North & West Local Health Care Partnership

Minutes of the meeting held on Thursday 2nd February 2006 at 12:00 noon in the Rhiconich Hotel, Rhiconich.

PRESENT: Dr Andreas Herfurt Lead Clinician Dr Alan Belbin GP Dr David Slater GP Assynt Ms Sheena Craig CHP General Manager Ms Elspeth Anderson Community Rehab Team Ms Rhiannon Pitt Superintendent Physio Mr Paul Adrian Physiotherapist Mrs Katie MacDougall Community Nursing Team Mrs Sandra MacFarlane Community Nursing Team Ms Lynn Twigger Community Nursing Team Mr Don Campbell Council Social Work Mr Roddy MacSween Highland Council Social Work Mrs Gail Pearson Highland Council Social Work Ms Jackie Ferguson Highland Council Social Work Mrs Sylvia Mackay N&WSCA Miss Christian Goskirk N&WSCCF Mr Johnny Morrison Durness Care Group

APOLPOGIES: Dr Chris Duckham GP Tongue & Armadale Dr Marion MacDougall GP Tongue Dr Cameron Stark Public Health Consultant Mrs Georgia Haire CHP Assistant General Manager – Sutherland Mrs Marion McFadyen Health Visitor Mr Findlay Hickey Prescribing Advisor Mrs Alison Liddell Macmillan Nurse Mrs Gillian Unger CVS North Mrs Anne Mackay CVS North Mrs Liz Baillie Highland Council Social Work Mr Bob Silverwood Highland Council Social Work

ATTENDING: Mr David Macmillan NHS Highland Finance Mrs Fiona Duff NHS Highland Mr Bill Cook Highland Council Social Work Services

1. MINUTES OF THE PREVIOUS MEETING

The minutes of the previous meeting were approved.

2. MATTERS ARISING

2.1 Fuel Cards

Sheena Craig reported that a paper on the issue is to be tabled at the next Area Forum Meeting. It would be helpful she said if staff could report the cost of fuel at the pumps locally.

North & West Sutherland LHP – 2/2/06 1 With regards the issue of Crown Cars being classed as a benefit for tax purposes Sheena reported that NHS Highland is looking to purchase vans for staff. These are not classed by the Inland Revenue as a benefit so can be taken home at night etc.

2.2 Maternity Services

NHS Highland has agreed to recruit Consultant Obstetricians for Caithness General. Sheena Craig is working on Adverts for the posts and Job Descriptions. She is also working with other agencies regarding the production of a promotional video which aims to encourage people to live and work in Caithness.

2.3 Patient Transport

Andreas Herfurt reported that Graham Macleod of the Scottish Ambulance Service has moved to take on the role of Manager of the Emergency Transport. Linda Kennedy has replaced him as Manager of Non-Emergency Services. Further, a Supervisor has been appointed to oversee the Patient Transport Service. Any issues or complaints should be reported to the Supervisor.

2.4 Anthony Nolan – Bone Marrow Register

Katie MacDougall reported that there has been a good response to the appeal from the Lochinver, Scourie, and Durness areas. She is still awaiting feedback regarding potential donors from the North Coast. Representatives from the Anthony Nolan Trust propose to visit the area in March. Those interested in becoming donors will be asked to complete some forms and will then be given an appointment time to see a rep from the Trust.

3. MENTAL HEALTH (Care and Treatment) () ACT 2003

Bill Cook was present at the meeting to talk about the Mental Health (Care and Treatment) (Scotland) Act 2003 which came into force on the 5 October 2005. Bill talked in some detail about the Act noting the roles and responsibilities of Health Boards and Local Authorities.

Bill went on to talk about Emergency Detention. In the main he said the provisions for Emergency Detention are similar to the old Act, in relation to the role of the GP and Mental Health Officer (MHO).

In the case of a Compulsory Treatment Order a hearing is now heard before a Tribunal rather than by the Sheriff Court. A Tribunal is has three members; Firstly a legal member (The legal member is also the Convenor of the Tribunal); secondly a medical member and thirdly a general member.

Under the terms of the Act and individual can now make an “Advanced Statement”, whereby an individual can write down how they would like to be treated if, in the future, they become too unwell to make decisions about themselves. These statements must be written down, signed by the person making them and witnessed by someone who works with people with enduring mental health, e.g. Medical Practitioners, Clinical Psychologists, Nurses and Social Workers etc. Individuals also have the right to a “Named Person”, who is nominated to get information about their condition. This replaces the previous situation whereby it was the nearest relative who was given information.

North & West Sutherland LHP – 2/2/06 2 4. GMS

Out of Hours

It was reported that Tracy Ligema has taken over as Project Manager for Out of Hours.

Alan Belbin noted that the rumours reported to him last month regarding the lack of Out of Hours Care in Kinlochbervie and Scourie had been false. The Locum GP had been on Call on Monday 2nd and Tuesday 3rd January ’06.

Enhanced Services

Fiona Duff reported that there will be some changes to the Directed Enhanced Services. Practices will, she said, receive a letter about this. In general she said the changes were around the five new enhanced services, which include a register of carers, register of patients with a learning disability, cancer management, 48 hour access to treatment and regular health checks for patients. In terms of local enhanced services the main change will be around the treatment of depression.

Quality and Outcomes Framework Point (QOF Points)

Fiona reported that the Quality and Outcomes Framework Points will be changing.

5. FLU PANDEMIC

Sheena Craig asked stated that there was a need for the LHP to do some planning for a possible Flu pandemic. It was agreed that this should form part of the Agenda for the March meeting.

6. RECRUITMENT & RETENTION

Community Rehab Team

It was reported that the Technical Instructors are to start their HNC in Occupational Therapy at the end of February.

Allied Health Professionals

At the January meeting of the LHP Georgia Haire had reported on a new inducement scheme for hard to fill posts which had been launched by the Scottish Executives. Findlay Hickey had asked if the scheme covered existing post holders. Sheena Craig reported that it did not.

GP Scourie/KLB

The interviews for the Scourie/KLB Post which were due to be held in mid February have been cancelled. Two candidates had had to pull out and the third is unable to attend on that day due to other commitments. It has therefore been agreed that the remaining candidate, when available will act as Locum for a period of two and a half months. If at the end of that period he/she is still willing to apply for the post an interview will be arranged.

Further the practice is to be re-advertised. The advert will be changed slightly to clarify one or two points e.g. it will be made clear that two GPs are required for the practice.

North & West Sutherland LHP – 2/2/06 3 In response to a question from Andreas Herfurt, Fiona Duff noted that the Scourie/KLB Practice computers were replaced in January; however no decision has been made regarding the system to be used. The existing contract has been renewed temporarily and the new GPs, when appointed, will make the decisions regarding the system to be used.

Fiona also noted that she is working alongside the existing Practice Staff to update the Practice leaflet.

7. OLDER ADULTS BUSINESS CASE – ACTION PLAN (FORMERLY KNOWN AS CARE OF THE ELDERLY)

Andreas Herfurt reported that a public meeting arranged by the Community Council been held in Melness on Monday 30th January ’06. The aim of the meeting was to clarify the rumours surrounding the future of Caladh Sona. There was a very large turn out for the meeting. Officials present at the meeting were Harriett Dempster (Director of Social Work), Cllr Margaret Davidson (Chair of Housing & Social Work Committee), Cllr Rita Finlayson (Social Work Portfolio Holder for Sutherland) and Cllr Sandy Mackay (Councillor for the area). A large number of people voiced their concerns over the proposed extra care housing. An area like this needs residential and respite beds it was said. Harriet Dempster had agreed as the meeting closed to write up a short note of the meeting highlighting the main points raised. This had been done and was made available.

It was noted that the Highland Council would as part of their Budget Setting meeting today (2nd Feb) be discussing the future of the Assynt Centre.

8. FINANCE

David Macmillan made available information relating to the LHPs financial position for the period ending 31st December 2005. The LHP is forecast to under-spend by £104,000. This is largely due to Prescribing and AHPs he said.

As a whole the CHP is forecast to under-spend by £126,000. Caithness locality is forecast to over-spend by £96,000; Caithness Acute to over-spend by £195,000, Management to over-spend by £10,000 and East Sutherland to under-spend by £323,000.

Sheena Craig noted that some of the under-spend will be used to purchase equipment for the CHP area.

9. NHS HIGHLAND TOBACCO POLICY

Sheena Craig stated that the NHS Highland Tobacco Policy is to be implemented on 8th March 2006. It is in line with the legislation banning smoking in Public Places which is due to come into force on 26th March 2006. The Policy includes guidance on where and when staff can smoke their rights as members of staff to work in a smoke free environment and so on.

10. PLACE OF SAFETY EVALUATION

Sheena Craig reported that the evaluation of the Place of Safety Project for North & West Sutherland has been completed. It is a very positive report she said. There was a suggestion that the CHP areas “pool” their Place of Safety” funding. However, North Highland CHP has decided

North & West Sutherland LHP – 2/2/06 4 not to do this. As part of that agreement it will have to provide “in hours” staff to escort patients to New Craigs.

11. AOCB

11.1 Protected Learning Time

Fiona Duff raised the issue of Protected Learning Time for staff. Gerry O’Rourke and Miles Mack are looking at this she said and will be in touch with the practices in the near future, if they have not already written. It was agreed to invite them to a future LHP meeting to discuss the issue.

It was suggested by Andreas Herfurt that LHP meeting days could be used for Protected Learning, with learning events taking place either before or after the meeting.

11.2 Community Nursing Review

Sandra Macfarlane noted that she has been asked to represent Community Nurses in the Highlands as part of the Community Nursing Review which is being lead by Paul Martin.

11.3 North & West Sutherland Care Alliance

Sylvia Mackay noted that under the terms of the Alliance’s Service Level Agreement (SLA) with Highland Council only those clients referred by Social Work can receive respite via that contract. She therefore encouraged Community Nursing and AHP staff wishing to make referrals to do so via Social Work. This will ensure that clients have a SID Number she said.

11.4 Dental Services

Sylvia Mackay stated that she had heard that there have been problems with the School Dental Service. Neither Schools nor parents have been informed officially she said. It was agreed that the LHP should invite Alex Fraser to a meeting to discuss the issue. It was also suggested that the Education Authorities should be asking questions of the Dental Service.

12. DONM

The next meeting of the North & West Sutherland Local Health Partnership will take place on Thursday 2nd March 2006 at 12:00 noon in the Ben Loyal Hotel, Tongue.

North & West Sutherland LHP – 2/2/06 5