View Full Version : Partnership unable to agree on redesign of services

22-Dec-11, 13:24
Members feel there is insufficient reassurance

North Highland Community Health Partnership (CHP) Governance Committee has been unable to come to an agreement on the proposed model for the redesign of services in the area.
Members attending an extra-ordinary meeting of the committee, held in Thurso on Tuesday December 20, felt there was insufficient reassurance about improved outcomes for patients. This was due to some conflicting clinical views about some aspects of the model.
However, the committee agreed there had been good public consultation and that the voice of the public had been heard and taken on board. It was clear that the public want to see this approach maintained to continue building trust.
The plan, which had been revised in line with earlier feedback, was to invest in improving community based services, provide palliative and end of life care in the Thurso area and develop the Dunbar site as a centre for health and wellbeing by consolidating most services on one site.
The approach would be to maximise the parts of the building and site that are in best condition and provide services when and where they are most needed. While these elements have broad support, the main areas of concern relate to closing the 12 inpatient beds at the Dunbar Hospital and reducing the operating hours of the Primary Care Emergency Centre (PCEC) to 9am to 9pm.
North Highland CHP General Manager, Sheena Macleod, said: “Change is always painful, but the status quo is not an option. It is important that community support is strengthened to cope with an increasingly elderly and frail population. It makes no sense to continue to invest in services we don’t need, yet not fund what we do need. This isn’t about cuts and savings or change for change sake, but planning for the future.
“The number of over 75s in Caithness is due to double between 2008 and 2033 and it is clear there needs to be a shift from hospital care to care at home. The proposal would turn the Dunbar site into a centre for health and wellbeing.
“I am bitterly disappointed that the committee was not able to make a decision. If we are not careful, we are going to be doing the people of Caithness no favours. We must not miss this opportunity to plan for the future.
“We heard, at the meeting, the importance of inward investment and opportunities and the proposals will support all of this. But I also absolutely accept that there are still concerns expressed by local representatives and we take these seriously. We need to sit down with the councillors and others who have taken the time to respond and keep working together.
Dr Moray Fraser, Clinical Director for North Highland, echoed Ms Macleod’s views.
He said: “It is my opinion, based on almost 20 years involvement with the Dunbar, and direct discussion with many GP colleagues, that the model is a sensible one. Closing the beds does not present a risk to patients.
“But I agree that it can hardly be helpful for the public or other committee members to not get a consensus from the GPs. So we must get round the table and resolve this as a matter of priority.”
The meeting was attended by around 40 local people. Part of the meeting included hearing from a number of representatives who provided feedback to the committee on some areas of concern or for ideas for further collaboration.
The Scottish Ambulance Service confirmed at the meeting that they have no concerns about the impact of the proposed changes.
Members were told that the proposal would not result in any negative impacts on the socio-economics of West Caithness. NHS Highland is also looking for wider opportunities to locate some support services in Caithness.
Staff who have permanent posts would continue to be employed by NHS Highland. Some staff would increasingly work in the community rather than in hospital and some staff would be offered redeployment to other areas.
A year ago, the governance committee set the strategic direction for the management when they unanimously accepted the need to accelerate change in the way services are delivered across Highland.
The committee unanimously supported the strategy to care for more people at home, instead of in hospital, resulting in inpatient care being concentrated in the most modern facilities to free up resources for better outpatient and community services.
And members recognised that the case being made by management to transform services in West Caithness was consistent with NHS Highland and national strategy.
But they could not fully endorse the proposed West Caithness model because of some apparently conflicting clinical views about impacts on patients.
The CHP Management Team will look in detail at the outstanding concerns expressed and set up further discussions. An update on the position will be presented to the next committee meeting in February.