Community Lochs Parish Forum
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LOCHS PARISH FORUM (Working Title) NOTE OF MEETING OF LOCHS PARISH FORUM, MONDAY 13th NOVEMBER, 2006, HELD IN STORLANN, RAVENSPOINT, KERSHADER, SOUTH LOCHS In attendance Morris Black Roderick Macritchie Donna Macdonald Donna Graysmith Christine Macleod Mary A MacIver Finlay MacIver Peggy Buchannan M Kennedy Anna M Kennedy D Macleod Nellie Kennedy Gemma Holden Joan Mackenzie KR Mackay Mary Macdowall Colin Brand Margaret B Macleod Ann Moqbel Donald Macdonald Marilyn Macdonald Angus Macdowall Christine McKee – Primary Care Manager - NHS 24 Finella Morrison – Lead Nurse, Community Malcolm Smith – Director Social Work, CnES Cllr Alec Mackintosh Cllr Annie Macdonald Apologies Rev A Coghill Dr Marshall Susan Barker Dr Rigby Margaret Macleod C Macaulay Donald Crichton – Local Health Council Michael Cook – Community Health Co-ordinator, H.B Julie Yates – Public Health
Opening Welcome Cllr Annie Macdonald welcomed all to the meeting. Note of the last meeting was approved by Donna Graysmith and Colin Brand. Matters arising – Paediatrics, noted. During the meeting the following was raised and discussed as follow:
Mr Malcolm Smith, stated quite clearly that residential day care is not an option because small scale provision is exceptionally expensive due to the high level of staff required. Mr Mackintosh stated possibility of having a Day care facility in North Lochs area at the house beside North Lochs Surgery, as this did not seem to be used. There is a need in particular for carers looking after elderly parents each day, to give the carer as well as the user of service a change of scenery. Agreed by the Scottish Executive to bring Health into the Community, however, the Executive needs to ensure money follows this. – meeting agreed with this. Possibility of better use of Care Unit in Gravir. Possiblity of care home unit like Carloway? Malcolm Smith explained the following: Would this be small scale residential outwith Stornoway area? Would this be used all the time? Sharp edge of needs, requires 3 staff minimum at any one time to be available, 24 hour care, costs very, very high. Carloway Care Unit is specialising in Alzheimer’s, needing intensive support. Day centres are in Ness, Barvas and Carloway as well as Stornoway. First Step is to identify need in Local area. – agreed this was sensible and Malcolm Smith and Finella Morrison to report back to next meeting with outcomes. Therafter funding and resources will be an issue. Christine Macleod, Leurbost then explained: Her home had been up to standard in the late 1990’s and would be available for use to the Social Work Department if the need arose, this facility is excellently situated beside the Community Hall in Leurbost, had passed all rules and regulations in the late 1990’s as a Day Centre. Facility needs Fire Doors, ample parking available, wheel Chair facilities are included, would serve the whole of the North and South Lochs area, and ideally placed for minibus (North Lochs). If this facility would be bought it could possibly save expense of “new build”. Possibility of Social Work working together with the community. Suggestion of hospital discharges which would lead to fellowshipping, friends, various disciplines, physiotherapy, food preparation, hair dressing, rehabilitation from hospital to build confidence prior to entering own home. It was pointed out that there are a number of lonely people in North and South Lochs with varying degrees of need. Respite for families seen as very important – locally. Befriending issues were also raised – voluntary action Lewis has such a scheme and it may work well in Lochs area. Groups in areas are Silver Darling, Cairdean Cordall Cheann a Loch and Pairc Social Club – possibility of all groups working together. Meeting agreed for each village to be addressed separately throughout Pairc, Kinloch and North Lochs in relation to type of Day Care provision which may be required:
Finella and Malcolm Smith to assess above together with local nurses. Report back to next meeting. Meeting unanimously agreed on the positive benefits of day care, for the health service users and the support it can offer to family carers. It was agreed that Finella and Malcolm would take the lead, linking with community representatives to support work on a needs assessment for day care. Even if the “business case” is made funding would be a challenge. The opportunity potentially available through the property in Leurbost was noted.
It was explained Mr Michael Cook is looking at the overall transport situation throughout the islands, to ensure that best use and best value may be achieved which would mean that it may be feasible to use and co-ordinate minibuses when at present they are lying idle.
Christine McKee gave background information re: NHS 24, and stated that this had started over 2 years ago. Christine explained that GP’s were not employees of the Health Board. They have a contract with the Health Board agreed between the British Medical Association and the Government. Under the old contract GP’s were responsible for their patients 24 hours a day 7 days per week. Shortage of GP’s ensued and the main barriers to recruitment was the long working hours. British Medical Association and Government agreed strategy that it would be Health Board responsibility for Out of Hours working. If GP’s opted out of out of hours work they would lose the associated funding. Vast number of GP’s have decided to opt out. Pairc, South Harris, South Uist and Barra decided not to opt out and they still continue to care for their patients as in the past. NHS 24 started life as an advice centre, which was national and operating from Aberdeen, Glasgow and Edinburgh – this expanded into call centres where an operator would pick up phone ask protocol list of questions and pass on to a Nurse, who would then explain what your next step as patient would be (generally known as triaging the call). A Highland “Hub” was created in Inverness, which would act as an intermediary between NHS 24 and the local GPs. Staff at the “hub” have local knowledge about how to access local GPs, District Nurses, etc. Safety net which is in place is that if there is not an NHS24 nurse available to triage the call within 40 minutes then the call will automatically be put through to the GP on call. The Health Board have received very few complaints about NHS 24. Generally felt that people do not like to complain. Should any member of the public wish to make a complaint or comment on the service they have received then please do not hesitate to contact Ms Christine McKee on 708026. It was made clear that it is up to each individual Doctor if they wished to be on Out of Hours duty. Concerns raised at meeting were as follows: Nurses not getting through to the system. Repeating yourself at least twice over the telephone. If patient is unconscious how to you retrieve their name/date of birth etc for the telephonist/nurse on the other side of the phone? May lead to confusion in elderly people, and may wait until morning, which could be dangerous. Inverness link may not be working very well. Why all the protocol? Why information in the press and media are not more aware of how to complain about this service? Gravir Practice has not opted out of Out of Hours service and gives an excellent service. Concern if Out of Hours service does possibly start then what will they know about medical history, as local GP knows latest medical history. If person has a Heart attack and dies if ambulance was called will it take away corpse? Answers Even though there are flaws in NHS 24 the previous system was not perfect, and some experiences are not very good whereas others experiences are good. It was not perfection pre NHS 24.
There is a national body with an ongoing training programme in relation to protocol. IF PATIENT IS UNCONSCIOUS PLEASE CONTACT THE AMBULANCE IMMEDIATELY, DO NOT USE NHS 24. WARNING: DO NOT USE 999 NUMBER ILLEGITIMETATLEY TO BYPASS NHS 24. It is not part of a GP’s contract to contribute to Out of Hours, there is no obligation on GP, choosing to do this is Not Standard Practice. GP’s are on call between 6pm – 8am and there is 24 hour cover by GP’s from 8am – 8pm at weekends and on Public Holidays. If person has a heart attack and dies an ambulance will not take corpse away, Police will need to be called and doctor on call or patients doctor will need to sign death certificate. There should be no charge for the ambulance to be called to this type of incident. Cllr Alec MacKintosh asked who Carloine Weinz was – answer she is a communications officer/press officer for NHS 24, she had been speaking to Cllr MacKintosh prior to this meeting.
Mr Malcolm Smith explained to the meeting that there will be a report going up to the next series of Council meetings in December regarding meal preparation. This will discuss the new pilot scheme which will be set up in Stornoway and the West-side of Lewis to distribute ready made hot meals quickly throughout the community to be delivered between 11.45am and 2pm, there will be no evening or night time service. Financially at present it costs £10.00 per meal to prepare – this service may be excellent or mediocre. The main driving force is finance constraints, Social work budget is already £400k over budget. There is also food hygiene regulations eg: personal care, preparing a meal, serving food, leaving this home and moving on to next home where you first start with personal care etc.. Around 300 people are receiving meals at present. Pilot will begin at the end of January and continue for 3 months. Pilot to include: co-ordinator to ask what type of meal each person would like each day for a fortnight (2 course meal) from a menu selection sheet. Meals are pre prepared and frozen, then taken to a “centre point” (Grianan for Stornoway, Lionel for Ness, Carloway for West Side, unsure re Lochs area). Meal is then re heated, delivered in “Hot Boxes” to homes. Home carers will be available and ready to assist with food if required. Payment for each of the “frozen meals” is roughly between £2.30 and £2.50 per day. If this proves to be successful it could be broadened out into other areas, if people on their own require meals who would reach a certain criteria, this would not happen immediately. Need to see this is in action and see how this works. In Aryshire the scheme seems to be very successful. Concerns were raised about the home carers have they been consulted or are they to be redeployed? Many will be redeployed in personal care duties. There are fixed hour contracts in place already in Ness and Barvas.
Members of the meeting felt concern over the future of the Gravir Practice. This was a Private matter, and not up for discussion at this time, Dr Barker has not intimated that he is retiring and it is Dr Barker’s General Practice. Morris Black has stated that Pairc Community Council has invited Dr Barker along to the next meeting to discuss this matter. Concern over the disability access to Gravir Surgery due to steep incline of the road. Cllr Annie Macdonald has written to Mr Michael Cook re this and other issues which were previously raised and is awaiting a reply.
Cllr Alec MacKintosh asked the meeting to be held more formally with a constituted body to make meeting more structured, and also to have a number of contact persons. Cllr Annie Macdonald asked for a show of hands as to how many people would like to formalise this meeting - no-one wanted to formalise the group yet. It should be noted that there are already 64 groups in the Lochs area. Agreed to continue informally for the time being. Date of Next Meeting set at 13th February 2007, between 7 and 9pm at North Lochs Community Centre.(if available). if unavailable Laxay Hall. Please keep an eye out for the poster nearer the time.
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