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Report Your Views Feedback 15May15 FINAL Argyll & Bute MULL & IONA HEALTH AND CARE REVIEW Thank you for talking to usus,, your views areareare important to ususus YOUR VIEWS! Community Feedback REPORT FINAL 15th May 2015 Mull & Iona Health and Care Review Website : http://ow.ly/EUZpD Page 1 of 44 Background Providing high quality, safe and affordable health service to remote and rural communities across Scotland is challenging. It is a challenge for the present and for the future. Rural GPs have been making changes over the past few years to the way they provide services once their surgeries are closed “Out of Hours”. But this is just part of the bigger picture. The Mull & Iona Health and Care Review Group was established in October 2014 to ensure a high quality, person centred, sustainable and affordable integrated health and care service (in and out of hours) for the communities on the islands by October 2015. The action plan is in line with the Scottish Government’s 2020 Vision for Health and Social Care. The review will run for a period of twelve months. Once approved, the Oban Lorn and Isles Locality Management will put in place a plan to implement the recommendation(s). The review does not include day to day operational issues. The review has identified a proposed model for primary care (GP) service for Mull and Iona. Before implementation, it is essential to gather feedback from communities and staff across Mull and Iona about the proposal. In March 2015, the Communications and Engagement Group developed an information pack which was posted to all households on Mull and Iona. The pakcs included information on current services provided on the islands, the proposed model for primary care (GP) service, Frequently Asked Questions (FAQs) leaflet, and the schedule of engagement activities. Approximately 2,000 packs were posted to all households on the islands at the end of March. The information packs included a feedback form “Your Views!” (Appendix 1). Local people were encouraged to complete and return the feedback form by post using the Freepost envelope supplied. 74 feedback forms were returned by post. Appendix 2 provides the detailed unedited responses for information. People were also given the option to complete the feedback form online through Survey Monkey. The same questions were used to ensure consistency. A total of 18 responses were received and these have been included in the report. The deadline for submitting the “Your Views!” Feedback Form was Wednesday 15 th April 2015. With the postponement of the drop in event on Iona due to adverse weather conditions, and in response to requests for additional events, the deadline for feedback was extended to 30 th April. The Argyll & Bute CHP held a series of engagement activities during late March and throughout April. The Schedule of Community Engagement Activities has been included at Appendix 6. Members of the Review Group Page 2 of 44 and Communications & Engagement Group attended the various activities, where we saw and spoke to approximately 300 people. Most of engagement activities took advantage of well established community based events, for example the Community Café in Bunessan or village coffee mornings. For Dervaig and Ulva Ferry, we ran conversation cafés where people were invited to come along for a ‘cuppa and a cake’ and have a conversation about the proposed model. Compared with previous engagement events, this proved the best and most effective way to meet and speak to as many local people as possible. People were encouraged to write their views, concerns or comments on table cloths. These have also been written up and included in this report (Appendix 4). In addition to these activities, the Review Group held five drop in information sessions in Tobermory (two sessions), Craignure, Bunessan and on the Isle of Iona. The NHS Highland (Argyll & Bute) generic email address was provided for anyone wishing to share their experience of the services or indeed provide comments. 6 people used the generic email address to provide feedback and 3 letters were received. These have been included (Appendix 3) in the overall feedback report but do not include names to maintain anonymity of the authors. “Your Views!” Feedback Results The evaluation of the feedback received has provided both a quantitative and qualitative feedback. A total of 92 feedback forms were received. The following provides a brief summary of the quantitative and qualitative feedback. Referring to Question 1, some respondees declined to answer therefore totals may not match the total number of feedback form received (92). In terms of qualitative feedback, given the volume of responses received a summary of the main issues or points provided have been included in the main body of this report. Appendix 2 provides the detailed unedited written feedback received from all responses received (“Your Views!”). Page 3 of 44 Q1 Do you understand what is being proposed for primary care (GP) services on Mull & Iona? No of Responses % Yes 77 86.5% No 5 5.6% Don’t know 7 7.9% n= 89 100.0% 11 respondees declined to answer this question and 1 person answered this question twice therefore the control total will not match the actual number of responses received (92). If no or you are unsure, what information would be helpful? • Details of the other “tried and tested” hubs in other remote and island communities • How many GPs will there be? Are the 4 GP posts full time? • How many GPs based in Bunessan? Tobermory? Will it be two each? • Practicalities about how the merged practices will work in reality • Not everyone clear there will only be one locum GP covering Out of Hours (OOHs) based at the Community Hospital (hub), in Craignure • Rota for GPs? • Are we now looking at an island wide practice for Mull & Iona? • What will the name of the combined practice be? • Clarity on charges for taxi or community transport to / from the hub OOHs • Will clinics, for example physiotherapy, be only available at the Community Hospital? Q2 Having considered the proposed model for primary care services, do you have any comments or concerns that you would like to share with us? Remember, this is your opportunity to tell us what you think about the proposal. • A lot of anxiety about the proposed model • Concern about the GPs having to travel between surgeries reducing the amount of time they have available to see patients • Concern the amount of travelling between Tobermory and Ross of Mull will “act as a disincentive for recruitment” • Will combining the two practices create sustainable working conditions for the doctors • Concern that there will only be one doctor providing Out of Hours service for the whole of Mull • A lot of people are very worried travel times in response to emergencies, particularly Out of Hours for people living on the Ross of Mull & Iona Page 4 of 44 • Concerns about the ‘hub’ being based in Craignure • Travel is a key issue for a lot of people • Clarity required on who is responsible for organising community transport or taxi service, will this be available for the return journey, who will pay for this • Not all volunteer drivers are willing to transport people who are ill and need to be seen by a GP based at the hospital • Travel times in an emergency will put people’s lives at risk - added risk during summer with tourists then risk of the Ross being cut off when the road through the Glen is closed • Travel times Out of Hours is worrying • Inadequate ambulance provision cited as a major concern- people on the Ross would like to see any additional provision based in Bunessan • Role of Community First Responders seen as a real benefit although some people are still unclear about their actual role • People on the Ross of Mull & Iona want a doctor permanently based in Bunessan; likewise people in Tobermory want a GP based permanently there • People are looking for more detail about how the combined surgeries will operate, both daytime and Out of Hours • Role of NHS 24 needs to be explained • Many people want continuity of care from the same doctor; practice manager & other practice staff • Some people still want to see a commitment for home visits, anytime of day or night Q3. Do you have any other comments, ideas, concerns or questions? Do you have any thoughts on what the practice consulting hours should be i.e. when you can get an appointment to see your GP? There were many comments provided. In summary these included : • Iona – people would like to see a practice nurse visiting the island as was the case years ago (for taking bloods, blood pressure, well woman clinics, immunisations, etc) possibly on a separate day to the GP • Some people would like to have seen other options, not just the proposed model put forward • Feeling the proposed model is a further retrospective step in NHS services provided on the islands • Combination of having appointments and drop in surgery times favoured • Impact on the social economic and environmental health of the community with particular regard to a larger more balanced population and improved community resilience – model seen as a “backward step to make living and working in the area much less attractive to many and for some probably unacceptable” – proposal “looks very damaging to the ambition to have a healthy and vibrant local economy” Page 5 of 44 Summary A total of 99 responses have been received, either by post, online using Survey Monkey, emailing to the generic email address or by letter. This represents a reasonable response. Based on the feedback, a number of key themes / general points have emerged.
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