To put in place a sustainable, high quality and affordable in and out of hours health service for the Isle of Islay population

NHS – ARGYLL & BUTE CHP

Mid Argyll, & Islay Locality

Islay Health Services Review Implementation Group Notes of Meeting held on Friday 14 November 2014 @ 1000 Islay Service Point, Bowmore with VC

Present: Alison Guest, Co-Chair Councillor Robin Currie Anne Tait Catriona Bell (for Islay McEachern) Gill Hearle Moira Gillies Dawn Bingham Ann Pilley Kate Dumigan Alan Beresford (GP Business Manager)

By VC: : Martine Scott, Hilary Simpson (Notes) Dunoon: Elizabeth Reilly

Agenda Key Discussion Points and Agreed Actions TO BE Item ACTIONED BY 1.0 Welcome and apologies.

Alison Guest welcomed everyone to the meeting. Apologies were received from Dr McGrann, Councillor Horn, Stephen Morrow, Sheena Clark, Dr Pickering and Lloyd Wells.

2.0 Update on IT Provision No update available from Stephen Morrow but brief update from Alan Beresford in Practice Update.

Notes of Last Meeting 3.0 Notes from the last meeting held on Friday 3 October 2014 were adopted.

4.0 Matters Arising

4.1 Recruitment /Housing Alison Guest reported that she had emailed ACHA with regard to the availability of housing for incoming Health and Social Care staff but A Guest had not as yet received a response. Alison to follow this up.

4.2 Practice Update To be discussed at item 9.0: Draft Action Plan

4.3 RCOP Update  Alison Guest reported that the RCOP development day had been postponed and that this would take place in January 2015.  The RCOP Booklets have arrived in Islay and have been distributed to all GP Surgeries and the Cyber Café and they will also be sent to the café at Ballygrant and in the Dental Surgery.

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 It has been decided not to hold conversation cafes but to utilise the meetings of pre-existing groups to disseminate this information and for 1:1 discussion with individuals by H&SC staff. It was emphasised that RCOP is applicable to all aged 50 and over. Alison to send out the information received; narrative, A Guest presentation, booklet and questionnaire to all group members.  Alan Beresford asked whether the questionnaire data was being kept separate for Islay and Jura or whether this would be included in a total report for the Argyll & Bute CHP. He indicated that two thirds of the practice list for the Rhinns was over 65 and it would be helpful to know what services are required for each area. Alison Guest confirmed that data collated would be for the whole CHP and not individual areas.

4.4 Macmillan Room Update  Alison Guest asked that group members understand that this update was not for general public dissemination at present due to the sensitivity of the subject.  It has been necessary to rethink the location of the Macmillan Treatment and Relatives rooms as the footprint of the hospital cannot be increased as originally hoped. This means that the plans of the hospital will need to be revisited to identify alternative locations but it was hoped that this would not cause delay in the overall programme. The drawings are currently with the Macmillan architect to see how these rooms can be effectively incorporated into the building. Alison confirmed that all viable options were being considered including the possible relocation of administration and non clinical services to rationalise all available space in the building. She emphasised that the project would go ahead but that the original location would now be changed.  Alan Beresford indicated that there were some TVs sitting in his office which had been purchased for the ward through local fundraising. Gill Hearle explained that whilst the TVs had been purchased, the on costs for installation had not been funded and the quotation from the approved contractor for the hospital had been prohibitive. To be discussed outwith the meeting.

5.0 Remote and Rural Project Update

Martine Scott gave her apologies for not being able to attend the meeting on Islay in person, due to poor weather conditions and gave the undernoted update on the project.

 Martine went to the Royal College of General Practitioners Conference in Liverpool where they had a stand. A doctor from a rural practice in Skye also attended the conference and the microsite would be launched with the aim of attracting newly qualified GPs. The microsite was gaining publicity through bus and billboard advertising in Leeds. There had been a good amount of interest with a huge spike in traffic going to the microsite which was very promising, in fact one GP wanted to sign up immediately.  Six new adverts have been placed on the microsite including the post on Islay. Martine thanked Alan for his assistance with this.  A half page generic advert for all GP vacancies will shortly be placed in the British Medical Journal. The cost of advertising individual vacancies

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was too expensive and it was hoped the generic advert covering current posts would create interest. The advert will also be available on-line for four weeks.  Gill McVicar, Director of Operations for North and West Highland is currently undertaking a pilot project in Eigg (small isles) and West where they have had an empty Practice for two years. Instead of just advertising for a GP she is putting in place a multi-disciplinary team which includes a two day a week GPs service from Skye.  Data is being gathered in Argyll & Bute for future GP retirals as most GPs are now in their late forties and fifties.  Longer term solutions for the retention of GPs are also being looked at. Training is seen as being fundamental to the successful retention of GPs and Dr Adrian Ward is organising a rolling refresher programme with the possibility of a case advocating ongoing training being submitted to the Scottish Government.  A baseline evaluation is being undertaken by the University of the Highlands and Islands and contact will be made with key individuals regarding services.  Martine had attended a Rural Parliament in last week with 400 attendees. She reported that the Rural Parliament was trying to get healthcare raised on the agenda and it was interesting to see them taking themes such as broadband/connectivity and ferries/island links to the Scottish Government for approval. Alan Beresford noted that there were plans to increase broadband to 10G in some areas and he asked if there were any indication on when this would be implemented in NHS Highland. Alan to contact Stephen Morrow regarding this. A Beresford  The issue of recruiting GPs to work in rural areas with specialist skills was raised. Students from remote and rural areas were applying for medical school places but were not being successful, even though they were qualified. The need to grow our own R&R GPs was discussed and Martine confirmed that there had been 20 outcomes from a recent workshop in Fort William which had been attended by herself and Dr M Scott Pickering. Martine to send details of the outcomes to Alison Guest.(attached)

6.0 Islay Dental Facilities Update

 Elizabeth Reilly reported that the post for a salaried dentist has been re- advertised as a fixed term post for just under an 18 month contract with a closing date of 21 November and that there have been a couple of enquiries. She indicated that there have been several adverts placed for this post and it was regrettable that a suitable applicant had not been found to date.  The private dentist who has expressed interesting in setting up a Practice on the Island is progressing through the various stages required but as stated at the previous meeting, this is a longer term option. Elizabeth reiterated the benefits of having both a private and a public dental service on the island.  It is hoped that the dental premises may be relocated in the hospital but this will not be easily achieved given that the hospital footprint cannot be extended.  A needs assessment of the dental services required for Islay and Jura will be undertaken to establish exactly what is needed on both islands. It is accepted that there is a need for an island dental service and that an additional dentist on the island is required as the current work load is too Page 3 of 6 To put in place a sustainable, high quality and affordable in and out of hours health service for the Isle of Islay population

much for Mrs Formby on her own. In the interim a dental therapist will visit from time to time to assist. Elizabeth Reilly to discuss this with Stephen E Reilly Whiston and to keep the group updated on the situation.

7.0 Integration Update

 Alison Guest confirmed that Christina West has been appointed as the new Chief Officer for the Health and Social Care Partnership. Her first task will be to draw up structures for the new partnership but there is no further information at present.  Staff Nurse Dawn Bingham has started in a post which overarches both community and ward teams. She will work one long shift a week on the ward and the remaining time in the Community.  A fixed term Health Care Support Worker post which has been funded by Change Fund moneys is being recruited to work on the ward and in the community to look at re-ablement. The post is for 15 hours per week and will provide hospital to home support. Closing date for applications is on 21 November.  Dawn is currently undertaking district nursing training and re-ablement training along with other nursing staff on the ward.  Discussions are taking place between multi-disciplinary teams and the GPs regarding the future structure for integrated health and social care from April next year. Step up/step down beds are also being discussed regarding re-ablement and rehabilitation of patients but it has not been decided on how this will be implemented.

8.0 Terms of Reference

Amendments to be made as follows:

 Remove James Brass as e-Health Representative and leave blank. H Simpson  Alan Beresford queried the requirement to conclude GP contract and partnership negotiations by end March 2014. Alison Guest confirmed that this was in respect of the in and out of hours services as well as the hospital contract.  Councillor Currie asked about the anticipated life span of the group. Alison Guest explained that the remit of the group now includes the integration of Health and Social Care services and the requirement to meet after the end of August 2015 will be reviewed at that point. It was All agreed at the last meeting that monthly meetings are still required.  Terms of Reference to be signed off at the next meeting. Agenda Item

9.0 Draft Action Plan

Outcome 1: Single Islay GP Practice  Alan Beresford reported that a GP had visited earlier that week who was interested in a permanent post on Islay and who would be available from August 2015.  Three expressions of interest for the GP posts, two of which included CVs for the permanent posts have been received in the last two weeks.  A previous locum, Dr Donal Murray has expressed interest in a fixed term contract when he has finished on Mull.  A long term locum, Dr Lewis MacKinnon has been recruited for three Page 4 of 6 To put in place a sustainable, high quality and affordable in and out of hours health service for the Isle of Islay population

months starting in December.  Two requests have been submitted to look at moving the dispensary at Rhinns to another area away from reception and it is hoped that funding will be identified for this work.  The telephone system at Rhinns is not fit for purpose and the new system will not be installed until the middle of December, due to supplier issues. The new phone system will allow for a prescription hotline (answer phone line) which will allow patients to order repeat prescriptions out of hours, and an 0800 number for patients to be able to speak to a receptionist on any of the sites which will alleviate the problems of half day working and allow patients to see a doctor at the other sites.  It has been identified that a generator is required and a bid to Estates will be drawn up for a portable generator. There have been two recent power A Beresford cuts resulting in the loss of vaccines which are costly.

Outcome 3: Islay Integrated IT System  Areas for improvement in IT at the Rhinns have been identified. Both pharmacy manager software and VISION infrastructure will be installed around mid to late December to allow records to be accessed in all three sites. Funding has been agreed by the CHP for the additional IT equipment and services.

10.0 Communications & Engagement Sub Group

Verbal report received from Ann Pilley as below:

 Ann reported that there was still no date set for the next Communications & Engagement Group meeting. She had met the previous lunchtime with a few members and got the impression that some of the members were feeling a bit frustrated for a number of reasons. Ann reminded the group that NHS Highland is statutorily obliged to consult with the public, which is the role of the sub-group.  Ann requested that ten minutes be kept at the end of each Implementation Group meeting to agree bullet points on what should be disseminated in the Ileach, on Twitter and on Facebook. Alison Guest indicated that it had been agreed at a previous meeting that the Chair of each meeting would write some bullet points for the Ileach and asked if these should be sent to the Communications & Engagement Sub Group to formulate into an engaging and interesting report. Bullet points suitable for disseminating from this meeting are: two new posts; dental update, some of the GP information, details on the Remote and Rural initiative and the microsite, Health and Social Care Integration update and workforce integration.  A calendar giving 2015 publication dates for the Ileach would be useful to allow meetings to be timed just prior to production.  Ann suggested an approach be made to the Ileach to ensure that an article regarding Health, Wellbeing or the Health and Social Integration A Guest process is published every month. Ann or Catriona, Alison and Alan to arrange meeting with the Ileach Editor to discuss.  The Community Council website has not been updated on health issues for some time and this requires to be updated routinely.  Ann will write an article for the Ileach regarding the three PPF meetings A Pilley taking place before Christmas.  Ann requested that it be agreed for Catriona Bell to deputise for her at meetings to ensure a link with Communications and Engagement. Terms Page 5 of 6 To put in place a sustainable, high quality and affordable in and out of hours health service for the Isle of Islay population

of Reference to be amended.

11.0 Any Other Business

None.

12.0 Papers for Noting

12.1 Adopted notes from Friday 3 October 2014

13.0 Dates of next meetings

Times of Meetings: 1000-1230 Venue: Islay Service Point with VC availability

Wednesday 17 December (to be cancelled due to clash with Health &Social Care drop in event on Islay that day)

Friday 9 January 2015 – Next Meeting

Anyone wishing to use an alternative VC should confirm the VC location, VC number, contact email and mobile phone number to [email protected] at least 10 days in advance of each meeting in order that a bridge can be arranged.

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