Argyll & Bute Health and Social Care Partnership Oban Lorn & Isle Locality Mull and Iona Locality Planning Group 14 th September 2016 11.15am Meeting Room Mull & Iona Community Hospital Present: Apologies: Annie Macleod (AML), NHS Highland, Chair Shaun Davidson (SD) NHS Highland Fiona Brown (FB), Mull Community Council Billy McClymont (BMC), Mull Community Council Kate MacCallum (KMC), NHS Highland Jenni Hodgson (JH), Argyll & Bute HSCP Morag MacLean (MM) North Argyll Carers Centre Anne Baxter (ABa), Ross of Mull Action Group Gail MacGregor (GMG), NHS Highland SR Ruhemann (SR) Iona Community Council Andy Brady (ABr), Scottish Ambulance Service Colin Whiteford (CW), Scottish Ambulance.Service Minty MacKay (MMK), Ross of Mull Action Group Katie Gordon (KG), Iona Community Council Dr Vic Linnemann (VL) Retired GP Susan Spicer (SS), Scottish Care Elaine Garman (EG), NHS Highland, Lindsay Barr (LB), NHS Highland Caroline Champion (CC), NHS Highland Colin Morgan Julie Walker, Tobermory Pharmacy Margaret Burnip (MB), Argyll & Bute HSCP Karen Thwaites-Jones (KTJ),NHS Highland Video Conference Dr Richard Wilson (RW), NHS Highland Steven Malcolm (SM), Argyll & Bute HSCP Stephen Whiston (SW) Head of Strategic Planning and Performance Item Detail Action 1. Welcome and Apologies AML welcomed everyone to the 3 rd Mull and Iona Locality Planning Group meeting. Apologies were made as noted above. People in Mull and Iona will live healthier, longer and happier lives 1
2. Notes of Last Meeting The minutes of the last meeting were read and the following amendments noted: The colour coding of the Primary Care Action Plan document is Green = On Track; Amber = Work Commenced but not completed; Red = Not on Track. Grey indicates that the task has been completed and the item should be removed from the document or moved to the end. ABr indicated that he had requested that a further SAS Incident and Performance report be compiled. 3. Matters Arising 4. Mental Health AML suggested that this item be carried forward to the next meeting as DW was not present. 5. Primary Care Development Plan Shaun facilitated the discussion: Anticipatory Care Planning: - Tobermory Chronic Disease Management Programme registers are now up to date and gold standards framework meetings are in place. The team has looked at practice respiratory clinics as part of the chronic disease management for Tobermory; 1 clinic has been successfully completed and 2 more are planned. Anticipatory Care Plans; KMC is providing training to the Protected Learning Time events for Primary Care on Mull. KMC has compiled a list of all patients from the GP practices who are aged 80 and over; the patients will be cross referenced with Social Work and those not known to either service will be offered a visit by Community Nursing. Anticipatory Care Plans will be developed where appropriate. FB noted that it was important that contact was made face to face and not over the phone; ideally local knowledge was preferable. KMC spoke about the first in-service day for nurses, when the team profiled their case load and cross referenced it. The system for sharing anticipatory care plans between Health & Social Care professionals is still being developed. A Primary Care Development manager is to be appointed; the post is currently being advertised externally. People in Mull and Iona will live healthier, longer and happier lives 2
AML & SD had a meeting with Steven Morrow and Iain Ross to discuss how the IT infrastructure for services can be improved on Mull between primary and secondary care, this includes the surgery on Iona. Steven Morrow is leading on this project. AML indicated that the chosen system would be procured for the whole of NHS Highland and not specifically for Mull; it was noted that contracts were due for renewal in January. Estate Services are undertaking the scoping exercise for Salen Surgery as the present site is not fit for purpose. Potential options are to extend the present site, carry out remedial work to the present surgery or move to Craignure; once the outcome of the scoping exercise is known, formal consultation with the island community will be undertaken. There is a pilot in Scotland to support the Out of Hospital Cardiac Arrest strategy. The Scottish Fire and Rescue Service is currently planning a roll out of the pilot to the following stations in OLI; Tobermory; Craignure; Salen and Bunessan on Mull along with Coll, Tiree and Colonsay. SD will update as information becomes available. SD 6. Draft Scenario Planning A table top exercise, led by the SAS, is to be held. The first planning meeting was held on 26 th August and a further meeting is planned for 20 th September. The exercise itself will be held on the 10 th November and an invitation will be sent to all attendees. The aim of the table top exercise is to give all agencies and departments, including local community members, an opportunity to share information and discuss roles and responsibilities in response to a variety of medical emergency situations on the islands. Community input will be asked for in the form of scenarios that can be worked through as part of the table top exercise. There was a discussion around which GPs would be required to attend; it was agreed that Dr Alex MacLean and Dr Frank Teunisse would be present and Dr Jens Ludders, Locum, who has worked in the Ross of Mull would have input into the scenario setting meeting on 20 th September. Ideally around 8 community representatives would be invited along with First Responders from all over the island; travel expenses for Community Representatives could be paid. People in Mull and Iona will live healthier, longer and happier lives 3
Police Scotland and the Coastguard would not be invited to attend but would be made aware of the exercise, this to be further discussed at the meeting of 20 th September. Actions AML to speak with Drs MacLean, Teunisse and Ludders regarding the planning meeting on 20 th September. SR and BM nominated to email ABr with scenarios and names of 8 Community Representatives from all areas of the island. AML SR, BM 7. SAS Performance Data ABr spoke to the SAS Incident and Performance report; the total number of call outs for August was 46; Monday was again the busiest day. There were between 2 and 8 major calls coming in with the majority of calls originating from within the PA65 to PA75 postcode areas. Several incidents were looked at in depth. In all cases the first responders arrived before the ambulance and consequently the ambulance was stood down. In one incident the Helimed was called; ABr explained in that case the ambulance is not required to wait as the Helimed has its own stretcher to ferry the patient. The response time from Bunessan to Salen with blue lights and sirens on was timed at 40mins. ABr advised one person based in the Tobermory area has been successfully recruited and commenced technician training last Monday. The hope would be that they would progress to be trained as a fully qualified paramedic. CW continued to say there are 3 people employed throughout the island and most of the calls are coming from the north of the island. There was a discussion around the practicalities of people applying to the SAS on Mull as there is a requirement that applicants should live within 3 miles of the area. The concern that there are only 2 vehicles was also raised. AML stated the SAS was part of the wider social care system and recruitment is difficult in any area; we have to grow our own staff in every discipline. RW was asked if his staff had any concerns regarding the provision of SAS services. RW advised the correct route for any concerns was through AML, GMG or himself, not to involve members of the public. AML requested GMG to advise all GP s to direct any concerns as RW requested. CGC GMG People in Mull and Iona will live healthier, longer and happier lives 4
8 Nursing Team Update KMC advised she has assessed the caseloads for Mull. From Craignure to Tobermory there are 227 cases which are currently being reviewed by her staff. KMC reported that currently her focus is on placing a localised team into the Bunessan & Iona areas to avoid long distance travel from other areas. Plans to have a Nurse led clinic once per month or more are being explored and she has requested that the clinic building to be painted in preparation. The clinic would be led by a nurse who can assess minor illness and injuries, undertake diabetic and COPD reviews and prescribe medicine. This would happen in conjunction with a GP in addition to a GP surgery. It would form part of the anticipatory care planning with District Nurses. KMC stated professionals would be more co-ordinated and a team approach would be used to deliver services. SR stated the community would need an explanation of what it is and how it would operate. AML advised the team are working to develop a neighbourhood team model and are developing a health and social care worker post which is going through HR processes at a local level presently. KMC informed she is exploring developing a new post; Practice Community Nurse. This person would work both in the community and in practices. AML suggested working with the staff in place and local people to develop a more flexible team. SD mentioned a development day coming up and that staff are ready for change. SD highlighted the need for flexibility within the team. MM highlighted the issues she has with unpaid carers needs and SR expressed the need for a nurse based on Iona. KMC advised an Iona based nurse would reduce a feeling of isolation and would be very much part of the wider team attending training and receiving support. KMC 9 GP Recruitment The closing date has passed for the current recruitment campaign and interviews will be arranged for early October. The plan is to staff the island with 5 full time equivalent GPs all year round; there will be no increase in the summer season. AML discussed the interview panel; RW will take the clinical leadership and 2 members of the community will be required. People in Mull and Iona will live healthier, longer and happier lives 5
AML stated they were back to the drawing board regarding a GP for Salen. The team are currently developing documentation to advertise Salen as a business to interested parties. RW stated recruitment across Scotland is in crisis and would welcome any help from the community to encourage GPs to come and work on Mull. It is becoming more difficult month by month not just on Mull but across all GP services Scotland wide. There was much discussion around how to attract GPs to Mull and the issues involved. The myth that Mull is a difficult and unwelcoming place to live; partner employment and family inclusion were some of the issues cited. Arran Island was mentioned as the team there were successful in recruiting a GP through the media of film. AML stated there was a small budget available for advertisement and a local company in Oban had been used in the past to make a film to recruit Doctors to the hospital in Oban. AML suggested approaching the company for advice. ABa also suggested that the Mull & Iona Trust could help and AML asked VL and KG to become involved in the project. RW informed that he was available to give information about the business side of the practice, the workload and appointment times which are less onerous than a city practice. He could also advise about the business aspect of Primary Care on Mull. ABa VL KG RW 10 Communication and Key messages The key points agreed from this meeting are: 1. Scenario plans to be in hand for 10 November, further information to be disseminated to include community reps. 2. We are progressing anticipatory care planning for the most vulnerable of the population and are on track for that. 3. KMC informed local teams are hoping to introduce Nurse led clinics on Mull & Iona. LPG was also delighted to welcome Kate and her family permanently to Mull 4. LPG reviewed all Ambulance data for August People in Mull and Iona will live healthier, longer and happier lives 6
11 AOCB MM requested more visibility for unpaid carers in the action plan Child health elements of the plan very much SW led, to get a health element in, give to AML soon as there is a timescale. Could something be sent to SD next week? SW advised today was very helpful AML agreed panel have been finalised to oversee integrated care fund allocation, AB and a community rep from Colonsay GMG mentioned there was a VC in Bunessan and to let ABa know in advance if it was required 12 Date of next meeting 12 October 2016 at 11.15am in the Meeting Room, Mull & Iona Community Hospital, Craignure, Isle of Mull NOB People in Mull and Iona will live healthier, longer and happier lives 7