improved by encouraging forged over many years. With greater transparency of the regards to timescale I have to be delivering the Clinical pressures and demands on the clear, although we have a three Change Programme, is whole system and identifying year Strategic Plan in place the more radical solutions. Our model transformational change we need responsible for leading Legislation to implement health will help us to work together to won’t come overnight. We do all the development of the and social care integration, passed generate new ways of supporting however recognise that we must by the Scottish Parliament in region’s new acute general people using all of resources we work at pace to make sure this February 2014 came into force on have available to us. significant change is delivered for hospital and is the Chief 1st April 2016. In this interview we our region. We have all entered ask Julie White, Chief Officer for Officer for the delivery of So what’s the vision for into this partnership for the long the key facts on the new Health the Health and Social Care run and we will be building on Health and Social Care and Social Care Partnership in Partnership in Dumfries and all of the energy, enthusiasm, Integration in Dumfries Dumfries and Galloway. Galloway? experience and ideas that have and Galloway. been used so far. Why do we need a Health and - Our Partnership’s vision is quite Social Care Partnership when clear, it’s ‘Making our communities How will you know that the we already have the NHS and the best place to live active, safe Partnership is getting it right? Council? and healthy lives by promoting independence, choice and - Although we have a Strategic I am committed to involving - Like all other health and social control.’ Plan with a Performance the public at every level in the care systems, we have been faced Management Framework that planning and delivery of this new with increasing demands against So what has happened in the last sets out our Key Performance Partnership across Dumfries and our limited resources. We need year? Indicators I am clear through our Galloway. to develop new ways of working commitment to participation and which will result in better health - The Partnership was officially engagement that the public and What’s your number one priority? and wellbeing in our communities established on the 1st April communities across localities will and an improved experience for 2016 with the formation of an tell us what we are doing well and - My number one priority for people who use our service and Integration Joint Board which has where we need to improve. Dumfries and Galloway Health and their families. members from the Council, NHS Social Care Partnership is simply to and our Partners. This is where the There are few short cuts or ‘magic improve the health of the region’s Health and Social Care integration key decisions that will shape our bullets’ that will ensure success population and to ensure that we is our opportunity to ensure that future services will be taken. from integration. We need to have the right support in the right the future looks significantly work with and for our local place at the right time to meet different. Our model in Dumfries In preparation for going ‘live’ with communities, building capacity the needs of the communities we and Galloway focuses on pooling the partnership we developed a and resilience and utilising the serve. our resources and expertise Strategic Plan and four Locality richness of the assets we have in each of the region’s natural Plans which set out how we plan available to us in order to jointly localities, building on assets to deliver our vision and improve develop and deliver a sustainable available in our communities to the support available to people future. design services in the best way 72 73 Innovations Tech Advances and New Hospital Integration

Construction of the new Piling and foundation works with the electricity connection district general hospital is for the wards, technical block, and gas installation now complete. energy centre, Women’s and Gas installation involved re-piping now well underway. Children’s block, and to establish a a new gas route from the Garroch construction village started shortly loaning viaduct through the thereafter. The village includes Garroch Industrial Estate. Work open plan offices, meeting rooms on the foul sewerage facility is and welfare facilities. ongoing and eventually will result in a replacement pumping station The build is made up of pre- close to the location of the original

fabricated concrete panels and one. Part of the foul sewerage New Hospital modular bathroom pods. This has rising main at Cargenbridge enabled the team to construct has been re-laid and deep well most of the exterior at a rapid pumping chambers have been pace, and with much less impact installed on the site of the new on the local community and hospital. The contract was awarded to High environment than traditional build Wood Health in March 2015 and methods. To mark the start of construction their construction partner Laing NHS Dumfries and Galloway held O’Rourke. Laing O’Rourke are Ward blocks one and two are now a ground breaking ceremony at a major construction company ready to have roofing materials the site of the new hospital. The Local suppliers and subcontractors and have extensive experience in installed, with ward block three not NHS, with High Wood Health are working with the project and developing hospitals in the UK and far behind, and the technical block and Laing O’Rourke welcomed in addition to being awarded internationally. areas are progressing through to Shona Robison, Scottish Cabinet contracts, they have taken the the second floor. Teams are now Secretary for Health, Wellbeing opportunity to attend free training working in the lower floors of and Sport to celebrate a significant workshops offered by Laing the buildings installing partitions, milestone for everyone involved. O’Rourke, covering a range of flooring and ceilings and working topics including health and safety on electrical and plumbing Community Benefits and digital engineering. Contracts fittings, and subcontractors coming up for tender in 2016 / have commenced with the Local people are benefitting from 17 include landscaping, fencing, ground works in preparation for working on the project. High bespoke joinery, road marking, soft construction of the residences. Wood Health and construction flooring and decoration. The energy centre is close to partner Laing O’Rourke have completion and has the boilers recruited to a range of roles and combined heat and power High Wood Health is on in administration, design, plants in place. The boilers schedule to meet the target construction, engineering, security have been supplied by a long date to handover to the Board in and catering. This includes established local sixteen graduates and thirty three possible are provided with September 2017. Laing O’Rourke company. apprentices. the opportunity to apply for are building the new hospital at positions suitable to their skill set, a considerable pace, and from a Over the coming High Wood Health and Laing experience and training. bird’s eye view the layout that we months the workforce O’Rourke are working in have only seen on plans and artist’s is scheduled to partnership with Dumfries impressions is now clearly visible. increase to in excess and Galloway Total Access So much has been achieved and of seven hundred staff Point (DGTAP), the Council’s the new hospital really is taking as detailed fit out is employability partners to ensure shape. underway. that as many local people as Major earthworks and preparation Enabling works for of the site started in March 2015. utilities are ongoing 74 75 High Wood Health and Laing O’Rourke have welcomed over twenty students on work experience placements, in addition to visiting local schools and hosting a construction jobs event for S3 pupils from across the region. The local college construction faculty has developed a good relationship with High Wood Health and Laing O’Rourke. This has resulted in work experience, site visits and talks on construction industry careers being made available for their students.

Preparing Staff

Work with staff to prepare for new ways of working in the new hospital is progressing well, including a change programme and workforce and transition programme. In preparation for the physical move to the new facility a Commissioning Manager is working with staff, external agencies and services, to achieve efficient transfer of equipment, followed by migration of staff and finally the safe transfer of patients in December 2017.

76 NHS Dumfries and Galloway Annual Report 2015/16

Communication Department Mid North Crichton Hall Bankend Road Dumfries DG1 4TG www.nhsdg.scot.nhs.uk

Date of publication: December 2016