North & West Sutherland Local Health Care Partnerhsip

NORTH & WEST SUTHERLAND LOCAL HEALTH CARE PARTNERHSIP

Minutes of the meeting held on Thursday 6th September 2007 at 12:00 noon in the Ben Loyal Hotel, Tongue.

PRESENT: Dr Andreas Herfurt Lead Clinician Dr Alan Belbin GP Durness Dr Marion MacDougall GP Tongue Dr Sarah Donald GP Rural Fellow Dr Dave Roberts GP Rural Fellow Dr Cameron Stark Public Health Consultant Mrs Georgia Haire CHP Assistant General Manager – Sutherland Mrs Lorraine Coe Clinical Nurse Manager Mr Bob Silverwood Highland Council Social Work Mrs Donellen Mackenzie Highland Council Social Work Ms Donalda Cook Highland Council Social Work Ms Lesley Mitchell Highland Council Social Work Mrs Sandra Sinclair Highland Council Social Work Mr Don Campbell Highland Council Social Work Mrs Sylvia Mackay N&WSCA Miss Christian Goskirk N&WSCCF Mrs Frances Arrowsmith Community Nursing Mrs Jean Maclean Community Nursing Mrs Ngaire Mingham Community Nursing Ms Elspeth Anderson Community Rehab Team Mr Simon Guttridge CPN Substance Misuse Ms Linda Forrest CHP Lead Occupational Therapist Mrs Alison Liddell Macmillan Nurse Mr Johnnie Morrison Durness Care Group

APOLOGIES: Dr Chris Duckham GP Armadale/Tongue Dr Ann Berrie GP Scourie/KLB Dr Moray Fraser CHP Medical Director Mrs Sheena Craig CHP General Manager Mr Miles Greenford Public Health Practitioner Mrs Ann Mackay CVS North Mrs Liz Baillie Highland Council Social Work Mrs Mairi Eastcroft Community Nursing Ms Lynn Twigger Community Nursing

ATTENDING: Mr David Macmillan NHS Highland Finance Mrs Fiona Duff NHS Highland Ms Fiona Macleod Caladh Sona Ms Margaret Gallagher Caladh Sona Ms Rona Findlay Caladh Sona

1. MINUTES OF THE PREVIOUS MEETING

The minutes of the previous meeting were approved.

N&WSLHP – Minutes 6/9/07 1 2. MATTERS ARSING

2.1 Paediatric Physio

Alan Belbin reported that he had met, along with local reps, with Sheila Lowther and Andrew Ward to discuss the concerns which have been expressed regarding the Paediatric Physio Service. Feedback from the meeting from Sheila and Andrew is expected.

2.2 Visits to Bases

Georgia Haire noted that a meeting had recently taken place regarding the report on the visits to the bases. A report highlighting the various items of maintenance required has been drawn up and work on that maintenance has been started.

With regards the possible re-location of the Community Rehab Team Georgia indicated that there were a number of options. She will she said be discussing these with the Team in the near future.

2.3 Airwaves Radio

Fiona Duff reported that she is to apply for a licence for the use of the Airwaves Radio. Her intention she said would be to apply for a licence which would cover all of North & West Sutherland, although there are one or two issues relating to that which she has to look into.

3. GMS

Enhanced Services

Fiona Duff reported that the Scottish Government has recently sent out a list of nine Enhanced Services. NHS Highland is at present debating whither to the final decision on which to follow should be a Highland-wide or CHP decision. It was noted though that a decision will be required soon as plans have to be with the Scottish Government by the beginning of October. The Enhanced Services will start in January ’08.

4. RECRUITMENT & RETENTION

Speech & Language Therapy

A Speech & Language Therapist has been appointed. She took up post at the beginning of September.

Consultant Psychiatrist

Andreas Herfurt stated that it was his understanding that interviews for the Consultant Psychiatrist post were to be held on 26th August, however, there was some confusion surround this as others were of the opinion that no decision re a Job Description had been made. Georgia Haire agreed to look into it.

GP Lochinver

Dr Alexander Maclean has been appointed as GP in Lochinver. He will take up post on 1st October.

N&WSLHP – Minutes 6/9/07 2 Rural Fellows

Fiona Duff introduced Drs Sarah Donald and Dave Roberts to the meeting. Sarah and Dave have been appointed as Rural Fellows and will be working in the area.

Nurse/Midwife

Jean Maclean noted that the post of Nurse/Midwife in the Tongue area is to be advertised in the near future.

5. OLDER ADULTS BUSINESS CASE (Formerly known as Care of the Elderly Review)

Sutherland Handyperson Service

In response to a question from Andreas Herfurt, Christian Goskirk and Sylvia Mackay stated that it was their understanding that the Sutherland Handyperson Service is to be funded by Highland Council Private Sector Housing Grant until the end of the financial year. This thought they understood was not in writing at present. During the time between now and then discussions are to take place regarding the future funding of Handyperson Schemes across the Highlands.

Older Adults Action Plan

Andreas Herfurt began by saying that he hoped that out of today’s meeting the LHP would come up with some sort of “Business Plan” for the way forward for care of the elderly in North & West Sutherland. Bob Silverwood stated that he would like to echo those comments. For his part he said he thought the time had come to look at more than just residential care, but to look at additional care incl. nursing care. He sighted the example of a new unit in Mull offering progressive care. It was noted that the short shelf live of Caladh Sona makes this discussion all the more crucial.

Ngaire Mingham noted that the Caladh Sona Action Group had recently been set up. She went through the reasoning behind the group in some detail and explained what it had done so far. This included visiting units in Elgin and Loch Carron and speaking to staff from a unit in Westry in Orkney. Fiona Macleod provided a brief explanation on what each of the units visited or looked at provided.

Don Campbell suggested that perhaps the LHP should be looking at care of adults and not just older adults. We should be thinking of adults with a learning disability and adults with mental health problems he said.

Andreas stated that from his point of view the meeting appeared to have reached a consensus on the type of care it wanted. While money and location were issues to be discussed they should not he felt be the issues the meeting got caught up in. This should he said look at the care that adults in North & West Sutherland need. It should reflect the needs of all parts of North & West Sutherland form Assynt to Melvich.

It was agreed that a Working Group should be formed. It should comprise: Bob Silverwood, Georgia Haire, Dr Andreas Herfurt, Dr Alan Belbin, Sylvia Mackay, Dr Cameron Stark, Jean Maclean, reps form Caladh Sona and the Assynt Centre and Reps from the Caladh Sona Action

N&WSLHP – Minutes 6/9/07 3 Group and the Assynt Centre Action Group. A meeting of the working group should be held ASAP. It will be held in Durness.

6. OUT OF HOURS

There was no new information.

Community Nurses

Frances Arrowsmith noted that the situation regarding Nursing on-call requires to be clarified. It was agreed to look into this.

7. SCOTTISH AMBULANCE SERVICE

Emergency Service

Alan Belbin noted that within the near future Kinlochbervie Ambulance will be losing a crew member leaving only two. This means that the Ambulance there will be for a large part of the time single manned. Fiona Duff asked that this information be passed on to Dr Ken Proctor who is monitoring the situation as regards the Ambulance Service.

Non Emergency Service

Sylvia Mackay noted that there still appears to be a problem with patients receiving clinic appointments out with the operating times of the Patient Transport Service. To date the Alliance has where possible supported patients by providing assistance with travel, but due to the end of its Lottery Grant it will no longer be able to do this.

8. FINANCE

David Macmillan made available information regarding the LHPs financial position for the period ending 31st July ’07. North & West Sutherland LHP was forecast to under-spend by £56,000 David went through in some detail the figures behind each of the headings.

The CHP as a whole is forecast to under-spend by £2,000 with Caithness Locality to under-spend by £101,000; East Sutherland Locality to under-spend by £1154,000; Caithness Acute to overspend by £202,000; Management to overspend by £40,000 and Marie Curie to overspend by £67,000.

9. PRESCRIBING

Fiona Duff reported that it was her understanding that the post of Lead Pharmacist for the CHP and Prescribing Advisor to Sutherland had been advertised but that there had been little or no interest, in the meantime David Dunn, Caithness Prescribing Advisor should have contacted Practices to arrange visits. Fiona noted that she would be attending a meeting along with Mary Morton (Head of Pharmacy Services) and David Dunn. She would, she said, ask them for an update.

10. AOCB

N&WSLHP – Minutes 6/9/07 4 10.1 Social Work Services

Ngaire Mingham voiced her concerns regarding the lack of Home Care in the Tongue area. Without going into too much detail the problems appear to be a lack of staff on the group to provide the service. In practice it means to Community Nurses are picking up much of what has been referred to Social Work as Home Care.

Bob Silverwood responded by acknowledging that there are problems, much of which is being addressed e.g. Home Carer Contracts and Conditions of Service, but noted that that does not help with the immediate problems of putting together a package. The Service is he said overspent. All Home Care packages therefore must be approved by the Area Community Care Manager, in the case of Caithness, Sutherland and Easter Ross.

Cameron Stark asked if a record is being kept of those requests which are made and which cannot be met – i.e. a record of unmet need. Bob responded by saying that to some extent there was a record but agreed with Cameron that it would be a useful exercise to monitor this information for a period of perhaps two months. It was suggested that community staff (nursing etc) should even where they suspect it will not be possible to provide the requested care request it none the less in order that the level of unmet need be recorded.

Georgia Haire suggested that the proposed Joint post be looked into again. Bob replied that he would welcome the opportunity to look at this again.

In response to a question from Alan Belbin regarding the Resource Allocation Panel, Bob Silverwood explained that there are two Resource Allocation Panels; a local panel and a Highland wide panel. The Highland wide panel reviews all large packages of care. The local panel looks at local allocations (locally funded) and where suitable refers these to the highland wide panel for consideration. Both panels meet regularly.

10.2 CPN Workload

It was noted that Andreas Herfurt and Lorraine Coe are taking forward the issues discussed at the previous meeting.

11. DONM

The next meeting of the North & West Sutherland Local Healthcare Partnership will take place on Thursday 4th October 2007 at 12:00 noon in the Rhiconich Hotel, Rhiconich.

N&WSLHP – Minutes 6/9/07 5