(Notes by JSS)

  • Dr Robert Cumming (Stobhill, Chair) (RC)
  • Nicola Surgeon (NS)
  • Dr George Venters (Edinburgh, V-Chair) (GV)
  • Becky Elliott Malcolm Allan (Stobhill) (MA)
  • Liz Porterfield  (LP)
  • Ken Barr (CATCHES, Cowal) (KB)
  • Julie McAnulty (Lanarkshire H.U.)(JMcA)
  • James Sandeman (HSFSE, scribe) (JSS)
  • Margaret Watt (Scottish Patients Association) (MW)
  • John Winton (LHC, Fife) (JW)

ActionPreamble: RC welcomed moves by the Scottish government in areas we have previously discussed in this forum, specifically: Elected Health Boards,  Primary Care & Services (Bill, September 2009),  Vale of Leven (a “best compromise”, with satisfactory monitoring in place, but residual concern over GP/Consultant cover – acknowledged by NS).

Glasgow Monitoring Groups: RC accepted NS’ decision to stand them down, but asked about a possible alternative mechanism to monitor remaining adult acute developments.NS Now that the ACADs were operating, the Monitoring Groups no longer had a function, and NHSGGC were not keen on a replacement. Questions raised by the Groups remain, to be resolved by NHSGGC (not the Government). Not convinced on the need for a successor to the Groups, but keeps an open mind.RC/JSS Repeated concerns about the lack of full information from NHSGGC: Medical staff in particular were in the dark.NS Clinical Forum supposed to be a channel of information, but accepts shortcomings. NHSGGC Review on 19th October may see this issue explored. ???

North Lanarkshire Mental Health: JMcA Acute Units policy not clear – the original intention of two units (one new, one refurbished) seemed to have been reduced to one (new), and the target date extended to 2013.  Proposals woolly from the start.  Still awaiting a response.NS Site (Monklands or Wishaw) not yet chosen.  Target is Financial Year 2012/13.JMcA Existing Monklands wards not up to standard. Bed numbers reduced from 2 x 112 to a total of 112.  NS Accepts there is need for modernisation.  Monklands plans probably set back by her decision to retain A&E.  Bed modelling generally will be kept under scrutiny. Offered to help if information is not forthcoming.RC Need for proper training of CHP staff who will take increased share of mental health care.

NHS Fife:JW FoI request for costs on the New Victoria Hospital extension had been answered (£17.3m)NS Insists commitments made will stand.  As much as possible of the Full Business Case will be published (i.e. with the minimum of “redactions”).JW Annual Review was postponed because of Swine ’flu – will it happen?NS Yes, in January 2010.  Earlier if possible. NS

Elected Health Boards:JW Concerns over pilot schemes so far, e.g. ballot papers not to show political affiliation.NS Pilots will be signed off next week, with the regulations yet to be finalised (details should be out soon).   NS Political parties will not be barred.  Election expenses will be limited.   Further schemes are on hold pending a review of the first pilots.KB Concern over NHS Highland scheme – recognised by NS.

Minor Ailments Service:MA Now that MAS is up and running, is SGHD monitoring its effectiveness, cost-effectiveness, possible improvements?NS Feedback suggests MAS is popular, but no nationwide survey is planned.MA What about costs of “over the counter” preparations (when generics are often cheaper) and implications for smaller (“marginal”) pharmacies? NSNS Keen to see greater use of generics.RC Welcomed the provision of confidential consultation areas.NS Feedback from pharmacists is positive on this point.MW Some patients cannot take drugs, yet have difficulty getting alternative medicines on prescription.MA Pointed out that homeopathic medicines for example can be obtained under the NHS.RC Added that some GPs are homeopathy-trainedNS Will consider this issue NS

IT/Data Protection:KB Cited Joseph Rowntree Trust survey of 46 Whitehall databases (some within the NHS), finding many failed to comply with the Act. Voiced concern over the pilot Electronic Shared Assessment, particularly on opt-out.NS ESA is an opt-in system, so is not accessible to all services.  KB But the assessments are drawn up before the patient is given the option.NS Electronic Care Summary requires express patient consent, and he/she can opt out. Data loss or misuse is never acceptable and we aim to make data as secure as possible: one reason for favouring opt-in. SGHD pragmatic approach to e-health (unlike England, which aims for a single national database).RC Raised the issue of Public Private Key Encryption to protect data.  NS Will obtain a fuller response NS

BECaD (Brent Emergency Care & Diagnostic Centre):RC Reminded NS that we have been unable to obtain the promised BECaD report.NS Will have this checked.

Beatson Oncology Centre:RC Beatson is “coping” but repeated concerns over services at Stobhill.NS Waiting Times at the Beatson have been greatly reduced, with chemo down to two weeks.RC Out of hours services are still not working as anticipated.NS General feedback on the Beatson is good.  Agreed that local access is best.

Private Healthcare Facilities:RC Raised use of Vanguard Healthcare to reduce Waiting Lists in Edinburgh Royal Infirmary.NS Confirmed there were no plans to increase use of the private sector, but  she will not prevent Health Boards using them where appropriate.  Scotland’s use of the private sector is minimal.   EU laws on cross-border treatment is under review.  One country may not always have the resources to treat all cases (e.g. swine ’flu cases to Sweden, England) NSMW Prostate cancer robotics treatment a case in pointLP Assessment by Health Technology Group is under way, as basis for planning of Scottish services.

Continuing Health Care:MW In view of recent discussions, what are SGHD’s intentions on CHC beds?NS No plans to close beds, although this is up to Health Boards. NHSGGC provision exceeds demand.  Board considering St Margaret’s proposals, and NS is hopeful the two organisations can reach agreement.MW Reported SPA have commissioned a research report on St Margaret’s – due in September.RC Asked if there is any nationwide study on hospice need.NS No, individual Health Boards are required to provide services needed.

Delayed discharges:JW Mentioned divergent views in Fife on whether responsibility lies with NHS or Council.  NS Partnerships are struggling to keep delayed discharges down, although current levels are well below 2006 levels.  SGHD carries out “census monitoring” and monthly checks.

Next meeting: To be arranged.  Meantime SHCN proposes to hold its next meeting on Saturday 3rd October