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Bminutes of SMART User Group 03-10-14

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Bminutes of SMART User Group 03-10-14 Minutes of SMART User Group held on Friday, 3rd October 2014 at 2.00pm in the Margaret Scott Room, SMART Centre In Attendance: David Gow, Head of SMART Action Les Malone, Modernisation Manager, SMART Keith Ferguson Mark Chapman Katrina Sweeney 1. Apologies: David Loughlin 2. Minutes of Previous Meeting – 22 nd August 2014 2.1 The minutes were approved as a true and accurate record of the meeting. 3. Matters Arising 3.1 It was noted that there was no matters arising which were not already on the agenda. 4. Presentation from Heads of Service 4.1 Prosthetics Service David Gow provided a presentation on the Prosthetics Service to the group. The following key points were noted: • There are 5 National Centres in Scotland for Prosthetics. • The SMART Centre provides Prosthetic Services to patients in Lothian, Fife and the Borders. • Approximately 23% of the patients attend the SMART Centre. • SMART has a number of services under one roof which provides greater integration across the services. • Prosthetics Service was previously based at the Princess Margaret Rose Hospital until the Hospital closed in 2002. The Service temporarily moved to the Eastern General Hospital following the closure. The Service then moved into the purpose built SMART Centre in February 2007. • The in-patient amputee ward was located 60 yards from the SMART Centre which improved access and more flexibility for the patients. • The SMART Centre has a suite of rooms which include walking bars for male and female patients, privacy rooms, plaster rooms and cast rectification room. • The following statistics were noted: o Approx 25% of Scottish population o 26000 wheelchair users o 1500 prosthetic users 1 o Centre based outpatient services 20000+ p/a o Domiciliary services o Mobile unit for driving assessment o Multi-disciplinary staff (80 plus) • Patients attending the SMART Centre for Prosthetic Services: o Patients attending 562 o Patients with 1 appointment 146 o Patients with 2 appointments 119 o Patients with 3 or more appointments 297 o Patients with 10 or more appointments 42 o Appointments for this group 539 o 42 patients (7%) used (22%) appointments o Ambulance patients (142) 25% o Average appointments/patient 4.4 • The National Centre for Prosthetics and Orthotics is based at Strathclyde University which is one of only two institutions in the UK offering undergraduate and postgraduate education in Prosthetics and Orthotics. • The process consists of: o a cast of the residual limb o a check socket is made from this o the cast is then rectified by adding or removing plaster o Workshop manufacture the socket in different ways depending on what is required i.e. lamination using resin which solidifies • The SMART Centre is one of two centres in Scotland who see Veteran patients for State of the Art Prosthetics since June 2013. • The Service also use new technologies such as Tracer Cad which is used for scanning limbs instead of taking a plaster cast. KF asked if it would be possible to have a similar presentation provided to the ELLA Group. DG commented that he would be happy to attend a future meeting. 4.2 Orthotics Service Kirsty Sutters, Advanced Orthotist provided a presentation on the Orthotics Service to the group. The following key points were noted: • Definition of an Orthotist is a person who having completed an approved course of education and training, is authorised by an appropriate national authority to design, measure and fit an orthosis. • Orthosis is an externally applied device used to modify the structural or functional characteristics of the neuro-muscular and skeletal systems. • All Orthotists are dual qualified in Prosthetics and Orthotics at the National Centre for Training in Prosthetics and Orthotics, Strathclyde University or Salford University. • 4 year course, Honours degree in Prosthetics and Orthotics. • All Orthotists are registered with the Health and Care Professions Council. • The Orthotic team Consists of 8 Orthotists and 5 Technicians. • The Orthotists are supported in clinic by 5 technicians. They carry out manufacturing as well as waiting repairs and walk in repairs on a daily basis. • The Orthotics Service moved into the SMART Centre in July 2011. • All Orthotists are based at the SMART Centre but travel to various satellite clinics. 2 • The Orthotists provide clinics for Outpatients at the SMART Centre, Roodlands Hospital and the Royal Infirmary of Edinburgh as well as covering the wards at Royal Infirmary of Edinburgh, Royal Hospital for Sick Children, Liberton Hospital and the Astley Ainslie Hospital. • Examples of some of the items provided include: o Footwear o Insoles o Ankle Braces o Knee Braces o Spinal Braces • The Service also uses new technologies which include a system called Paromed to scan patient’s feet. This is a much quicker process and the scans are emailed directly to the manufacturer so the order is received the same day as the patient is seen. • The Service is also currently being trained on a new system for scanning limbs called Rodin which produces a 3D scan. Orthotists can then model the scan online to produce an appropriate device for the patient. • The Service received an award in October 2012 at the NHS Lothian Celebrating Success Awards in the category ‘LEAN in Lothian’. The group thanked KS for attending the meeting and providing a presentation on the Orthotics Service. 4.3 Technical Services Donald Stewart, Head of Technical Services provided a presentation on Technical Services in SMART to the group. The following key points were noted: • DS joined Lothian Health Board in October 1985. • DS became SMART Lead Technician in September 2009. • DS became SMART Head of Technical Services in July 2012. • SMART brought together the workshops and stores under one Head of Technical Services in 2009. • The Orthotics Service was added in July 2011 when the moved into the SMART Centre. • The Wheelchair Repair Service was brought in-House in October 2014. • The sharing of skills and the workshops have benefitted the patients journey across the services. • The Workshops are located in West side of the SMART building. • The Wheelchair Repair Service is based at the Community Equipment Service Store at Peffermill Industrial Estate, Craigmillar. • There is also a small workshop in OPD6 at the Royal Infirmary of Edinburgh and satellite stores throughout the Lothian's. • Technical Services if made up of the following staff groups: o Rehabilitation Technical Staff o Mechanical Engineers (5) and Electronic multi skilled Engineer (1) o Prosthetics (7) / Orthotics (5) Technical Staff o Mechanical / Artisan Craft Technicians o Wheelchair Repair Staff o Mechanical Technicians (Mobile – 8 {inc Vans}, Workshop Based – 3 and stores staff - 2) o SMART Stores o Multi skilled stores staff with responsibility for own areas (3) 3 • Technical Services is responsible for ordering, manufacturing and repairing bespoke devices provided to patients. This includes the delivery of stock devices. The group thanked DS for attending the meeting and providing a presentation on Technical Services. 4.4 Admin Services Gail Wishart, SMART Centre Manager provided a presentation on the Admin Service in SMART to the group. The following key points were noted: • Patients access all Services in SMART via Admin • Admin responsibilities include the Reception Area in SMART where we meet and greet patients who are attending appointments. Admin staff are the first point of contact and look after the patient when they are in the reception area. • There is a dedicated repair line for wheelchairs were staff rotate. • Both electronic and paper referrals are processed. • Appointments and arranged and letters typed and sent to patients. • Some services hand out follow up appointments to patients before they leave the building. • The service carried out a telephone audit over a year ago and found that approximately 1,200 calls were taken per week by the Admin out of approximately 15,000 out-patient appointments which take place in SMART. • The volume of telephone calls has increased since other services have moved into SMART i.e. Podiatry, Blue Badges, Neuro Rehabilitation Clinics etc. • The Admin Team are responsible for ordering other equipment in addition to Stores i.e. wheelchairs on behalf of clinicians. • The Service is currently looking at other communication systems: o new telephone system to improve access to a member of the Admin Team. o Text Messaging o E-mail – ensuring compliance with Data Protection requirements • The Service also co-ordinates appointments where patients use more than one service so that patients can attend on the same day for multiple appointments if necessary. KS commented that there have been a number of occasions when it has been difficult to get through to the Admin Team. Either the telephone was engaged or a message to say pleases call back later. KS asked why the Service did not use an answer machine. GW explained that this had been trialled in the past, however it was found that messages which were left on an answer machine did not include the necessary information to be able to identify the caller or to call them back. There were a number of instances where this had happened and it was decided not to use an answer machine. GW commented that this only appears to be an issue in the wheelchair service and that other services in SMART use an answer machine and don’t have this problem. GW explained that a general e-mail address would be setup within the next 2-3 weeks which would enable service users to contact the service via e- mail. 4 KF commented that concerns had been expressed within the ELLA Group about how appointments were issued. KF explained that patients would leave a message on an answer machine about making an appointment and that instead of being contacted to discuss this they would be sent a letter in the post with an appointment which may not be suitable.
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