Scottish Health Campaigns Network

 

 Minutes of meeting on 31st August 2013

 

Present:

Julie McAnulty (Chair)                                                Dr David Williams (Vice Chair)

James Sandeman (Secretary)                           Dr Patrick Trust (Treasurer)

Ken Barr          Cowal                                      Margaret Hinds            Health Forum SE

Alastair Glen    Health Forum SE                     Anne Hughes     )        (re Centre for

Tom Herbert    Stobhill                                                Catherine Hughes)       (Integrative Care

Lambert Sinclair  (former Treasurer)

 

Guests:

Dorothy-Grace Elder (Chronic Pain Campaign)           George Welsh                                Actions

Added item: Chronic Pain.  12 years ago D-GE (MSP at the time) was a founder member of the Holyrood Cross-Party Working Group on Chronic Pain.  A petition at that time collected 130,000 signatures.

The objective was, and remains, to obtain a residential centre for Scotland, as an alternative to sending patients to the Royal National Hospital for Rheumatic Diseases in Bath, which is itself said to be under financial pressure.  Wales also has its own centre.

Attendance at Bath involves first an assessment visit, followed if appropriate by a later residential stay of up to four weeks.

AG pointed out that treatment in Bath is paid for by the Scottish Government (some £1.1 million for 119 patients in the last 3½ years, or around £10,000 a head), but even if the patient qualifies for a refund of travel costs etc (two round trips of 800-1000 miles each) reimbursement can take weeks, imposing severe pressure on patients on benefits, already unwell and/or daunted by long lonely journeys.  Many Scottish patients are deterred by these obstacles, and therefore miss out on the benefits of suitable treatment.

In the 2000 debate in Holyrood Alex Neil MSP was supportive, and the Scottish Government has now launched a Consultation on the provision of specialist residential chronic pain services in Scotland,

(http://www.scotland.gov.uk/Publications/2013/07/9995/0, closing 27th October).

CH: it has been suggested that the Centre for Integrative Care at Gartnavel would be a suitable location: it is well placed, already sees 300 inpatients and 9,000 outpatients, and the two services could work well together.  The addition of Physiotherapy and Occupational Therapy would enhance the CIC.  Alex Neil had visited the CIC in July and was felt to be sympathetic.

Discussion moved on to Homeopathy.  The hospital was paid for through a homeopathic endowment, and its proximity to Gartnavel is seen as a bonus.

A CIC Action Group is being set up with charity status, hoping to have its first meeting in October.

NHS Lanarkshire plan to launch a consultation on Homeopathy.

We had hoped to have Dr Bob Leckridge of CIC speak to SHCN in 2012 but events conspired against his visit, and JMcA will contact him again.                                            JMcA

 

1) Apologies:   Dr George Venters

 

2) Minutes of 15th June:

A) Adoption moved by KB, seconded by DW.  Carried.

B) Actions: none outstanding

C) Matters arising: JMcA referred to the consultation on Cross Border Healthcare, to which she had submitted an SHCN response.  Only 22 responses recorded.  Matters to be resolved include cross-border payments, tariffs.  Royal College concerns over registration of doctors and surgeons.

 

3) Reports

A) Treasurer: PT expressed thanks to LS for his assistance following handover and delays in changing signatories.

Ÿ    Current balance £834.03.  Agreed to pay website hosting of £29.99.                PT

PT had (yet) another set of forms for new signatories: completed by JMcA and JS for PT to submit (again).                                                                                                  PT

B) Meeting with Alex Neil MSP: TH reported on July meeting, along with JMcA and JS, on the Stobhill Chemotherapy issue.  The Cabinet Secretary appeared to share our puzzlement at the apparent anomalies in the statistics seen, and would raise them with NHSGGC.  We hope for further news late September/early October.

C) Groups:

KB reported that he was no longer on the Cowal Out of Hours group.  Two salaried doctors are now covering OOH.

MH reported on the June visit to the Forum by Andrew Robertson (Ch, NHSGGC).

She reminded of the concerns expressed by Citizens Advice Bureau over increased workload resulting from the new benefits system.  This extra burden on a volunteer-run service comes on top of the patient advice and support service (PASS) which they had somehow inherited from the Health Council.

The Forum speakers include Cllr Matt Kerr (Glasgow, Social Work) in September, Dr Matthew Dunnigan in October (to be confirmed), Dr Stewart (A&E) in November.

CH added that while the welfare reforms are designed to discourage fraud they penalise long-term chronic sufferers who may be helped for a year but then have to fall back on savings and NI.  They encourage self-administration, but it has been alleged that the administrators are profiting from use of the appeal system.

KB suggested Community Councils and other groups might attract young people through school debating societies and social studies departments.

PT reported that the Vale of Leven group had closed.  He had joined the Helensburgh and Lomonds Group, which straddles the Glasgow & Clyde and Highland boundary.  He also mentioned the North of the River Solutions Group, championed by Jackie Baillie MSP.

He drew attention to the ticking time-bomb of GPs nearing retiring age, and the difficulty in recruiting young blood for rural areas.

 

4) Autumn Meeting with Cabinet Secretary

Ÿ    A) Agreed we would propose these October dates to Alex Neil:

Tue 22nd           Wed 23rd          Thur 24th          Wed 30th          Thur 31st  JMcA/JS

B) Issues:

1. Integrated care in a district hospital – PT continues to explore models of Primary/Secondary collaboration. He cited the challenges of MIUs closing overnight, A&Es closing in 2015, and emphasised the need to keep services local – avoiding if possible patients’ travel to “central” facilities.  Collaborative working includes the overnight on-call availability of social work and care services.

In W. Dunbarton/Vale of Leven GPs are taking on services which city GPs are reluctant to provide, and Nurse Practitioners are similarly broadening their scope.  More can be done in moving consultants etc to the patient’s area, and PT felt the Colleges were beginning to see the benefits of local, flexible delivery.

Local delivery is reinforced by the emergency retrieval system.

One possible obstacle could be challenges to revised working arrangements, although the EU specifically excludes health from trade agreement legislation.

AG saw some hope in the direction of travel in NHSGGC’s 50-page “Clinical Services Review – Fit for the Future”, seeking in improved Primary/Acute interface.

 

2. O/P Chemotherapy at Stobhill: following the July meeting with Alex Neil we will be looking for his update on the issue.

 

3. TrakCare: KB did not accept claims this was a pan-Scotland network, with difficulties in sharing information across Health Board boundaries.  This lack of communication has yet to be resolved.

Data protection issues continue to inhibit progress.  KB favoured a physical card system to ensure the patient held the key to access, while JMcA offered the alternative of an opt-in system using a USB fob.  Health Boards are holding back, and Social Work still do not use the CHI number identifier.

PT stated TrakCare was working in Primary, but not yet in Secondary, although out-of-hours x-ray transmission was working satisfactorily across Scotland.

Ÿ  Agreed PT/KB/AG would work together to produce a short paper/question for Alex Neil.                                                                                                                  PT/KB/AG

 

4. Stroke: MH felt progress towards public recognition of the importance of time is still painfully slow.  PT welcomed out-of-hours scans, but there was still the need to get the patient to the scanner.  MH and JS will draw up a form of words.                    MH/JS

 

5. Integration of Health & Social Care )

6. Chronic care in the community        )

9. Mental Health                                  )  JMcA saw these as closely linked, and she proposed to address them together.  Under Integration there would be Joint Integration Boards (JIBs) each under a Chief Officer, concentrating initially on elderly care.  The Public Bodies (Joint Working) (Scotland) Bill is now tabled and on line, and is likely to be heavily modified on its way through.  Areas of concern include:

>Statutory responsibility: where does it lie between the Chief Officer, the Health Board and the Local Authority?

>JIBs: are they to be “commissioning bodies”? (Beware English experience)

>Chronic and Mental Health: under whose budget?

>Areas covered: Health Boards and Local Authorities are not co-terminus.

JMcA expressed concerns that while the NHS is national, Social Work is local.  There are also VAT issues to be addressed, as registration varies depending on the status of the body involved.

KB pointed out that integrated working is already well under way in NHS Highland, with staff re-assigned where appropriate.  The main problem remaining is IT.

JMcA will draw these three issues together                                                  JMcA

 

7. Cross-border training, treatment: the recent consultation is just over, JMcA will consider whether to table a question at this stage.                                                       JMcA

 

Ÿ   Final questions for Alex Neil to be submitted to JMcA as soon as possible         (as above)

 

5) Membership, fees

Ÿ   Time was short – agreed to hold over discussion, as not a pressing concern

 

6) AOCB:

JMcA drew attention to the consultation under the NHS Longer Working Review which closes on 5th September.  PT may offer some input later.                                  PT

KB drew attention to Argyll’s closure of Care Homes, specifically Struan Lodge which it is hoped may be retained under an integrative care model.  The local group behind it will soon be seeking funding.

 

7) NEXT MEETING:     Saturday 9th November (subject to room availability)         JS ü