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Meeting of the Health Service Forum S.E held in the Larkfield Centre at 7.30 p.m. 10 May 2005
Contents
Minutes of the regular meeting
Presentation by Alex McIntyre, Project Manager for Victoria ACAD and Dr Brian Cowan, Medical Director of the GGNHS Board
We were surprised but very pleased to welcome Dr Brian Cowan to the meeting as well our invited speaker Mr McIntyre. Dr Cowan opened the presentation and outlined the services that will be available at the new Victoria ‘Hospital’ although he would prefer to call it an ACAD. In addition to the services that we have been told about on previous occasions there will be Chemotherapy and Haemodialysis as well as an emergency dentistry service, GEDS, working alongside the out of hours GP service, GEMS. Day surgery in ophthalmology and urology will also take place in one of the 8 day-surgery theatres.
Dr Cowan said that ideally the day surgery unit at the ACAD should be open from 8 a.m. till 8 p.m. but at present the plan is to open between 9 a.m. and 5 p.m. five days a week. Patients having day-surgery at the ACAD in the afternoon may not feel well enough to go home at 5 p.m. and will have to be transferred to the Southern General. As this service covers all of the South Side, will the ambulance service be able to cope?
Our Comment: We are not at all clear about the opening times of the ACAD. In January 2005 the information given to the South Monitoring Group by Robert Calderwood stated that the day surgery unit would be open 0800-21.30 hours. The ACAD Project Office advised us that day surgery hours would be 08.00-20.00 hours.
Dr Cowan stated that according to Dr Gillies, in the 13 years he has been involved in day-surgery at the Victoria there has not been a need to transfer a patient from day surgery to an acute bed. Day surgery for all of the South side will take place at the ACAD.
Our comment: The number of day surgery cases anticipated at the new ACAD will be very much greater than within the present Victoria Inf. and therefore the likelihood of a problem arising will correspondingly increase.
There will be 60 beds in the ACAD for patients being rehabilitated. These beds will partly replace the beds at the Mansionhouse unit when it is closed down. The occupancy rate of the 60 beds will be high.
Our Comment: These beds will not be available to ACAD patients. Rehab patients will have access to services at the ACAD if required
A minor injuries unit (MIU) will be available at the ACAD. Specially trained nurses will lead this service and will have access to the adjacent x-ray facilities. Dr Cowan was asked if there would be a publicity campaign to help the public decide whether to attend the MIU at the ACAD or the A&E dept at the SGH. In reply Dr Cowan said that the public are very good at self-diagnosis in deciding whether they have a minor or major injury.
Our Comment: According to the clinical effectiveness committee of the British Association for Emergency medicine Jan 2000 “ It is of paramount importance that the local population clearly understand the limitations of a given unit and use it appropriately.” “Every effort should be made to educate the local population as to the role of the MIU.”
Dr Cowan was asked if he could comment on how the doctors serving in the GEMS unit feel about working in the ACAD without the back up of A&E and an on-site acute hospital. Apparently there are few referrals from GEMS to A&E at present and this is not expected to change.
Mr McIntyre showed a plan of the Victoria ACAD. It will occupy 30,000 sq m and will be the size of Hairmyres Hospital. The new road across the Queen’s Park Recreation site will be started as soon as possible as it must be operational before the section of Grange Road between the School site and the Recreation site is closed. The issue of permits will control the parking at the ACAD. A parking permit will be sent to a patient in connection with a hospital appointment. Both lifts and escalators will serve the building. We were not told whether the lifts would have any seats for passengers, nor whether the escalators will be moving ramps or stairs. There will be internal planted courtyards and the kidney dialysis unit will have views across the remainder of the QPR ground.
In order to provide a seamless patient journey there will have to be an efficient computer system. We understand that the Scottish executive is spending £2m per week on developing such a system. In England billions of pounds are being expended. Dr Cowan felt that the GGNHS Board should have the majority of the IT in place for the opening of the new ACAD in January 2008. He did not comment on the time required for staff training in the use of the IT system. The Board is investigating the use of a voice activated computer system that would allow doctors to produce letters/reports without taped dictation and subsequent typing by clerical staff.
See Prof. McGregor’s comments.
Mr McIntyre said that in 6-8 weeks time the GGNHS Board will move to financial closure and the contractor will be appointed. Work should start on the ACAD in Summer 2006 and be complete by December 2007.
A question arose about the proposed size of the Southern General Hospital. The answer was 1200 to 1300 beds. This was followed by a further question whether this figure included Yorkhill. Neither Dr Cowan nor Mr McIntyre were willing to discuss the likelihood of the Yorkhill Children’s Hospital being sited on the SGH campus and the distinct possibility that ultimately there will be 2000 beds. The largest hospital in the UK!
Annual General Meeting
Annual General Meeting of the Health Service Forum S.E. held in the Larkfield Centre, Inglefield St. Govanhill on Tuesday 10 May 2005
These are draft minutes only and await approval at the next AGM of the Health Service Forum South East.
Welcome
Welcome by the Chairman Margaret Hinds
Apologies
Apologies from Douglas McGregor, Fiona Brodie, Dorothy Walls, Rhoda Ritchie, Catherine Milne, Mary McClelland, Alastair Glen
Minutes
Minutes of the AGM of 13 April 2004, having been distributed, were adopted as correct. There were no matters arising.
Election of office bearers
Election of office bearers: Pat called for nominations from the floor for the following offices:
Chairman, Vice Chairman, President, Vice Chairman, Secretary, Minute Secretary, Membership Secretary and Treasurer. The existing officers had already indicated their willingness to accept nomination and no other nominations were received.
The new board for the year is:
Chairman, Margaret Hinds; Vice Chairman, Eric Canning; President, Dr Pat Lally; Vice President, Prof Douglas McGregor; Secretary, Louise Laing; Minute Secretary, Mary Hamilton; Membership Secretary, Fran MacLennan; Treasurer, Aileen Fyfe.
The Treasurer’s Report
The Treasurer’s Report:
The Treasurer distributed the audited accounts for the year 2004-05. The Income and Expenditure account showed a shortfall of £537.26. The current bank balance is £811.74. Application for grant support will be made to East Renfrewshire Council. Glasgow City Council will only give grants for specific projects, not running costs.
It was decided that the membership fee will be £5.00 per year and that the fee for group membership will be £25.00. A renewal notice will be sent out with the minutes together with a covering letter.
Report from the Chair
Report from the Chair: This was deferred until the next regular meeting in June. Margaret took the opportunity to thank every member of the Forum for his or her support throughout the year.
There was no other competent business and the AGM closed.
Minutes of the regular meeting
Minutes of the regular meeting of the Health Service Forum S.E. held in the Larkfield Centre on Tuesday 10 May 2005 following the AGM.
These are draft minutes only and await approval at the next regular meeting of the Health Service Forum South East.
Welcome and Apologies
The Chairman opened the meeting and the apologies were taken as for the AGM.
Minutes
The Minutes of the 12 April 2005 were adopted as correct and there were no matters arising.
There was no time to consider any other items of business and it was agreed that the meeting close and that the remaining items on the agenda will be carried forward to the next meeting.
DATE OF NEXT MEETING TUESDAY 14 JUNE 2005
IT policy in Scotland
This is a short report, gathered from a number of sources, concerning the strategy, policy, and state of IT in the NHS today. It is based on the recent paper presented to the Health Minister for Scotland by Charlie Knox, the Head of IT policy for the NHS.
- The IT scheme being planned envisages a single-patient-record in which common parts will be shared by all agencies of the government. These will include all aspects of the NHS, the Benefits Agency, the Education Service, and the Police. It will envisage members of the public being able to ‘opt out’ of such a scheme, unless the practitioner thinks that the scheme will prove beneficial to the patient, or is in the interest of justice to society. Police can already require the production of otherwise confidential information. This single-record scheme is a big step from the multiple separate records of the present system.
- The new scheme is much larger, and less practical than a simple computerisation of the present one.
- The amount of resource needed by the new scheme is vast compared to present expenditure on IT in Scotland. In England, the initial production of a comprehensive scheme (National Program for IT – NPfIT) has already been funded and contracts deliverable in three years are already nearly two years old. The NPfIT has already let contracts for some £6.2B. ‘Computing’ the newspaper of the BCS has doubts over the practicality of this program, in particular it points out that the training of existing NHS staff has not been funded.
- All together the costs of any national scheme must comprise the cost of the software (which in general depends on the complexity of the scheme), and the number of records (i.e. people) in the population covered. As Scotland makes use of the GPASS scheme for about 800 of its 1000-odd GP practices the complexity will be lower than in England. The overall cost in England has been put at 4% of the total NHS budget on a recurrent basis.
Douglas McGregor
12th May 2005
