Chief Officer's Report
Argyll and Bute Council · 30 August 2023
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 30 August 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 Integration Joint Board Agenda item: Date of Meeting: 30 August 2023 Title of Report: Chief Officer Report Presented by: Fiona Davies, Chief Officer The Integration Joint Board is asked to: Note the following report from the Chief Officer Introduction I would like to welcome you to my Chief Officer Report for August and I hope you find it of interest. In this month’s report one of the areas I have outlined is that the Scottish Government’s Islands Programme has awarded £450,000 to assist with the modernisation and reconfiguration of the Tigh a Rudha care home on Tiree. The facility is owned by Argyll and Bute Council and run by the HSCP. This investment is very welcome and really good news for the local communities of Tiree and Coll who use the care home. I was also delighted that the Project Wingman bus was recently in Argyll and Bute as part of its tour around the NHS Highland Board area. This is a fantastic charitable project which was founded in 2020 in response to the COVID-19 pandemic and it provided a well-deserved opportunity for HSCP staff to pop along to the bus for a break and to enjoy free refreshments in a relaxing atmosphere. On the 5 July we celebrated the 75th anniversary of the NHS and I know that many HSCP staff celebrated the anniversary with local workplace events and there was an abundance of homebaking as well as plentiful tea and coffee. It was great to see so many people taking part on the day and I would like to thank all staff for their hard work and commitment to the people of Argyll and Bute. I also had the pleasure of attending an NHS 75th Anniversary Reception at the Scottish Parliament in June which was hosted by the Scottish Government. I attended the event with three members of staff who were drawn at random from a list of HSCP Excellence Award nominees who expressed an interest in attending.
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2 In the report I have also included a brief update on the recent iMatter staff survey and I was heartened to see that there has been a significant increase in the number of staff responding. Thank you to all HSCP staff for your commitment to this survey. A report on the full results of the survey will be presented to the IJB at its September meeting. It is also important that my report highlights some of the organisational challenges facing the HSCP and this month I have outlined the major pressures we are experiencing with the provision of General Dental Services across Argyll and Bute. As well as including information on what is going on locally I feel it is important to include regular updates on some of the key policy decisions that are taking place at a national level. This month I have included information on the accountability arrangements for the National Care Service and also the new national strategy on dementia. Thank you once again for taking the time to read the report. HSCP Updates iMatter Staff Survey The iMatter staff survey for this year concluded with a 48% response rate, a marked increase on last year’s 31%. While still slightly lower than the NHS Highland Board wide figure of 50% it is a 17% improvement on last year. While striving for continuous improvement it is important to celebrate the incremental improvements that we are making year on year and this is testimony to the ongoing work in this area and the commitment of HSCP staff. Strong employee engagement remains a priority for the HSCP and there has been focused work in recent years and we will continue to build on the feedback we receive to inform actions. A report on the full results of the survey will be presented to the IJB at its September meeting. Project Wingman The Project Wingman bus was recently in Argyll and Bute as part of its tour around the NHS Highland Board area. It was located at Mid Argyll Hospital in Lochgilphead from 26 - 30 June and was at Cowal Community Hospital in Dunoon from 3 - 7 July. HSCP staff (both NHS and Council) were invited to pop along to the bus for a well- deserved break and to enjoy free refreshments in a relaxing atmosphere on the big blue bus. They were also able to access well-being and self-care information and chat to colleagues from the Guardian Service, People Services, Spiritual Care Services and Talent Services.
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3 We would to thank everyone who came along on the day (over 200 staff attended across both localities) to visit the bus and our thanks to colleagues who volunteered to help when the bus was in Argyll and Bute. Project Wingman was founded in March 2020 in response to the COVID-19 pandemic and it rallied 6000 grounded, furloughed and redundant airline workers to provide a listening ear, a cup of tea and empathetic understanding. The tour around NHS Highland was funded by NHS Charities Together and NHS Highland Endowments. £450,000 Investment in Tiree Community Care Hub In May 2023 Argyll and Bute Council, on behalf of the HSCP, was successful in applying for funding of £450,000 from the Scottish Government’s Islands Programme to assist with the modernisation and reconfiguration of the Council owned Tigh a Rudha care home on Tiree. Tigh a Rudha is a critical part of the island community and provides essential care and support to elderly residents of Tiree and Coll when required. This investment will act as a catalyst to better meet the current and anticipated future care needs of both islands and will support Tiree’s and Coll's population retention and growth plans. Tigh a Rudha will be transformed into a modern and flexible Community Care Hub which will also provide onsite key worker accommodation, and intermediate, end of life and respite care facilities and GP beds. A short life discussion group involving the main stakeholders of the project, including both communities representatives, staff and GPs, has also been set up with the aim of supporting decision making on the future use and layout of the building in the context of what was approved by the Islands Programme and the Tiree and Coll Community needs. NHS 75th Anniversary Parliamentary Reception As part of the NHS 75th Anniversary celebrations the Scottish Government hosted an NHS 75th Anniversary Reception at the Scottish Parliament on 20 June. An invitation to the Reception was extended to all IJB Chief Officers and three members of their staff. The focus of the evening was based around: celebrating and demonstrating 75 years of achievement and how it has made a difference to people’s lives recognising the contribution of staff - across NHS, partners in care, voluntary organisations, and volunteers - thanking them for their hard work and commitment, demonstrating their achievement and successes, whilst acknowledging the challenges they face
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4 confirming the ongoing commitment to the founding principles of the NHS; looking forward and building confidence amongst staff about the future of the NHS, recognising that the way care is delivered will continue to change, with a particular focus on innovation and technology. The Chief Officer attended the event along with the following HSCP staff, who were drawn at random from a list of HSCP Excellence Award nominees who expressed an interest in attending: Karen Nonhebel, School Nurse, Mull and Iona Nadia Johnson, Mental Health Officer/Team Lead Mental Health Social Work, Helensburgh Adrian Angus, Porter & Assisted Vaccination Teams with transport and queue management, Lochgilphead Blue Green Prescribing for Scotland The HSCP's Public Health Team is participating in an exciting programme in partnership with Scotland's Hydra Nation and Glasgow Caledonian University to investigate how to increase the use of non-pharmaceutical approaches to common mental health conditions. This is in recognition of the environmental impacts of antidepressants and emerging evidence about the efficacy of antidepressant use. Scotland is abundant in natural water environments (blue spaces) which can help promote mental health and wellbeing. However, these blue spaces are at risk from pharmaceutical pollution such as antidepressant residues, for example, as a result of unsustainable prescribing practices, overprescribing, and improper disposal of unused medicines. Aside from the negative impacts on water environments, pharmaceutical use also contributes 25% of NHS Scotland's total carbon emission. Blue-green prescribing is the prescribing of water based non-pharmaceutical interventions and eco-informed prescribing of antidepressants to people with common mental health conditions. The research, defines blue-green prescribing as: 1. The prescription of blue space activities (e.g. swimming, kayaking, surfing, paddle boarding, canoeing, etc.) to people with common mental health conditions using social prescribing pathways. 2. Green prescribing – is the eco-informed prescription of antidepressants to people with common mental health conditions by considering antidepressants with less environmental impacts. The research hopes to inform a novel prescribing strategy to help reduce antidepressant pollution and improve public mental health. Blue-green prescribing could also help reduce prescribing costs and waiting lists for mental health services by making locally available blue spaces activities available and accessible to wider population groups. Further information is also available from the following Policy Brief.
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5 Vaccination Programmes The Spring/Summer COVID-19 vaccination programme across the HSCP was completed on 30 June 2023 and the overall uptake across all cohorts was 72.2% with the care home uptake at 92%. Our vaccinations teams are already working on preparations for the autumn/winter vaccination programme. The HSCP is also currently running pneumococcal and shingles vaccination clinics and staff have been lettering and texting those individuals who meet the eligibility criteria to invite them in for a vaccination. Integration Joint Board Unaudited Accounts The Unaudited Annual Accounts for the Integration Joint Board for the period 1 April 2022 to 31 March 2023 have now been published and a copy of the accounts can be viewed online here. Service Updates Orthopaedic Referral Pathway Redesign In 2021-22 all advanced practice physiotherapy (APP) staff within the HSCP undertook significant additional training to further develop their knowledge and skills around current best practice for the management of orthopaedic conditions. This additional training and review was part of a project to review and redesign the orthopaedic referral pathways for patients and to develop an Active Clinical Referral Triage process as part of the wider 'realistic medicine framework'. In 2022 redesign works started to create these new orthopaedic pathways for all Argyll and Bute residents to provide them with rapid access to specialist Allied Health Professional orthopaedic services including imaging, specialist injections and orthotics. The aim of this redesign was to ensure patients receive the right information, investigations and treatment at the right time and to ensure any patients requiring surgery had been offered all other options first. In February 2023 the new pathway changes were implemented with all but the most urgent referrals being directed to the specialist AHP service. This is the first AHP led service of its kind in Scotland and the results so far have been extremely encouraging as they highlight that out of every 100 referrals that would have previously been added onto a consultant waiting list only 35 are being added to the list now with the remaining 65 being managed successfully by local AHP services. The outcome of this redesign has been very positive for patients as not only does it speed up the process for them to be seen by an appropriate health care professional but at the same time it reduces the waiting times for patients who do need to be on a consultant waiting list freeing up consultant capacity and reducing patient travel.
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6 Organisational Challenges Dentistry Services The HSCP was formally informed on 19 May that The Hollies (Pain Free Dental Company), an independent dental practice in Dunoon, was intending to change their business model and plans to de-register from the provision of NHS dental services to adults from 30 September 2023. The Practice has informed patients in writing of this intention. This change to the business model in Dunoon mirrors the picture across the country where a national shortage of NHS dentists has significantly reduced access to NHS dental services (also called General Dental Services) in many Health Board areas. There are 14 Dental Practices within Argyll and Bute (who have varied commitments to NHS Dental Services) and none of these are currently accepting new NHS adult patients. Many Practices have reported difficulties filling dentist vacancies and dealing with the backlog of care following COVID-19. In addition to independent dental practices there is also what is called the Public Dental Service (PDS) which is a service run by local NHS Boards with dentists working for the PDS salaried and employed by the relevant Board. These are separate to independent practices and have a responsibility to provide emergency treatment (but not routine care) to unregistered patients. They also provide dental care to those individuals registered with the PDS who have additional support needs. The NHS Highland Dental Helpline (0845 833 2310) can offer advice to the public on which Practices are currently offering NHS registration for patients and it will also provide advice and appointments for unregistered dental patients with a dental emergency. For dental emergencies out of hours always dial 111. A reform process of dental services is also currently underway at a national level to understand and make improvements to the current situation. (The Scottish Government has also recently issued a press release on the payment structure for dentists which you can view here) National Updates Partnership on National Care Service The Scottish Government has reached an initial agreement with local government and the NHS about accountability arrangements for the National Care Service (NCS). The agreement aims to establish who will be responsible for people’s care once the NCS is established. Overall legal accountability will be shared between Scottish Government, the NHS and local government. Staff will continue to be employed by local authorities, and councils will still be responsible for assets like buildings and the delivery of services. Further information is available here.
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7 Health Secretary marks 75th anniversary of the NHS Health Secretary Michael Matheson has paid tribute to the staff who have helped deliver the NHS throughout its 75 year existence. Mr Matheson praised the extraordinary efforts of those involved with the service, particularly in the recent years of the pandemic. He also expressed his gratitude to those whose spirit of innovation has helped the NHS adapt over the years. Further information is available here. Update on Medication Assisted Treatment Standards Drugs and Alcohol Policy Minister Elena Whitham has welcomed research showing more people are getting treatment for problem substance use and said she is determined to oversee further improvements. The Medication Assisted Treatment (MAT) standards support the consistent delivery of safe, accessible, high-quality drug treatment, so everyone can get the same level of care wherever they live in Scotland. Further information is available here. Taking action on dementia Improving the lives of people with dementia is at the heart of a new 10 year strategy. The strategy, Everyone’s Story, outlines a vision for dementia policy over the next decade and identifies a number of priorities which would improve the lives of people living with dementia, their families and carers. These include support pre and post diagnosis, actions to enable more people to live well in their communities, involving those affected in the design and delivery of their own support and access to care from a skilled and trauma-informed workforce when appropriate. Further information is available here. Good News Celebrating the Voluntary Service of Heartstart Instructors 50 Heartstart instructor volunteers in Argyll and Bute are going to be awarded specially designed badges by Heartstart Argyll and Clyde in appreciation of their dedication and service in teaching emergency lifesaving skills in the community and schools. Heartstart is an initiative to teach young people and adults what to do in a life- threatening emergency. The two-hour training session teaches people to learn new skills such as how to recognise a cardiac arrest, perform Cardio Pulmonary Resuscitation (CPR) and use an Automated External Defibrillator (AED). It also includes basic emergency life support such as recognition of a heart attack and choking in adults, children and babies.
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8 Heartstart and the HSCP work closely to recognise the value of teaching these life support skills to members of the public, schools, workplaces and in local communities. The programme has been a long-standing successful training service spanning over 26 years. Their accomplishment is due to the dedication and commitment of Heartstart coordinators and volunteers involved in delivering the courses. Experienced Heartstart coordinators and volunteers provide training in their own time to communities and schools throughout Argyll and Bute. Ten of these volunteers have been providing vital life-saving training and services for over 25 years, with a further 40 volunteers delivering training for 5 years and more. All of these volunteers will be receiving the badge from Heartstart Argyll and Clyde in recognition of their valuable service and their dedication to the Heartstart project and Argyll and Bute communities. Further information is available here Victoria Hospital birthing pool is now open The new birthing pool at Victoria Hospital on Bute was officially opened in June by Isla Barton, Director of Midwifery for NHS Highland. Water birth is the process of giving birth in water using a deep bath (birthing pool). Being in water during labour is shown to help with pain as well as being more relaxing and soothing than being out of water. The water can help to support the Mum-to-be's weight, making it easier to move around and feel more in control during labour. The midwives on Bute have worked really hard to ensure that the installation was completed without much disruption, whilst continuing to support women in labour at the unit. We would like to take this opportunity to thank all staff, patients, and visitors for their patience and for their support throughout the process. Across Argyll and Bute our midwives work hard to continuously develop and improve maternity services that are safe and personalised, that put the needs of the women, their baby, and family at the heart of the quality care that they deliver. View the full release here. Cowal Community Hospital gifted a replica of the George Cross Cowal Community Hospital has been gifted a replica of the George Cross awarded to the NHS in 2021, in recognition of over 70 years of service and the exceptional efforts of NHS staff across the UK during the COVID-19 pandemic. We would like to thank Karen MacLagan, Team Lead and Medical Secretary, based within the administration team at the hospital for being the driving force behind applying for the replica of the George Cross and gifting it to the hospital. It recognises the extraordinary courage, compassion and dedication of all NHS staff from when the NHS was founded in 1948, and particularly recognises the dedication of all NHS staff throughout the challenges of the COVID pandemic. The replica George Cross and featured original award letter from Her Late Majesty Queen Elizabeth II have been proudly showcased within the main reception of Cowal Community Hospital. View the full press release here.
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9 Staffing Updates Health Improvement Principal Samantha (Sam) Campbell has recently been appointed as Health Improvement Principal. Sam joined the NHS Highland Public Health team in 2007 accepting the position of Health Improvement Officer. Through her continuous professional career development, she progressed to Senior Health Improvement Officer, then to Health Improvement Lead and to Health Improvement Principal in May 2023. Sam will be responsible for developing and implementing plans to improve the health and wellbeing of the people of Argyll and Bute and does this by strengthening working relationships with local partners and communities. She will continue to work alongside Argyll and Bute Living Well Networks and a wide range of stakeholders to improve the quality of services available to communities, carers, and their families. Senior Manager – Resources We would like to welcome Simon Deveney who joined the HSCP as Senior Manager (Resources) in June. This is a continuing role for the organisation, overseeing the registered adults’ services across the HSCP. Simon is an experienced social care professional having worked in and led registered services across Scotland and in the United States for 9 years, while also having spent the last 9 years working for the Care Inspectorate as an Inspector and Team Manager.