Notes by JSS

Present:

  • Dr Robert Cumming (Stobhill, Chair)……(RC)
  • Nicola Sturgeon (NS)
  • Dr George Venters (Edinburgh, V-Chair)..(GV)
  • Colin Cook
  • Cllr Vivien Dance (Hospitalwatch)………(VD)
  • Carmel Sheriff, et al
  • Julie McAnulty (Lanarkshire Health Utd)..(JMcA)
  • Dr Alastair Glen (HSFSE, Glasgow)……..(AG)
  • Dr Jean Turner (Scottish Patients Assoc.)..(JT)
  • Malcolm Allan (Stobhill)…………………(MA)
  • John Winton (LHC, Fife)…………………(JW)
  • Ken Barr (CATCHES, Cowal)……………(KB)
  • James Sandeman (HSFSE, scribe)………..(JS)

Action

NS’ arrival delayed by ten minutes, and she had to leave on time, leaving us barely 50 minutes.

Outpatient Chemotherapy:
RC acknowledged recent decision to continue the service at Stobhill and Vale of Leven.

Glasgow Monitoring Groups: RC repeated concern that the Groups had been deprived of timely and appropriate information.
NS:  Met the Chairs on 17th November, who had assured her information was adequate.  Did not recall having received the South Group’s report agreed 31/10/08 -
JS : passed her a copy of his draft.  Time precluded our asking whether a revised remit had been discussed with the Chairs.
RC/JS

Rehabilitation (drugs/alcohol):
RC: highlighted concerns that vulnerable patients were not being referred to Castle Craig etc early enough to prevent further brain and liver deterioration.
NS:  Such referrals are decided by local teams.

Patient information:
GV  pressed the need for patients themselves to have control.
NS  Positive agreement.  Referred to coverage of this point in the new “E-Health Strategy”,
now available on SGHD website.  Pilot schemes for on-line access by patients, e.g. in an Irvine GP practice.  Around 1000 patients signed up so far, and results are being monitored.  Agreed with GV that positive “opt in” is the way to go.

Consultations – electronic responses:
GV and RC complained that on-line responses are sometimes not accepted by the system, thus discrediting the consultation process.
NS  Understood the concern, but insisted “best practice” is used.  RC case to be checked. 

Evolving IT technology:
GV pressed for systems to keep up with developments in technology and personal attitudes.  Off-the-shelf packages are being developed as alternatives to the traditional monolithic approach still being tried in England.  There is a pool of relevant talent (e.g. in ISD).
NS  Again referred to the E-Health Strategy.  SGHD’s approach is incremental rather than the English “big bang” policy.  GPASS will continue, but may be modified to link in with developing systems.

Vale of Leven:
VD referred to the current consultation (closing early 2009), and to dismay over NHSGGC’s eagerness to centralise services.
NS  Would not prejudge the outcome of the consultation, but insisted that work continues on Maternity, Unscheduled Medical Admissions and the Integrated Care Model.
NHSGGC are looking at new services which might come to VoL (no details).
RC  Welcomed these positive statements, but insisted that concerns remain.

NHS Lanarkshire Mental Health plans:
JMcA Concern over plans for Acute Mental Hospitals – originally there were to have been two new builds but plans seem to be diluted, e.g. to a mix of new build and refurbishment.
There are fears that the capacity of the three existing units may not be sustained, with patients being decanted from Hartwood Hill (Shotts) to Hamilton and Coathill (Coatbridge).
Passed NS an additional paper for further consideration.  NS will study and revert.

Acute Stroke Care:
AG welcomed the new SIGN Guidelines to be launched in December.

BECaD:
AG referred to this Middlesex initiative combining Diagnostics, Day Patients and A&E which has been held up as a model to follow, but since its opening there has been very little information on its performance.
NS  There is still no definitive report on the BECaD, and some concern over it’s A&E performance, so it cannot yet be used as a template.

Patient Safety:
JT highlighted cases where lack of beds had led to patients being inappropriately placed (deceased patients not removed from shared ward, young cancer patient’s elective procedure repeatedly postponed, youngsters placed in adult wards).
NS Plan not to lose more beds in Glasgow before needs are assessed.  No universal agreement on how many beds is enough.
NS/NHSGGC  Stressed importance of Community Care, accepting the need for adequate resources.
RC “Grey area” of re-admissions not logged as such, so a needs assessment is difficult.
GV This analysis can be done (ISD have the capacity).

Minor Ailments Service:
MA raised apparent anomalies over who is to be eligible for MAS.
NS Entitlement is to stay as at present, so removal of prescription charges will make no
difference.
MA Only 11% of eligible patients have registered, and this has since declined.
NS Accepts the service has not been adequately advertised/promoted, and the decline could be due to registrations lapsing when unused for a period.  More promotion is in hand.
MA Is the service cost-effective?  Shortage of staff may deter patients from attending.
NS Pharmacies are contracted to provide the service, so this should not happen.
MA Need to ensure the range of services is appropriate.
RC Stressed the poor take-up of prepayment certificates for prescriptions.
NS This is to be addressed early next year .

C-diff in Fife:
JW reported that an earlier 9-point Action Plan had now been replaced by a 20-point (“traffic lights”) plan, but some items were not applied because they were not yet resourced.
NS Checking the Board’s information system to ensure C-diff cases are flagged up by specialty.  This will be in the public domain.  NS/NHSFife  New Care & Environment Inspectorate (external inspection) under NHSQIS and linked to PPF network. There is currently too much self-assessment, but this inspection will be every 3 years, more frequently for poor performers, and will strengthen the process.
JW Single rooms – 20% in proposed new builds is inadequate to allow isolation.
NS The Business Case has been passed and is now fixed.

Stracathro ISTC (Netcare): JW accepted that as the contract has a year to run it is too early to decide on its future, but it is poorly placed for many Fife patients, and is it cost-effective?
NS The numbers attending are going up.
An evaluation will be carried out nearer the time.         NS

Dental Services in Fife:
JW highlighted the lack of information on Dentists’ private clientèle, making overall planning difficult.
NS Dentists as independent contractors are not obliged to report numbers of private patients.
NHS Dental registration in Fife is ahead of other areas.

Rural ambulance services:
KB acknowledged the increase in air ambulance provision, but repeated the need for adequate surface ambulance availability to link with helicopters which often cannot land close to a patient.
NS Accepted there were still challenges (single-manning being one), although there were now more vehicles than before.
KB What about linking Ambulance/Fire services locally, along Danish lines (where this service is private, but the method might be appropriate here)?
NS Individual area services are studying alternative ways of working.

The meeting ended on time, thanks to skilful but sympathetic chairmanship by RC, and allowing NS to proceed to her other commitments.
No date has yet been set for a further meeting, but will be advised in due course. RC/NS