alphaStracathro Stroke Rehabilitation
THE ANGUS CHP
Unit Opens Its Doors
The purpose-built fit for transfer - they can return
Stroke Rehabilitation to Stracathro within a couple
of days for rehabilitation.
Unit at Stracathro
Hospital, which “When an individual
officially opened its experiences a stroke, a series
Picture courtesy of The Courier - Dundee
of clinical decisions are made
doors to the public on
about the most appropriate
January 9, has been setting for their care,” said
welcomed as a Gail Smith, Lead Clinician,
milestone in the Stroke MCN, NHS Tayside.
h o s p i t a l ’ s “Effective management of
patients depends on a
redevelopment. specialist service that can
An Open Day was held at the respond to the particular
10-bedded unit on Thursday, needs of each individual
January 5, when more than patient.
180 members of the public, “Stroke rehabilitation in
staff from other areas/wards/ hospital or within the
departments, Local Authority Alison Talbot, Gordon Meldrum, Jane Reid, Margaret Smith, community is patient-centred,
and the Voluntary Sector Dorothy Duncan, Gail Smith and Ruth Leslie Melville with a team of healthcare
took advantage of the celebrate the opening of the Unit professionals contributing to the overall
opportunity to go along, meet the staff Unit, with all its new facilities, is really management of a patient’s needs. Every
and have a look at what is being offered. wonderful and all the staff are very keen stroke survivor’s journey is different and
Key contributions to the Stroke Unit’s and clued up about what is required in that is why the Stroke Rehabilitation
design came from patients, carers, staff stroke management. Team at Stracathro is dedicated to
and other members of the public and, providing patients with individualised
during the Open Day, visitors were “The Stroke Unit is yet another sign of
patient care. At the new Stroke Unit,
encouraged to comment on the mission/ the growing significance of Stracathro
patients will receive help and support to
vision statement for the ward and and the Friends of Stracathro will be
relearn how to carry out day-to-day tasks
feedback any other suggestions. working in close liaison with the Unit to
so they can return to their own home or
provide extra equipment,” continued Mrs
a suitable care environment.”
“This is one of the most encouraging Smith, who was one of the Specialist
days I have ever spent at Stracathro,” Team which produced the first On February 20, MSPs Alex Johnstone
said Mrs Margaret Smith, a member of international study demonstrating that & Nanette Milne visited the Stroke Unit.
the Friends of Stracathro Support Group management of stroke patents in a They commented that they were very
and one of the members of Angus dedicated unit produces better outcomes impressed by the whole set up at
Integrated Health Project Team which than admitting to general medical wards. Stracathro and were encouraged by the
was set up to implement the remarkable order and air of tranquillity
recommendations for the development Ward 7 in Stracathro Hospital’s A-Block
that seemed to pervade the area.
of Ambulatory and Diagnostic Treatment has been completely refurbished to Gail Smith, Clinical Services
Centre Services across Stracathro and provide the accommodation for the new Development Manager/Lead Clinician,
Arbroath Infirmary sites. “The Stroke Stroke Unit, which is capable of taking Stroke MCN, NHS Tayside
14 patients and has a link corridor to the
Allied Health Professional Therapy Suite.
The Stroke Unit is part of a
comprehensive redesign of health
service provision in Angus, which aims
to deliver up to 80% of healthcare needs
locally. Patients in Angus who suffer a
stroke will still initially be admitted to
Ninewells Hospital in Dundee for
immediate assessment, and in case
surgical intervention is required. One of the wards in
The Nurses’ Station However, if suitable - and when clinically the Unit
Developing Angus Community Health Partnership’s
Virtual Public Partnership Forum (PPF)
The Scottish Executive Advice Note for CHPs regarding involving people (including patients, carers, members
of the public, community groups and voluntary organisations) indicates that, in order to ensure that
consultation is real and meaningful, all of these individuals and organisations need to come together in a
‘virtual forum’. This guidance follows the principle set out in Patient Focus and Public Involvement in
Partnership Care and builds on information contained in the CHP Statutory Guidance 2004.
Public Involvement will be a key aspect support the PPF and offer active 3. To support wider people involvement
of the quality framework for CHPs and assistance and resources to allow the in planning and decision-making while
will be monitored as part of the PPF to develop’. In Angus, the Head of contributing to cultural change within the
governance, accountability and Planning and Performance for Angus public sector.
performance arrangements. The Advice CHP (Sheila Phillips) has been
Note confirmed the development of the identified as the Involving People Co- Therefore, the PPF will be the main
Scheme of Establishment for NHS ordinator. Resources have been mechanism by which the CHP engages,
Tayside CHPs, which includes details of identified by the Scottish Executive in communicates and maintains a
how each Public Partnership Forum order to take this forward and meaningful dialogue with the people of
(PPF) should be established locally. discussions are currently underway in the community which it serves. The PPF
order to ascertain how this small will be a network of people and
In response to this guidance, Angus CHP resource can be used to best effect. organisations who have experience or
has begun the process of establishing a interest in health care services within
PPF, incorporating existing local The Role of the Public Angus and will provide the opportunity
involvement mechanisms, including Partnership Forum for local patients, carers, members of the
those used by partners, to ensure that a The Scottish Executive Advice Note public, community groups and voluntary
culture of community engagement and describes three main roles for the PPF. organisations to be involved in designing
partnership working is fostered with local and delivering services.
communities. 1. To support and enable the CHP to
inform local people about the range and The diagram below demonstrates the
The Scheme of Establishment states location of services and information result of initial discussions regarding
that: ‘Each CHP will appoint an Involving which the CHP is responsible for. membership of the CHP Public
People Co-ordinator to work with and Partnership Forum - but please note that
2. To support and enable the CHP to this is not definitive and further
discussions are ongoing regarding
Angus District engage local service users, carers and
the public and to have discussions identification of the members of the
Nurses – Bulletin about how to improve health services,
the wider health improvement agenda Sheila Phillips,
Head of Planning and Performance/
Board and raise health issues from a
community perspective. Involving People Co-ordinator
To improve communication between
Angus district nurses, a Bulletin Board
has been set up on the intranet
specifically for district nurse use.
On this board, district nurses in Tayside
can share any non-confidential/
operational information, such as
particular successes, challenges with
wound care products, clinical
procedures/products or news about what
is happening in their area regarding any
aspect of district nursing.
To access the District Nurse Bulletin
Board, go to the NHSTayside home page
and select ‘Forums’ from the left-side
menu. To add information to the
noticeboard, you must register with a
User Name and Password, which can be
done using the tab at the top of the Forum
page (most users use their Ldap User
Name and Password).
Acting Clinical Services Manager -
Community Health Services
Welcome to this month’s edition of the coming few
Alpha and, despite the cold weather, months, along
the clinical agenda in Angus continues perennial issue
to heat up! of transport and
how to get to our
Within long term conditions, a pilot project looking at community hospitals!
frequent admissions to hospital is about to begin in
two sites and we will continue to look at ways of To end this month’s column, some information about
delivering more aspects of care within Angus. We an initiative led by Angus Community Planning
hope to have an Angus colposcopy service up and Partnership, which will focus on alcohol and the effect
running soon, seeing some 500 women per year, and it has on Angus communities. Did you know that:
we also hope to see a renal clinic established in the There has been a 100% rise in reported drinking
near future. by 13 year olds since 1990?
In 2004/5, there were 420 alcohol-related hospital
We are optimistic about our Service Directory discharges for Angus residents?
development, which is now Tayside-wide, with In 2002, there were 225 drink driving offences in
funding and management support. The IT business Angus?
case for the proposed general practice system Angus currently has 402 liquor licences?!
change goes before the Finance and Resources
Committee this month and, with overwhelming Misuse of alchohol has economic, social, health and
support from both Primary and Secondary Care, we environment costs for our communities. Angus is
are hopeful we will very soon be following NHS planning to adopt a ‘community collaborative’
Grampian’s lead. approach, working with local communities and
relevant agencies to identify local issues and actions.
In addition, our Lead Clinicians’ Network, along with
the clinical services managers, has been working on As always, if you require any further info about any
a Clinical Services Plan for Angus. This plan will set of the above, or would like to contact me, my e-mail
out clearly our clinical priorities and targets for the address is firstname.lastname@example.org.
coming two to three years.
Wishing you all a Happy Easter.
As part of all of the above, we need to look at how Michelle Watts,
we can develop one of our best resources - our Clinical Director,
community hospitals. We will be focusing on this over Angus CHP
The Physiotherapy Department, A-
Block, Stracathro Hospital, were
delighted to receive a Biodex
Treadmill & Gait Trainer in
December. The funds to purchase
this welcome addition were kindly
donated by the Friends of
The state of the art treadmill has already
been used with several stroke patients
in order to facilitate earlier mobilisation.
The treadmill can be used to improve gait
pattern, endurance and speed with
patients who are beginning to mobilise
independently. However, it can also be
used with the body weight support to
begin gait training with those patients
who are unable to stand.
Stroke Unit, Stracathro Hospital
HOW ARE WE DOING?
Susan Wilson, General Manager, reports on the Development of Angus
Community Health Partnership
In 2004, the Scottish Executive issued Delivering for Health, which introduced Community
Health Partnerships (CHPs) as the key vehicle for delivering a ‘paradigm shift’ in the way the
NHS in Scotland delivers its healthcare.
Current View Evolving Model of Care
Geared towards acute conditions Geared towards long term conditions
Hospital-centred Embedded in communities
Episodic care Continuous care
Disjointed care Integrated care
Reactive care Preventative care
Patient as passive recipient Patient as partner
Self-care infrequent Self-care encouraged and facilitated
Carers undervalued Carers supported as partners
Low tech High tech
The CHP Committee
Following a period of development and orientation, The CHP Committee is a Standing Committee of NHS
Angus CHP Committee held its first formal meeting Tayside Board and works to the principles of Good
on January 16, 2006. Governance.
The Committee, which meets once every two months in
open public session, is responsible for assuring the The Principles of Good Governance
Governance of the CHP in working towards the required
paradigm shift and for providing 21st century health care The standard comprises six core principles of Good
which is: Governance, each with its supporting principles.
Safe - avoiding injuries to patients from the care that is
intended to help them.
Effective - providing services based on scientific
knowledge to all who could benefit, while refraining from
providing services to those not likely to benefit (avoiding
underuse and overuse respectively).
Patient-centred - providing care that is respectful of,
and responsive to, individual patient preferences, needs
and values and ensuring that patient values guide all
Timely - reducing waits and sometimes harmful delays
for both those who receive and those who give care.
Efficient - avoiding waste, including the waste of
equipment, supplies, ideas and energy.
Equitable - providing care that does not vary in quality
because of personal characteristics such as gender,
ethnicity, geographic location and socio-economic status.
CHP Committee Members Operational Level
The Community Health Partnership’s services are
Mr Ian Wightman Chair - Angus CHP Committee delivered locally by nearly 2,000 staff and Independent
Contractors with specific responsibilities for an
Ms Susan Wilson General Manager, Angus CHP agreed portfolio of services and interactions.
Dr Michelle Watts Clinical Director, Angus CHP
Fundamentally, these services must be delivered in
Dr Gordon Crosby General Practitioner partnership with:
Mrs Gail Smith Clinical Services Development The public, service users and the Voluntary Sector -
Manager, Angus CHP we are required by statute to form a Patient/Public Forum.
Local Service Partners - our biggest partners are Angus
Dr Susan Logie Consultant Psychiatrist Council Social Work & Health Department and we move
into Joint Headquarters at Orchardbank in April. We are
Dr Geraldine Brennan Consultant Physician
also working increasingly closely with the Housing,
Dr Charles Allison Consultant Anaesthetist Education and Leisure & Recreation Departments and
have effective interfaces with Community Planning
Dr Brian Kidd Clinical Senior Lecturer in Partners and the Community Planning Team.
Mrs Diane Manzi Community Pharmacist Our Joint Planning and Performance is supported by the
Joint Strategic Support Unit (JSSU). This covers all Care
Dr Martyn Merrett Consultant in Dental Public Groups within Joint Future legislation and Health
Health Improvement Policy and the lead agency is Social Work
Mr Steven Whittaker Optometrist & Health.
Ms Angela Murphy Physiotherapy Services We are required by NHS Tayside Board to evidence
Manager, Angus CHP improvement and assure governance and accountability
for the resources we deploy. This is now done via a
Ms Lesley McCallum Staff Representative
performance system called Citistat, which identifies key
Mr David Sawers Chief Executive, Angus improvement targets and holds managers to account via
Council monthly scrutiny meetings. This is a new system which is
being piloted in Tayside for the Scottish Executive and, to
Dr Robert Peat Director of Social Work & date, is proving very successful, helping NHS Tayside to
Health, Angus Council maintain its strategic scrutiny, accountability and
Ms Vivien Smith Community Planning commissioning roles.
Manager, Angus Council
Mrs Maureen Angus Public Partnership
Robertson Group The Single Delivery Unit
Ms Mai Hearne Chief Officer, Angus
Association of Voluntary In January, 2006, NHS Tayside Board agreed to the
Organisations formation of a Single Delivery Unit which would
encompass all three CHPs in Tayside and the previous
Mrs Glennis Middleton Non-Executive Director,
This is a positive move as, although partnership and
Clinical Leadership service improvement have been developing in local areas
Promoting clinical leadership is a key objective of with local partners, the greatest challenge has always
NHS Tayside. With this leadership, comes been for the NHS to work across its own vast and complex
responsibility and accountability for change and system. Over many years, a historical ‘divide’ between
improvement. community and acute, hospital-based care has been the
Clinical Leaders need to be able to influence clinicians of all
professions. In Angus, we have a Clinical Director, Dr Michelle In Tayside, this is no longer the case. The Single Delivery
Watts (who is also a GP in Angus), and a network of identified Unit will focus on facilitating the paradigm shift previously
Clinical Leaders with a responsibility for working across the mentioned and will work to improve the care pathways,
NHS system and with the Managed Clinical Networks. Each quality and timeliness of care provision across all
of these Leads is managed by the Clinical Director.
operational services. There will be a Single Delivery Unit
Committee (again, a Standing Committee of NHS Tayside
These are sessional appointments but all Clinical Leaders have
a predominantly clinical role, e.g. doctor, pharmacist, nurse, Board), with a ‘whole system’ operational improvement
physiotherapist, etc. and bring their leadership skills to accountability. Angus CHP Committee will remain the
influence other clinicians across Angus and the patients’ Governance body for locally-delivered health services.
pathway of care.
Continued on page 6
Continued from page 5
Services and Responsibilities
Within the CHP, we directly manage an extensive range of services for the local population and we also host two
services for the Tayside population. We have tried to organise these services and their portfolios to match closely with
our Partners’ structures, thus enhancing opportunities for joint working and service delivery.
Service Department Portfolio of Responsibilities
Adult Mental Health (Angus) •All Adult Mental Health NHS services in Angus
and Tayside Specialist •Further discussion re Joint Management for Social Work Services under Lead Agency Protocol
Learning Disability Services •Tayside Specialist Learning Disability Services at Strathmartine and Carseview
(Manager - to be appointed) •Lead for Tayside Learning Disability Redesign
Note - Community Learning
Disabilities already devolved to individual CHP areas
Children & Family Services •All Health Visiting and Public Health Nurses including Specialist Nurses, Integrated Community
Heather Goudie School Teams, School Nurses and Public Health Practitioners
•Lead for operational health improvement in CHP
•Implementation of Hall 4 and Nursing for Health
Clinical Improvement and •Clinical Governance & Performance, including Clinical Safety and Risk Management
Nursing Leadership •Clinical Audit and Service Redesign support
Gail Smith •Primary Care Development
Rhona Guild (Deputy) •Clinical Governance Committee
•Lead Clinicians’ Network
•Training and Development
•Professional Nursing Leadership
•Leads for Unscheduled Care and Long Term Condition Management Projects
Community Health Services •All District Nursing Services
Charlotte Douglas •Long Term Illness Case Management How are we
•Practice Nurse Development
•Specialist Nursing in Community Services
Although the change
Corporate Services •CHP Committee management from Local Health Care
John Rodwell •Site management Co-operative (LHCC) to
•Allied Health Professionals line management Community Health
•Admin and Clerical Services
Partnership (CHP) has
•Capital Planning and Business Planning
been easier than in many
General Management •Overall accountability for Angus CHP delivery areas, there have been
General Manager - Susan Wilson exciting challenges in
establishing the CHP
Minor Injuries, Illness and Out •All MIIU Work/Development Committee, building on
of Hours Services •Anticipatory Care our Partnerships, and
Hazel Simm •Orthopaedic Support working towards a single
•Out of Hours interface with Tayside & NHS 24 NHS system.
Older People’s Services •Community hospitals
Liz Goss •Medicine for Elderly Assessment and Rehabilitation - Stracathro We have had to organise
(Bed base and Day and Ninewells interface the CHP to cover a vast
Treatment Services) •Continuing Care range of services to the
•Lead for Palliative Care local population and
•Psychiatry of Old Age Services, except Community, where Social beyond, whilst still
Work are lead agency keeping a focus on
•Lead for Early Supported Discharge and Prevention of Admission improvement and
Out-Patient Services •All satellite Out-patient units in Angus, including Stracathro accountability.
Susan Skene •Interface with ADTC
•Lead for Out-Patients Tayside Project and Service Directory We are close to achieving
•Lead interface with Diagnostic Services, eg Radiology the final organisation.
The CHP Committee has
Pharmacy •Pharmacists line management been set up, and, at the
David Gill •Medicines Management Committee
next meeting, we hope to
•Local Implementation of Pharmacy Modernisation and Community
sign off our Clinical
•Contract Budget management Improvement Priorities
for the coming year,
Planning & Performance •Interface with Community Planning and Joint Strategic Support Unit which we will share with,
Sheila Phillips •Performance Management/Workplans and seek approval from,
•Lead for Voluntary Sector and Patient Public Involvement the Healthy, Safe and
Substance Misuse Services •All NHS Tayside Substance Misuse Services
(N.B. Tayside-Hosted Service) •Interface with Blood Borne Virus Services
Contributions and news items for Issue 38 (May, 2006) should be submitted to Lynda Kemp, Angus CHP Office
Manager (email@example.com) by Tuesday, April 25. Many thanks to everyone who contributed to Issue 37.