C.A.T.C.H.E.S.

Ken Barr reported that there had been a lack of consultation about the possible closure of a Care Home in Lochgilphead.   As a result of protests, no decision will take made until such time as a consultation exercise has taken place.

CATCHES Report

The third Annual General Meeting took place on the 22nd April 2008 at the Argyll Hotel.

Since our last AGM Members of Catches have attended two CHP meetings, three PPF meetings, 2 locality PPF meeting, 3 A&B CHP eHealth Working Group meetings, two NHS Scotland meetings in Clydebank one on healthy living and one on HAI, one A&B CHP website meeting, two meetings with Nicola Sturgeon and two SHCN meetings. In addition members have attended CCCF management meetings and public forums.

At both meetings with Nicola Sturgeon the chairman raised the question of the ambulance service here in Cowal but in particular in the remote and rural communities. At the most recent one he posed the question that was printed in the paper and got the reply that the new chief executive was looking into the situation. He also brought up at the request of the North Action Group, a similar group to CATCHES based in Caithness, the report that the P&J had made on the 9th April which stated that 15 ambulance stations in Highland were manned by only one crew member the previous weekend for a period of at least 24 hours and in another ambulance station there had been no crew member at all. Her response was that she could not comment on individual cases. He retorted that this situation was utterly unacceptable.

The Chairman also handed her a paper giving some concerns on the Document "Delivering for Health in Remote and Rural areas" which Bill Lawrie had prepared for him. These were again relating to proposals regarding the ambulance service suggesting additional roles for the crews. As they cannot meet their current targets it seems odd to us that additional responsibilities are being considered.
The Chairman handed her another paper regarding an eHealth Problem that has arisen in Argyll and Bute which emanated from a recent eHealth Working Group meeting. Basically Argyll and Bute CHP are trying to trial a data transfer system from patients home to the consultant/care team to reduce the necessity of the patient having to travel to the relevant hospital. Unfortunately the service provider does not have an approved server within the NHS firewall system nor does the NHS have a server within the firewall able to access the system. So the trial, the training of staff, and the purchase of equipment has had to be put on hold. The problem is that there is within NHS Scotland an organisation that is meant to help - The Scottish Centre for Telehealth - but to date that help/advice has been lacking. So he asked her for an explanation of the role of the SCT.

Regardiing the Continuation of CATCHES Bill Lawrie said we are part of the Scottish Health Campaign Network and should continue with CATCHES as it is the bigger picture we are also interested in and allows us to speak directly to the Secretary For Health at the twice yearly meetings organised by the SHCN..

The AGM was followed ba an OPEN MEETING

Around ten members of the general public attended. One lady voiced her concern for the Medicine for the Elderly ward at the Dunoon Hospital. She was greatly disturbed that those patients needing 24 hour nursing attendance were being sent to Paisley and that her friend was in the process of being moved when the patients lawyer stepped in and advised the authorities that it was against her human rights to move her from an area where she had friends to a place where no one would be able to visit her. She also understood that there were only two beds for the Elderly in Dunoon Hospital

Evelyn Hide informed her that there were ten beds in Dunoon Hospital that would cater for the elderly. Another member of the meeting also spoke out about the closure of the Medicine for the Elderly Ward and he said there appeared to be some confusion arising around care within and care without the hospital and also on the availability of money for this purpose to care for patient care in the home and patient care in the hospital.

Evelyn said there were two areas that we ought to be fighting for i.e. patients who need 24 hour intensive nursing care and medical care and those patients who only need daily care and no medical care or intensive nursing.

Further discussion on the Dunoon Hospital and its services followed.

Meeting with Minister for Health and Wellbeing

We welcome the Scottish Government’s recognition of the important part played by the ambulance service in ensuring equity of access to health care for people in remote areas and the particular challenges SAS meets in fulfilling this function.

Although we believe the target times for emergency ambulance response in remote rural areas to be appropriate, the percentage of times SAS are required to meet those targets is not. A life saving service ought to aim to meet its targets as close to 100% of the time as is possible. Nor is the time required for onward transport to appropriate care taken into consideration either from the site of the emergency or for inter hospital transfer from Community Hospital to centres of excellence. In such cases time is frequently of the essence with rapid onward transfer to specialist treatment a life saving necessity. Such transfers need to be treated with the same degree of urgency as a 999 emergency.

While creative thinking will no doubt go a good way to improving the emergency services in rural areas, we consider that considerable investment in vehicles and professionally qualified staff is also required if a safe, sustainable service is to be provided.

Taking into consideration the comments above, we ask the Secretary for Health what steps are being taken to ensure that a safe and sustainable ambulance service will be provided for remote and rural areas?

REMOTE AND RURAL REPORT

C.A.T.C.He.S would wish to make the following observations and would be grateful for the Secretary’s comments:-

The report is generally good - but we have witnessed similar fine words in previous reports and on this occasion hopefully look forward to more positive actions.

We, however, have the following reservations:-

1.    Page 14 - Anticipatory Care

Traditionally a role for G.P's Health Visitors, District Nurses etc., the report suggests that "Technicians from the Scottish Ambulance Service can undertake planned home visits ......” Ambulance Personnel have great difficulty in achieving their current targets without adding to their responsibilities. We doubt a satisfactory patient outcome from of this initiative.

2.    Page 15 - Long Term Condition Management.

We have similar doubts that for Anticipatory Care "paramedics could fulfill this role'

3.    Page 31 - Rural General Hospitals.

"All RGHs must be supported by robust retrieval and transport systems ..."

Surely this must apply to all Hospitals.

4.    Page 48 Acute Medicine Service.

"Three team member's will be required .............to provide a 24/7 service".

To achieve this members would have to work 8 hours a day. 7 days a week without holidays or time off.

5.    Page 87 Emergency Response.

"the SAS needs to adopt a more creative community approach to fulfill its responsibilities".

We agree with the implication that the SAS is not fulfilling its obligations.

6.    Page 88  transport.

"A nationally co-ordinated response, which brings together all the existing or proposed services under the umbrella of one organisation, ** but one which is more embedded in the NHS Territorial Boards than the SAS currently is ....."

Surely this is not one issue but two,  second issue starts at **

As the umbrella organisation will have to co-ordinate not just SAS but also Private Bus Companies, Aircraft. Ferries and other services it will require a separate identity.

** We have maintained for some time that the SAS would be more effective reporting to CHPs and co-ordinated nationally.

We have had one meeting to discuss our response to the consultation document on Health Board Elections which was sent to the Department directly and also copied to SHCN.

Members of our group sit on the PPF for Argyll and Bute; two of us as CATCHES; two as Community Councilors and one as a private member.

Since the may meeting we have had correspondence with the Health Minister concerning the Ambulance Service in Cowal and the problems with Care in the Community