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Clinical Reference Group 25 th March 2008

Clinical Reference Group 25 th March 2008. 14.00 Introduction and Welcome (John Turner) 14.10 Remote and Rural Healthcare (Andrew Sim ) 14.40 The Project (Martin Hill)

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Clinical Reference Group 25 th March 2008

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  1. Clinical Reference Group25th March 2008 14.00 Introduction and Welcome (John Turner) 14.10 Remote and Rural Healthcare (Andrew Sim) 14.40 The Project (Martin Hill) 15.00 Workshop session 1 (All, in groups) 15.45 Tea/coffee 16.00 Feedback/Agree Priorities (All, in plenary) 16.20 Workshop session 2 (All, in groups) 17.20 Feedback/Alternatives (All, in plenary) 17.40 Future CRG meeting arrangements 17.45 Close

  2. Western Isles – Clinical StrategyClinical Reference Group Current Stage – Scope/Emerging Themes Martin Hill Programme Director

  3. The Project • Clinical strategy for the next 3-5 years • For the people of the Western Isles (all providers) • Deliver best practice/modern standards • Improve health and quality of life • Phase 1 - create vision/service model • Phase 2 – test vision through consultation • Process of engagement/open debate

  4. The Challenges • Different models of care (on and off island) • Provide more care locally • Off-island referrals increasing • Workforce availability • High costs/inefficiency • Sustainability of current services • Resistance to change • Small and ageing population (and staff)

  5. The Opportunities • Highly motivated workforce • Clinical networking (on and off island) • Telemedicine/e-health • Skills and role development • New providers • Stronger partnerships

  6. Feedback from Project Launch • Lack of clarity about current services • Incoherent patient pathways • Services not sufficiently patient-focussed • Need reassurance about same chance of survival as someone on mainland • Poorly integrated emergency care • Want integrated community “hubs”/locally enhanced services

  7. Feedback from Project Launch(2) • Make far more use of IT/telemedicine • Redesign resident v. visiting consultant services • Challenges of transport/travel • Want to retain access to mainland hospitals • Many premises not fit for purpose • Need better leadership

  8. Identifying the Priorities • Hospital services:- • Specialty by specialty , best practice review • Activity and outcomes • Patient pathways – acute (investigation/referral/treatment/follow up) • Patient pathways – long term conditions (diagnostics/self/shared care/reduced admission) • Potential for clinical networking and shared care • Future challenges

  9. Identifying the Priorities (2) • Primary and community based services:- • Extending primary care teams • Managing long term conditions • Wider use of protocols (emergency care, assessment/triage, referral, transport) • Extended partnerships (hospitals, local authority, voluntary services)

  10. Workshop session 1 • What particular clinical service areas should we concentrate on for review, that are significant in terms of an overall clinical strategy (identify 6 – they can be individual specialties or wider service areas)? • Why these particular areas? • Who should lead/be involved in the initial review?

  11. Workshop session 2 • Taking each of the top 3 service areas for initial review in turn, how would you describe the service, using a range of descriptors (e.g. patient pathway, use of beds, organisational structure) ? • Which data should be gathered/reviewed? • What alternative arrangements for each of these 3 service areas should be considered to improve the service and/or it’s sustainability?

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