Minutes of a regular meeting of the Health Service Forum on Tuesday December 9th 2003 held in the Larkfield Centre at 7.30 p.m.

Contents

Apologies

Welcome

Minutes

Correspondence

Glasgow South Monitoring Group

Report from the Health Board meeting of 16^th December 2003

Implementation of Acute Strategy

Financial Report

Next Meeting

Appendix 1

Apologies

Apologies were received from Elspeth Dick and Mary Markey.

Welcome

Margaret Hinds was in the Chair and welcomed everyone. It was noted with great sadness that Caryl Ogilvie had died.  His contribution to the work of the Forum was considerable, and in particular the knowledge which he brought from his lifetime experience of working as an architect within the NHS branch of the Common Services Agency.

The guest speaker, Niall McGrogan was introduced as Head of Community Engagement for GGNHS Board. A handout entitled Community Engagement and Transport was given to all those present. Various ways forward are being explored. These include a) bulk buying of bus tickets and sending a bus ticket to each patient along with their appointment details, b) social amenity funded routes, better non-medical patient transport, influencing infrastructure developments, c) disabled access, e) on hospital site shuttle buses are being considered, also improved parking, access and sign posting on site. The safety of all persons on hospitals ground is of utmost importance, f) community transport initiatives for visitors are being reviewed.

Mr. McGrogan advised that it is a legal requirement for the Health Board to develop a Green Travel Plan. A full time person is to be appointed to deal with transport needs of communities. This information will be fed back to the transport supremo. The meeting was opened to members for questions.  Mr. McGrogan was thanked for speaking at the meeting.

Minutes

The minutes of the meeting of the 11^th November were approved and adopted as correct.

Roderick McDougall of City of Glasgow Land Services provided ACAD Hospital Patient Information - Hours of opening and anticipated patient numbers by department. (See appendix 1 at the end)

A further set of tables addressed:

1) number of patient arrivals between 7 a.m. and 7 p.m.

2)   number of departing patients between 10 a.m. and 10 p.m.

3)   number of staff arrivals / total staff and breakdown of staff

Correspondence

1. Stewart Maxwell MSP sent the Forum a copy of a letter from Dr Colin Hunter regarding trainee GPs. He confirmed that the GP Registrar would be maintained at 280. There are more training practices than funded training places. A regional quota system is operated to ensure a spread of doctors in training across Scotland. It was decided that a letter should be written to Dr Hunter asking a) whether the number of doctors in training equalled the number retiring, b) what is the predicted need for GPs in the next 10 years? c) what plans are there to match future requirements?

2.  A letter was sent to Tom Divers, Chief Executives of GGNHS Board, asking once again to see the proposed plans for the building on the ACAD site. We also queried the wisdom of purchasing an awkward piece of land from the City of Glasgow at the QPR ground. A suggestion was made that a more rectangular plot would allow for easier design of the building and give the Health Board additional land for future use.

3.  A letter was sent to Chief Inspector Angus McPhail of Strathclyde Police regarding the traffic issues surrounding the building of the new ACAD and querying the fact that there is no police representation on the transport monitoring group.

4.   Letter to Sir John Arbuthnott, chairman of GGNHS Board, requesting a meeting sometime in January 2004.

Glasgow South Monitoring Group

James Sandeman gave his personal report on the meeting of the 5^th December. The main points were:

a) A&E. There is no monitoring group covering A&E and this topic will not be added to the remit of the South Monitoring Group.

b) ACAD car parking; there will be 450 dedicated spaces, some street parking will be lost and problems    will occur during construction (2005-07).

c)   Bed numbers; refurbishment of Vicky wards has reduced the bed numbers by 100.  More beds are to be made available in Mansionhouse unit and the Southern General.

d)   Waiting times; the limit of 9 months should be met by the 31^st December 2003.  Actual numbers waiting remain static so far.

e)   Staffing;  EU legislation kicks in next year effectively reducing junior doctors’ hours by 33%. Scotland faces an increasing shortage of consultants, which is driving all NHS Boards to poach from each other and concentrate them on fewer sites.

The Monitoring Group next meets on the 23^rd January, when it will be asked to suggest ideas to bridge the staffing gap.

A Public Meeting called by the newly reconstituted Langside, Battlefield and Camphill Community Council was held on the 8^th December to discuss the GGNHS Acute Strategy. The audience was addressed by Dr Jean Turner MSP, Margaret Hinds and Charlie McCafferty an  A&E nurse at the Victoria. Charlie McCafferty expressed concern with the proposed minor injuries units which will be staffed by nurses without consultant back up. For example, if he thought he was suffering a heart attack he would want to be seen by a doctor. There is the feeling that the whole acute strategy is being rushed through because of the lack of beds. Margaret commented on the bed shortages which have reached a critical point. Also the European Directive reducing the working hours of young doctors. Compliance will be monitored and hospitals fined if they do not comply. The NHS has known about this legislation for years yet does not seem to have increased the number of doctors to compensate for the shorter working hours. Jean spoke of her concern at the cases of constituents who come to her surgeries expressing great concern with delay in treatment. We are pleased that Langside Community Council has made the issue of acute health provision high on their list of priorities.

Report from the Health Board meeting of 16^th December 2003

Sir John advised that the arrangements for Centre for Population Health were well advanced, and that appointments would be made in the near future. The scheduled opening date is 1^st April 2004. 

He had another recent meeting with MSPs and  these should be held at regular intervals.

Implementation of Acute Strategy

Dr Cowan spoke on emerging pressures and stressed that none of the issues suggested a pattern of provision outside the framework agreed by the Minister. The challenge is about sustainability of current services until the date envisaged.  European Working time Directive (EWTD) effective from 2004 really taking hold from 2009. Training implications from 2005/6 impacting on A&E, General Surgery and Anesthesia.  Maternity provision from 3 to 2 in 2005, ACADs 2007, 3 inpatients sites 2010 - 2012. By 2006 under severe pressure on frontline services.

The Board has shared these issues and implications with the Minister.  There is a national policy context in which all of this sits. Both Monitoring Groups have been informed. Sir John advised that this was open for discussion via the media. Shortage of nurses and radiographers.  Clinical shortages across Scotland.  New IT to construct rotas and handle EWTD.

Partnership for Care

Interviewing for new Board in January. Corporate management team working on a scheme of delegation - possibility of a new HR appointment

Current year end prediction, deficit. Best estimate £10M, worst £19M.

Performance Review Group must look at recovery programme.

Waiting Times

"Inching their way towards December target" There were 101 people waiting for 9 months at the end of last week. The real challenge will be sustaining it.   3,500 patients had been targeted to reach this at a cost of £6M. A close focus will have to be given to Ortho. By December 2005, 9 month waiters have to be reduced to 6 months.

Complaints Quarterly Report

The new complaints procedure may be in place by April, however it could be December. The Board will need to commence alternative advocacy services to account for the demise of the Health Council.

Maternity Services Review     

There will be a public session in relation to the Maternity Services review in the Radisson SAS Hotel, Argyle Street, on 20^th January 2004.

Forum's Points of Concern

We would have expected the evidence in relation to the Maternity Review to be published in the Board's latest Newsletter to be discussed . It was not and no one queried this.  The tender process for the Beatson was discussed and endorsed. However, the invitation to Tender and negotiate (ITN) for the ACADs was not even mentioned.

End of report.

The Acute Strategy appears to becoming more and more untenable month on month.   There are worrying reports in the media of possibly closing A&Es in the Victoria and Stobhill next year.  Also closing the in- patient services in the Victoria and Stobhill in 2006, not in 2010/2011 as we were led to believe.

Questions which must be answered;

If the A&Es are to close at the Vic and Stobhill will the Southern General and the Royal Infirmary be able to cope? We doubt it. The Vic is the second busiest A&E in Glasgow.  Will the SGH and the Royal cope with the increase in in-patients due to the closures of the Vic and Stobhill? We doubt it. There has been a critical shortage of in-patient beds for years in Glasgow, and the shortages have occurred in summer as well as winter and with no flu epidemics!  

The Forum will respond to the consultation on the closure of the Queen Mother's. The consultation ends in February 2004.

Financial Report

 The Treasurer reported that there is a balance in the bank of £1896.07. The reply received by the Secretary from Glasgow City Council in response to our letter asking for the reason why a grant had been refused stated that grants are given for specific projects not for running costs.

There was no other competent business.

Next Meeting

The date of the next meeting  - January 13^th 2004 at 7.30 p.m. in the Larkfield Centre.

Appendix 1

ACAD HOSPITAL,  GRANGE ROAD, GLASGOW

HOURS OF OPERATION & ANTICIPATED PATIENT NUMBERS

December 2003

  TOTAL                                                395,500          1,569

Our comment:

The minor injuries unit is open 12 hours per day Monday to Friday, after 9 p.m. you must head for the Southern General or the Royal Infirmary.