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1.     Present and Apologies

1.1    The following attended the meeting:
John Palmer (Chair)               Edinburgh CHP (NHS)
Lesley Craise                     Dr. Bell’s
Jenny McKenzie                    Leith Central Community Council
Julie Boyle                       Aberlour Outreach Edinburgh
Anne Nixon                        Home – Start
Linda Wilson                      Out-patient Team Manager, Leith CTC
Michael Gray                      Access to Industry – Transition
Anne Munro                        Pilmeny Development Project
Sam Anderson                      The Junction
Jaki Wood                         Public Health Nurse Team Leader
Anne Dey                          CEC Development Manager, Older People’s Day
Alison Wilkie                     Leith Links Community Council
Neena Agarwal                     MILAN

1.2. The following gave their apologies:
Anne Conafray                   ELCA
Linda Newlands                  Persevere Community Health Flat
Fiona McRae                     NEECS
Joyce Gegan                     Port of Leith HA
Mary Elton                      Sure Start (Speech and Language Therapy)
Helen MacFarlane                Edinburgh Leisure
Ewan Blain                      CEC Health & Social Care
Judith Craven                   Substance Misuse Locality Clinic
Lynne Bradford                  Community Drugs Problem Service
Patricia Burns                  Alcohol Problems Service
Madi Martin                     NE LHP Care Co-ordinator
Heather Elliott                 District Nurse Team Leader
Sian Fiddimore                  Access to Industry – Transition
David White                     Assistant General Manager, Edinburgh CHP
Loraine Duckworth               Partnership Development Officer, Leith NP
Joyce Gegan                     Port of Leith HA

2.     Minutes of the meeting of 12th February 2009
2.1.   Agreed as a correct record

3.    Matters arising from previous minutes
3.1   John regretted he had not yet met Vivienne Robinson, head of Working for
      Families to discuss childcare vouchers

3.2   Neighbourhood Partnership sub-groups
      There was some confusion as to whether the Children & Families sub-group
      had met. Jenny said she had attended a meeting on 10th March; others had
      been unaware of this. It was important to cross-reference the two groups;
      John to clarify with Christine Mackay.
                                                              Action: John Palmer

3.3   Survivors of Domestic Abuse group
      John reported the LHP wondered whether it was best for this group to
      continue meeting in Leith CTC. It was supported by Women’s Aid and he was
      discussing a way forward with them; whether they could advertise themselves
      a bit more and where to meet. Lesley and Anne N both offered their premises.

4.    Drugs and Alcohol
4.1   John said he had circulated the up-dated Drugs and Alcohol section of the
      plan, reflecting the discussion held at the last meeting. It included potential
      actions and ideas to be followed through. He had received additions from
      Turning Point and Bethany. He had also had a discussion with GPs, whose
      experience had very much reflected that of the sub-group.

4.2   John added the Edinburgh DAAT was meeting this afternoon to confirm the
      allocations made from the monies for which it invited bids last November. This
      affected both city-wide and local services; when these were public it would be
      important to try and influence how city-wide services were provided in Leith.
      Sam said The Junction had been invited to discuss a second round of bidding
      to ensure local services were properly catered for.

4.3   Julie asked why the plan included an action of increasing support to families
      affected by substance abuse, when Aberlour Outreach’s funding had been cut.
      John replied this had been the subject of considerable discussion at the last
      meeting and including it would hopefully draw the sub-group’s concern to the
      attention of the Neighbourhood Partnership.

4.4   Anne M asked about the issue of alcohol misuse and older people, particularly
      men. There was some discussion about whether it should go in here or the
      Older People’s section. It was agreed it should be added to the Drugs and
      Alcohol section, with a cross reference to the Older People’s section.
                                                               Action: John Palmer

4.5   Lesley raised the issue of women misusing substances also suffering from
      unresolved traumas and PTSD. What services were available to help them?
      Julie said they mostly used counselling. Lesley wondered if this was the most
      effective method; she wondered also about the effectiveness of body
      techniques, which mostly had to be purchased privately.

      It was agreed more knowledge was needed on the subject. Lesley and Julie
      would provide John with research they were aware of. John would also raise
      the subject with colleagues in the Public Health department and get some
      expert advice.
                                                               Action: John Palmer

4.6   Anne M raised the issue of substance misuse among the BME communities,
      both the newer East European ones and the longer-term South Asian and
      Chinese ones. There were many cultural issues that meant a single-stranded
      approach might not suit all. Others thought this would apply across a lot of
      issues across the whole Health Action Plan. It was agreed:
             1. To have a separate BME section in the Health Action Plan
             2. To call a meeting to tease out the main issues.
                                                               Action: John Palmer

4.7   John said the South East LHP had a Drug and Alcohol Practitioners’ Forum
      that drew in NHS, Social Work and voluntary sector workers from Gracemount
      to Portobello. He wondered whether we should create a similar forum in North
      East LHP, who would be charged with drawing up plans to implement the
      suggested actions in the Plan. People thought this would be a good idea, as it
      was a specialist area; the forum could then report back to the Sub-group. It
      was agreed to arrange a meeting in the second week of May.
                                                               Action: John Palmer

5.    Early Years and Support for Families
5.1   John explained the logic model he had circulated was an attempt at a quicker,
      easier to read version of the Early Years section in the Action Plan. This latter
      had now been up-dated with the outputs received from the five voluntary
      sector organisations; he thanked them all for their input. On Indicators he was
      working with Ailene Preston to get accurate figures of the assessments done
      by Health Visitors of children up to their entry to Primary School.

5.2   Lesley reported the Leith Early Years Forum has met twice since February. It
      mainly consists of practitioners from Nursery schools and Children and Family
      Centres and the voluntary sector. They had thought through the needs they
      perceived in the area and had established a number of working groups:
             1. Mental health of parents and children
             2. Bi-lingual families
             3. Informing and involving parents and developing a directory of
             4. Joint training with Public Health Nurse colleagues on the roll-out of
                the Team Around the Child.

5.3   Jaki reported the Public Health Nurses monthly meeting had been informed
      about the roll-out of Team Around the Child. This follows the publication by
      CEC Children & Families and Edinburgh CHP of the ‘Parenting and Caring
      Framework’ for the city. John had also presented the work of the NP, the
      Health and Wellbeing sub-group and the Early Years Forum. He was now
      asking them to describe their services and their views on gaps to be added
      into the action plan.

5.4   Jaki added the PEACHIE programme, which works both ante- and post-natally
      with vulnerable mothers, is about to run a programme at Dr. Bell’s. Alison,
      whose baby, Reuben, also attended the meeting, said she had received
      fantastic support from services in the area, including the breast feeding group
      at Dr. Bell’s and the mother’s group at Ocean Terminal. She knew about
      these groups from a leaflet she had received from the midwife when she was
      discharged from hospital. She asked about the composition of the breast
      feeding group at Dr. Bell’s. Lesley said they kept careful records of people
      attending and they got a good proportion from the deprived parts of the area.

6.    Care of Older People
      John explained the section circulated was very much an outline, although
      when he had originally drafted it he had consulted with Ewan Blain and other
      staff in CEC Health & Social Care. He had also added references to older
      people that appear in other sections, such as Physical Activity and Mental
      Health. There was lively discussion of the following points.

6.1   Age barriers
       Providing different services based on historical age cut-off points, as
         happens within the NHS and Health and Social Care, is institutionally
         discriminatory and not person-centred. The example was given of moving
         people from adult mental health services when they are 65 years into
         geriatric services, when the latter are not well-resourced to meet the
         person’s needs.
       What constitutes old age is culturally determined, and what is considered
         old in one community may not be the case in another.
       People with long-term conditions do not fare well when age barriers are

6.2   Re-ablement
      The sub-group would welcome sight of any evaluations of the introduction of
      re-ablement. They felt however it was being introduced to resolve the issue of
      bed blocking and delayed discharge from hospital, and not as a preventative
      measure to help reduce higher level need. The emphasis should be changed
      to greater prevention.

      There were also concerns that the 6 weeks package might not be sufficient for
      some patients. They wondered too how well it provided for people with long-
      term conditions and whether appropriate assessments were made of people’s
      abilities. There were also gender and cultural issues to be considered in re-

      They felt re-ablement did not help re-able people in a social sense; i.e. help
      them overcome their social isolation.

6.3   Discharge Planning
      Considerable disquiet was expressed about perceived inefficiencies in the
      discharge planning system. Points raised were:
       Lack of forward planning

         Discharges without proper co-ordination with the family and not taking into
          account gender and cultural issues
       Discharges on Fridays without proper social care support in place,
          resulting in people being at home without support until Monday
       People living alone being discharged to empty houses, with no preparation
          being made in the house – food, warmth etc.
       Discharges without effective connection to voluntary and community
      It was thought discharge protocols could be further looked at, and that
      information sharing and joint training sessions could be arranged between
      NHS, CEC Health and Social Care and voluntary organisations and patient

6.5   Directory of Services
      Anne D said the Portlee Healthy Living Group was collecting information about
      voluntary and community organisations providing local services and hoping to
      publish this on a web-site. John said there was a web-based database
      available, held by Craigmillar Ability Network, a copy of which should be
      suitable for this purpose. Julie questioned how accessible this would be for
      older people. Anne M acknowledged this, but said they were hoping to recruit
      community groups to act as ‘champions’ for the directory and help those
      without web access to use it.

6.6   Other older people’s issues raised were:
       The Portlee group has received funding for a pilot study to look at a
         ‘community connector’ post. John said Craigmillar Ability Network had
         such a post, both to develop the database and recruit volunteers to help
         people get to the services to which they have been referred.
       Older carers of older people and their support needs
       The new Adult Protection legislation and the possibility of joint training
         between statutory and voluntary organisations on the issues; there was a
         particular concern about financial abuse.
       Fuel poverty and the choice between heating and eating; Anne M said she
         was working with Changeworks and the Care and Repair service on this.
       Food and nutrition for older people; John said he would check whether this
         has been raised in the city’s Joint health Improvement Plan food and health
       The design and provision of ‘housing for life’; this was something that could
         be taken up with the Housing and Built Environment sub-group.
       Advocacy services for older people; with the demise of SAGE there was
         now nothing available. Anne M said however the council had been
         considering this and she thought a report was going to committee in May.
       People with learning disabilities are now living longer, and although the age
         barrier for them to receive appropriate services has been reduced to 55
         years, this may not meet all their needs.

6.7   John suggested, as there was a large agenda here, the Portlee Healthy Living
      Group could be charged as a reference group for the issues; to look at
      prioritising them; proposing appropriate actions; and drawing up plans to
      implement these actions. It would report back to the Health and Wellbeing

      sub-group on its progress in the same way as the Early Years Forum and the
      proposed Drug and Alcohol Practitioners Forum. Anne M said she thought the
      group would welcome this and she would liaise with John over the
      membership. This was agreed.
                                               Action: John Palmer, Anne Munro

7.    AOCB
      John reported on the following services and conferences:
       Lifeline Pregnancy Counselling and Care, 24a Haddington Place, 0131 557
       Leith Baby Co-operative, Leith Acorn Centre YMCA, 1 Junction Place,
         every Wednesday 11.30 am -12.30 pm; buy cheap named baby products,
         parents group
       ‘Better Breaks for All’ – Shared Care Scotland, 23 April, Dunfermline.
       Blood Borne Viruses, 19th June, Dundee. M.y.paterson@dundee.ac.uk
8.    Date of Next Meeting
8.1   John reported there had been a request from community representatives to
      hold evening meetings to enable those who work to attend. He said he was
      experimenting with an evening meeting in Craigentinny & Duddingston NP and
      would consider how this went before making a decision on the timing.

8.2   Thursday 4 June 2009

9.    Agenda of Next Meeting
       Early Years outcomes – report back
       Drug and alcohol outcomes – report back
       Services for older people – report back
       Mental health issues


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