Information Session 1

Fingal Centre, Portree High School, 13th Feb, 2020

What happened?

The panel consisted of David Park, Tracy Ligema, Cameron Stark, Hannah Macleod, Jean Slimon, Dr Le Ball and Mairi MacDonald. There were also representatives from other agencies in the audience who could answer questions if required / appropriate. 

The schedule for session 1 was

•             Introductions and overview of the option appraisal process (Norman) 10 mins

•             Background (David and Tracy) 10 mins

•             Demographics (Cameron) 10 mins

•             A GP Perspective (Hannah) 15 mins

•             Panel discussion 1hr 15mins

The Presentations

Here are all of the presentations from Informations session 1

Questions and Answers

Here is a transcription of the questions and answer session from Information session 1 

OPTIONS APPRAISAL
Q & A Session 
7.30pm – 8.30pm Thursday 13th February 2020
 

Ronald MacDonald - Appreciated David Park’s example of equally portioned pie chart (showing
finances spread between Hospital Inpatient/Home Care/Nursing Residential Care) and his thoughts
that funds could be traded between departments. There is a need for extra funding to provide
equitable care; there is a need for innovative ideas in a business plan. We have to be forward
looking as this opportunity won’t come again for this generation.
Norman Sutherland – to David Park, maybe the pie needs to get a bit bigger
David Park – There are different ways to look at this and different funding streams. If Capital
Investment is to be made available that’s an extraordinary piece of money to get but that application
would have to be made to the Scottish Government. Revenue is base funding coming to the Health
Board and only changes marginally each year. This is a complicated formula ,ENRAC, looking at
population, deprivation etc. .
Fay Thomson – My understanding of the Options Appraisal is that we shouldn’t look at funding,
we’re looking at solutions. Sir Lewis Ritchie says that beds should be close to family and friends. We
should not be considering finance restrictions.
Norman Sutherland – Yes, we jumped ahead there. What might the future of the hospital look like?
David Park – There are challenges and options
Dr Le Ball – from my perspective of caring for older folk and Cameron Stark’s slide says it all, about
the older population here. There are a lot of fit older folk here. But lots require more care as
Hannah’s slide shows. For old folk needing care, there has been a reduction in settings; we have to
be aware of that. We don’t have appropriate settings. Some old folk don’t feel safe in their own
house. Is there some way we could use Portree Hospital in future?
Norman Sutherland – from earlier slides there are a lack of younger folk. I’d like to see ages of
population
Cameron Stark – there are less young folk compared to older. An ageing population will have less
young folk to care for them.
Stuart MacPherson – Dr MacLeod iIs this the 1 st time your colleagues have seen your presentation.
(Clarified colleagues as panel).
Dr MacLeod – this has been discussed at SLR Workstream meetings over the past year. There is
concern over series of losses (referring to bed closure)

Stuart MacPherson – You’ve confirmed through information gathered if application is robust enough
the case has been made.
David Park – we’d like to get to the point where all information can be handed over to Health Board
and Scottish Government. We have to look now at what’s required, what needs are etc.
Stuart MacPherson – The health service we have now is what we thought we needed 30 years ago,
there are committed funds for housing, employing young folk, positives for Skye The Scottish
Government considers the need for University School. There are changing national formulas.
Norman Sutherland – It’s been proven the best way to get folk to work in an area is to get them to
do their training there, they’ll come back.
Tim Moore – How many beds were in the facilities that are gone?
Charles Crichton – 45
Norman Sutherland – What do you need?
Catriona MacDonald – Is there a model of care available that we don’t have here?
Dr Le BALL – RAC, rapid assessment care, a new model of care being used here. Re enablement
team go out to houses to get folk on their feet, here rurality is a problem. RAC is the best use of
professional’s time.
Dr MacLeod – We can’t squeeze everything into the one box we have at the moment. In terms of
efficiency multi professionals working together, co-location, community beds, it doesn’t have to be
in hospital. Thinking flexibly would be ideal to have staff and beds together.
Norman Sutherland – the process has to start now
Catriona Leslie – we need staff. There is a need for tied housing, till we have staff nothing will
improve.
Jean Slimon – an example is LSHA working with Raasay and Broadford
John Laing – There could be a cluster of houses with a carer covering development.
David Park – If we need to change priorities that can be looked at
Le Ball – there has been segregation of old people culturally. We should think of young and old living
together. We’ve moved away from that.
Norman Sutherland – What can we do here?
Anne Gillies – Huge thanks to LSHA and NHSH on Raasay. Working with them we identified 2
houses; they bought them and will let them out to nurses.
We’d been told by NHSH if they owned the houses it would reduce their spending.

Eric Green – All leases are cost against our capital spend. I don’t think that’s a barrier to us. We’ve
worked successfully with LSHA. We would prefer tenant to be tied up to property but there is
nothing to stop us being involved.
John Gordon – Remember time when council houses were let to teachers, nurses etc. The current
points system doesn’t allow that to work. We’ve recently met with Head of Highland Council re this,
discussions are ongoing to try and address issue.
Neil Ferguson – I appreciate all that has happened tonight. I’d ask the Health Board to look at a
recent development in Stirling.
Norman Sutherland – Care village
St Columba Church rep – (his name is on list) – If stats are right the beds in care homes are grossly
inadequate. Are hospital beds being used for folk that should be in care homes?
Dr MacLeod – Yes. If there are not enough carers the strain is passed on to the next care tier, there
is already a knock on effect. Insufficient care on one level puts strain on tier above, that’s not to say
that the tier above isn’t required.
David Park – there are differ4ent resources to treat folk at different stages. As condition changes
e.g. dementia, we have to provide differing levels of care. Is decision made for next 5 yrs or 20 yrs.
Nationally less folk are in care homes. Length of stay now less than 2.5 years,
CS Workshops with care home providers show that care homes need 100 beds to be viable.
Caroline Gould - Concerned that rights of people with disabilities will be met. At present some
disabled are unable to visit family in Home Farm. It is wrong to have NHS services in non NHS
premises as they don’t have requirement to meet disabled standards.
Eric Green – Absolute guarantee that all future premises will comply.
Ruairidh MacKinnon – LSHA got money for pilot to let people reside in their own homes safely. We
need to be proactive and not firefighting after.
Norman Sutherland – Keeping folk at home for longer
Mairi MacDonald – Good to keep folk at home for longer when possible, doesn’t work for all need to
look at flexible beds and housing, if not being used by one health provider can be shared with
another.
Norman Sutherland - In world of uncertainty all you can prepare for is that we have flexibility
Mairi MacDonald – discussing what other areas have that we don’t, why not look at what we have,
unique active community involvement, recruitment, housing, staffing, local agencies in co-
production. Successful lots of good points
Fay Thomson – those working on community beds are concerned at number of locals being sent
away to e.g. Aviemore, Aultbea being sent away from families, Dr’s MacLeod and Crichton have
produced good data. Is there a figure on number of people who are sent away to care homes

Tracey Ligema – I do have the figures, but not here.

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