HELENSBURGH & LOMOND PLANNING GROUP ANNUAL REPORT 2008/2009 1
CONTENTS Introduction 3 Role & Remit and Composition of the Helensburgh & Lomond 3-4 Locality Planning Group Role & Remit Composition Organisation Membership Frequency of Meetings and Attendance 5 Page Issues and Topics 5-12 Overview Vision for the Vale of Leven Hospital Service Level Agreements NHS Greater Glasgow & Clyde Modernisation and Redesign of Mental Health Services in Argyll & Bute Victoria Infirmary Integrated Care Centre Scottish Ambulance Service Provision and Performance Conclusion 12 Appendices 1 Helensburgh & Lomond Planning Group response to Vision for the Vale of Leven Hospital Consultation 26 January 2009 15-19 2 NHS Greater Glasgow & Clyde Consultation - Respondee letter dated 9 March 2009 20-21 3 Deputy First Minister & Cabinet Secretary for Health & Wellbeing - Submission Response dated 15 July 2009 22-23 4 NHS Greater Glasgow & Clyde Vision for the Vale of Leven Update - Board Paper No. 09/45 18 August 2009 24-26 5 Redesign of Mental Health Services in Argyll & Bute - Deputy First Minister & Cabinet Secretary for Health & Wellbeing response to preferred Option submission dated 15 July 2009 27-28 2
1 INTRODUCTION The then Minister for Health and Community Care established the Helensburgh & Lomond Planning Group when NHS Argyll & Clyde was dissolved on 31 March 2006. It reflected the decision to preserve the integrity of co-terminosity between the Argyll & Bute Council s area and NHS Highland as a primary factor in determining the population split but with acknowledgement of the communities close relationship with Greater Glasgow & Clyde with regard to the provision of services to that community. Its establishment was to give Helensburgh & Lomond residents a structured opportunity to contribute to the planning of hospital and specialist acute services provided by and in Greater Glasgow & Clyde. A description of the role, remit and membership follows. This was also a reflection that the population of Helensburgh & Lomond access services within Greater Glasgow, Paisley and Greenock and there were at that time significant local and political concerns that the patterns of those historic patient flows would change as a result of NHS Board boundary changes in a way which would create issues for the population or that desirable changes to Greater Glasgow & Clyde services are less likely to be achieved for patients in a CHP outside the new Greater Glasgow & Clyde boundary. 2 ROLE & REMIT AND COMPOSITION OF THE HELENSBURGH & LOMOND LOCALITY PLANNING GROUP a) Role and remit of the Helensburgh & Lomond Planning Group is described as follows: The Group will be led by the Argyll & Bute CHP and will bring together senior staff from Greater Glasgow & Clyde and Highland NHS Boards to monitor acute services provided to the area and examine and agree any proposed changes. The Group will focus specifically on services provided by NHS Greater Glasgow & Clyde to residents in Helensburgh & Lomond. b) Composition The Group will be chaired by a non-executive Board Member with specific links to the Argyll & Bute Community Health Partnership and the Helensburgh & Lomond locality. Greater Glasgow will be represented by the Acute Division Chief Operating Officer and Director of ASR (Acute Services Strategy) Implementation & Planning. As well as senior representation both clinical and managerial from the Argyll & Bute CHP, Highland NHS Board will be represented by its Director of Planning & Performance and Director of Community Care. The Public Partnership Forum (PPF) will propose two local representatives to the CHP for inclusion in this Group. Argyll & Bute will have 3 places for local Councillors to reflect the future 3 multimember wards. The role of Councillors in this forum in respect to the Argyll & Bute Council remains to be clarified. The local MSP. 3
Representation from professional and other advisory structures will be sought when appropriate. Representation from Lomond Patients Group. c) Organisation The Group will meet formally four times a year. Hold public meetings perhaps at the beginning and end of the year. The Group will produce an annual report and forward plan to be submitted to the Minister for Health. The plan will set out any proposals to change the specialist services delivered to the local population for comment and debate. d) Membership NAME Bill Brackenridge Derek Leslie Dr Michael Hall Anne Helstrip Stephen Whiston Al Reay George Freeman Vivien Dance Robert Calderwood Jane Grant Helen Byrne David Bruce Jim Proctor Mairi Harvey Jackie Baillie DESIGNATION Chairman, Argyll & Bute CHP General Manager, Argyll & Bute CHP Clinical Director, Argyll & Bute CHP Locality Manager, Helensburgh & Lomond Head of Planning, Contracting & Performance Argyll & Bute CHP Councillor, Argyll & Bute Council Councillor, Argyll & Bute Council Councillor, Argyll & Bute Council Chief Operating Officer (to April 2009) Chief Operating Officer (from April 2009) Acute Services Division Greater Glasgow & Clyde NHS Board Director of Acute Services Strategy Implementation & Planning Greater Glasgow and Clyde NHS Board Helensburgh & Lomond Patients Group Public Partnership Forum Representative Public Partnership Forum Representative MSP 4
3. FREQUENCY OF MEETINGS & ATTENDANCE The first annual report was published and covered the period 2007/2008 and was presented at a meeting in public on 30 October 2008. This report covers the period since then up to the establishment of the Vale of Leven Monitoring Group which had its first meeting on 23 November 2009. In that period the group has met on seven occasions, with regular attendance from the majority of members and with additional representation invited, dependent on the subjects under discussion. 4. ISSUES & TOPICS Overview The previous annual report concluded that latterly the primary and substantial focus of the business of the Helensburgh & Lomond Planning Group had been the various public consultations and engagement exercises, conducted by NHS Greater Glasgow & Clyde around proposals to modernise mental health services and maternity services, together with emerging proposals concerning the sustainability of unscheduled medical care at the Vale of Leven Hospital. The outcome of all this work was eventually set out in a number of recommendations that were considered and accepted by the Board for consideration by the Deputy First Minister and Cabinet Secretary for Health & Wellbeing and subsequently in a Vision for the Vale of Leven Hospital. These substantial issues dominated the work and focus of the group during 2008 and 2009. In addition, the group also considered particularly the ongoing process of the modernisation and redesign of mental health services in Argyll & Bute, the continuance of a range of services provided through Service Level Agreements with NHS Greater Glasgow & Clyde and more local developments associated with the Victoria Infirmary Integrated Care Centre. Vision for the Vale of Leven Hospital In the course of the period the culmination of the work of the Helensburgh & Lomond Planning Group in response to the Vision for the Vale of Leven Hospital Consultation was captured in a response submitted on behalf of the group on 26 January 2009. The submission is attached (Appendix 1). NHS Greater Glasgow & Clyde subsequently considered the response to their consultation at their Board meeting on 24 February 2009 and intimated in a letter issued to all respondees the outcome of those considerations and that these proposals to develop and improve services at the Vale of Leven Hospital in Alexandria now agreed would be submitted to the Deputy First Minister and Cabinet Secretary for Health & Wellbeing (Appendix 2). The Deputy First Minister and Cabinet Secretary for Health & Wellbeing issued her response to the submission made by NHS Greater Glasgow & Clyde on 15 July 2009. (Appendix 3). NHS Greater Glasgow & Clyde considered a paper at its Board meeting on 18 August 2009 which provided an update and next steps in relation to implementing the Vision for the Vale of Leven Hospital, making particular reference to the establishment of a 5
Monitoring Group charged with overseeing the development and delivery of the Vision for the Vale plans, incorporating NHS Greater Glasgow & Clyde and NHS Highland (Appendix 4). The Appendices clearly set out matters concerning the eventual establishment of a Vision for the Vale of Leven Hospital and subsequent monitoring arrangements which subsume the previous arrangements for the Helensburgh & Lomond Planning Group. This group has now been established under the Chairmanship of Mr Bill Brackenridge and will have its inaugural meeting in public on Monday 25 January 2010. Service Level Agreements (SLAs) NHS Greater Glasgow & Clyde Services in Glasgow and Clyde provided to Helensburgh & Lomond (Argyll & Bute) residents are provided by an SLA agreement between NHS Highland and NHS Greater Glasgow & Clyde. This contract covers activity conducted in hospitals within the Glasgow & Clyde boundary as well as a number of SLAs that cover services provided on an outreach basis into the Helensburgh & Lomond area. The Agreement for 2008/09 and arrangements for 2009/10 were concluded through an exchange of letters between Mr Robert Calderwood, Chief Executive, NHS Greater Glasgow & Clyde and Dr Roger Gibbins, Chief Executive, NHS Highland and amounted to a total value of some 48m (this investment includes services provided for patients beyond the Helensburgh & Lomond area). Monitoring of activity is ongoing between officers of the Argyll & Bute CHP and NHS Greater Glasgow & Clyde. A summary analysis of new outpatient, day case, elective inpatient and emergency inpatient activity is set out in the table and charts that follows : New Outpatient Activity Helensburgh & Lomond Residents Hospital 2004/05 2005/06 2006/07 2007/08 2008/09 Western Gartnavel 642 700 650 591 677 Royal Sick Children 225 190 163 140 200 Southern General 157 210 202 180 238 Glasgow Royal Infirmary 86 114 84 100 115 Glasgow Dental 338 441 312 302 322 Canniesburn 119 124 85 77 61 Royal Alexandra Hosp. 501 610 532 543 696 Inverclyde Royal Hosp. 54 35 23 31 31 Vale of Leven 2875 3145 3471 3894 4296 Victoria Infirmary (H'burgh) 1359 1154 945 842 987 Total 6356 6723 6467 6700 7623 Other 29 47 41 41 51 Grand total 6385 6770 6508 6741 7674 Locality areas are defined by the patient postcode. Ref: IR2010-00224 Extract: January 2010 6
New Outpatient Activity Comparison by Site Helensburgh & Lomond Residents Other Victoria Infirmary (H'burgh) Vale of Leven Inverclyde Royal Hosp. Royal Alexandra Hosp. Canniesburn Glasgow Dental Glasgow Royal Infirmary 2008/09 2007/08 2006/07 2005/06 2004/05 Southern General Royal Sick Children Western Gartnaval 0 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 Day Case Activity Helensburgh & Lomond Residents Hospital 2004/05 2005/06 2006/07 2007/08 2008/09 Western Gartnavel 456 431 520 398 419 Royal Sick Children 71 78 51 78 67 Southern General 29 31 45 41 43 Glasgow Royal Infirmary 66 52 33 29 44 Canniesburn 48 53 49 49 63 Golden Jubilee NH 18 34 48 56 81 Royal Alexandra Hosp. 296 338 339 368 443 Inverclyde Royal Hosp. 51 12 5 6 5 Vale of Leven 1645 1735 1763 1464 1810 Total 2680 2764 2853 2489 2975 Other 25 22 26 22 25 Grand total 2705 2786 2879 2511 3000 Locality areas are defined by the patient postcode. Ref: IR2010-00224 Extract: January 2010 7
Day Case Activity comparison by site Helensburgh & Lomond Residents Other Vale of Leven Inverclyde Royal Hosp. Royal Alexandra Hosp. Golden Jubilee NH Canniesburn Glasgow Royal Infirmary Southern General Royal Sick Children Western Gartnaval 2008/09 2007/08 2006/07 2005/06 2004/05 0 200 400 600 800 1000 1200 1400 1600 1800 2000 Elective Inpatient Activity Helensburgh & Lomond Residents Hospital 2004/05 2005/06 2006/07 2007/08 2008/09 Western Gartnavel 247 232 312 203 208 Royal Sick Children 52 38 36 31 51 Southern General 70 88 82 96 90 Glasgow Royal Infirmary 34 49 40 33 42 Canniesburn 43 40 28 19 18 Golden Jubilee NH 31 34 24 35 57 Royal Alexandra Hosp. 271 295 312 356 378 Inverclyde Royal Hosp. 19 13 3 8 6 Vale of Leven 236 279 247 204 187 Total 1003 1068 1084 985 1037 Other 32 27 21 13 13 Grand total 1035 1095 1105 998 1050 Locality areas are defined by the patient postcode. Ref: IR2010-00224 Extract: January 2010 8
Elective Inpatient Activity comparison by site Helensburgh & Lomond Residents Other Vale of Leven Inverclyde Royal Hosp. Royal Alexandra Hosp. Golden Jubilee NH Canniesburn Glasgow Royal Infirmary Southern General Royal Sick Children Western Gartnaval 2008/09 2007/08 2006/07 2005/06 2004/05 0 50 100 150 200 250 300 350 400 Emergency Inpatient Activity Helensburgh & Lomond Residents Hospital 2004/05 2005/06 2006/07 2007/08 2008/09 Western Gartnavel 97 105 112 78 83 Royal Sick Children 115 99 91 63 83 Southern General 43 39 30 38 58 Glasgow Royal Infirmary 25 15 19 19 20 Canniesburn 7 10 3 4 13 Golden Jubilee NH 2 6 Royal Alexandra Hosp. 680 804 930 938 969 Inverclyde Royal Hosp. 5 6 9 9 19 Vale of Leven 936 986 919 1015 1049 Total 1908 2064 2113 2166 2300 Other 70 43 55 39 38 Grand total 1978 2107 2168 2205 2338 Locality areas are defined by the patient postcode. Ref: IR2010-00224 Extract: January 2010 9
Emergency Inpatient Activity comparison by site Helensburgh & Lomond Residents Other Vale of Leven Inverclyde Royal Hosp. Royal Alexandra Hosp. Golden Jubilee NH Canniesburn Glasgow Royal Infirmary Southern General 2008/09 2007/08 2006/07 2005/06 2004/05 Royal Sick Children Western Gartnaval 0 200 400 600 800 1000 1200 Modernisation and Redesign of Mental Health Services in Argyll & Bute The group received a number of presentations and papers relating to plans to modernise and redesign mental health services for residents in Argyll & Bute. Mental health services for residents in Helensburgh & Lomond are for the most part provided through agreements with NHS Greater Glasgow and Clyde and feature a range of services, both community and hospital based. The preferred option for the redesign was submitted to the Deputy First Minister and Cabinet Secretary for Health & Wellbeing for approval after a considerable process of involvement and public, stakeholder and staff engagement and received her approval under cover of her response of 15 July 2009 (Appendix 5). The implementation of the approved option is now proceeding under the governance of a project board and within the structure of a project brief, the centre piece of which are five service design groups, interconnected but focussing on : Primary Care, Early Intervention and Health Improvement Mental Illness in the Community and Crisis Response Long Term Conditions and Severe and Enduring Mental Illness An Interface Group looking a needs of other client groups who come into contact with the service, i.e. Child & Adolescent Mental Health, Addictions, Learning Disability and Dementia An Infrastructure Group looking at non-clinical support services Each group is populated by service users, NHS, Local Authority, Police, Scottish Ambulance Service staff, independent sector, and voluntary sector. The output of these groups is expected to be reported to the Project Board in February 2010 with any implications for the Helensburgh & Lomond community reported to this group. Victoria Infirmary Integrated Care Centre The group received frequent updates on the developments on the Victoria Infirmary site. These developments, which have been underwritten by a considerable modernisation 10
and investment in the existing facilities, see a range of services provided for the locality, including : Community Mental Health Team Integrated Care Team Learning Disability Team Psychology Public Health Podiatry Addictions School Nursing Speech & Language Therapy Audiology Radiography Community Dentistry Range of visiting outpatient clinics Not all improvements have been finalised but once complete an appropriate public statement will be issued to ensure all residents are fully cognisant of what is available to them. Scottish Ambulance Service Provision and Performance Scottish Ambulance Service provided frequent briefings in the course of the period covered by the report describing Scottish Ambulance provision relating to the transfer of patients within and between the Helensburgh & Lomond locality and Greater Glasgow & Clyde providers, including achievement against response times. The Scottish Ambulance Service continues to work with partner agencies to improve the quality of care it provides to patients and local communities. The Patient Transfer Service (PTS) continues to identify ways to improve punctuality, particularly for priority one patients arriving and being uplifted less than 30 minutes prior/after their appointment. Argyll performance is included in the statistics collected for the Argyll & Clyde area, where 81.9% was achieved for arrival, against a 71% target and 77.5% was achieved for uplift against an 89% target for 2008/2009. The service continues to work with NHS Boards to identify ways to improve this by reducing abortive journeys, cancellations and inappropriate use of PTS resources for patients who do not have a medical need for ambulance transport. Accident and Emergency Services continue to experience a year on rise in demand (4.5%). Despite this the Accident & Emergency Services continue to reach patients quicker than ever before. Several initiatives such as 1 st Responders, Paramedic Response Units and Paramedic Advisors deployed in the control centre all contributed to this improvement. Performance in 2008/2009 varied considerably between stations. At year end the Argyll & Clyde area achieved the following performance : Category A performance was 58.8% against a national target of 75% Category B performance was 88.4% against a national target of 95% Urgent performance was 91.6% against a national target of 95% The main reasons for this level of performance are attributed to rises in call-outs during out-of-hours periods, on call working, inter-hospital transfers (IHTs) and significant 11
challenges around geography. The table that follows outlines individual station performance throughout the Argyll & Bute Area : Argyll Demand and Performance 2008/2009 Station Cat A Cat B Urgent Total Cat A % Cat B % Urgent % Emerg Emerg Calls Arrochar 116 211 66 393 32:8% 61:1% 87:7% Campbeltown 267 342 647 1256 47:1% 90:4% 91:9% Dunoon 437 686 1072 2195 79:6% 88:5% 95:2% Helensburgh 594 989 550 2133 68;75 93:2% 92:3% Inveraray 104 138 80 322 25;0% 44:9% 82:5% Islay 59 124 292 475 42:4% 79:0% 91:7% Lochgilphead 201 391 435 1027 49:8% 90:5% 90:1% Oban 375 643 817 1835 51:2% 89:9% 90:4% Tarbert Loch Fyne 46 80 85 211 69:5% 82:5% 82:3% Tiree 8 13 77 98 37:5% 84:6% 93:5% Mull 25 70 179 274 20:0% 34:3% 89:3% Rothesay 264 353 677 1294 70:5% 94:6% 93:4% Totals 2496 4040 4977 11531 58:8% 88:4% 91:6% CONCLUSION This summary of work of the Helensburgh & Lomond Planning Group clearly provides confirmation of the substantial influence on matters affecting and continuing to affect the population that it was set up to serve at the dissolution of Argyll & Clyde. A particular acknowledgment and thanks is due to the public for their considerable and positive involvement and contribution which informed and supported the activities of the Planning Group. This level of engagement undoubtedly had a significant impact on the design of the processes that have been established to monitor the implementation of the Vision for the Vale of Leven Hospital. The business that is specific to the Helensburgh & Lomond related services will continue to feature in the agenda of the new Vale of Leven Monitoring Group which is now established. Appreciation is expressed to all members of the former Helensburgh & Lomond Planning Group for their active and positive participation in what, over the years, has been quite a challenging environment considering the issues under scrutiny. 12
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