Am Bratach No. 304
As we went to press, plans to develop a new single health and social care hub facility on the north coast of Sutherland were to be put before the board of NHS Highland on Tuesday of this week. The proposals follow a period of consultation as to the future of care home services currently provided at Caladh Sona, Talmine, and the Melvich Community Care Unit in Portskerra.
In 2014, the Highland Council agreed to a £1.5 million capital spend for a replacement facility for Caladh Sona, opening up debate as to its scope and location. A report on the NHS-led formal consultation, which took place between July and October 2016, sets out the three options on the table. The report asserts that, of these, building a new care home facility in one location garnered the highest level of overall support.
According to an NHS consultation document, the hub concept could combine a range of facilities alongside residential and nursing care beds: suggestions of what these might be include GP services, community nursing, physiotherapy, occupational therapy, speech and language therapy, podiatry, dentistry, social work and even the ambulance and fire services.
Christian Nicolson, NHS quality improvement lead for the north-west, said that the board would not be invited to agree on a final location for the hub at this stage. The board will be asked to approve the model in one location (replacing the two existing residential care home facilities located in Melness and Melvich). Further, the board will be asked to approve the recommendation that further work is required around the preferred location.
The NHS has been quite open as to its preferred location from the outset. A summary public consultation document published in July 2016 stated: If their recommendation was implemented NHS Highland would run services in a new purpose built facility in the Kyle of Tongue area. Perhaps predictably, therefore, a report on the consultation period identifies the Kyle of Tongue as the front runner for a new facility, stating that 64% of respondents were in favour of this area. However, it acknowledges that significantly more people did respond to the consultation from the Tongue area, potentially skewing the result.
In March 2016, Am Bratach highlighted the issue of fair representation of views across all areas, drawing particular attention to Scourie and Kinlochbervie. Asked whether further efforts had been made to gather opinion from this area, Christian Nicolson stated: Copies of the consultation survey were made available to people in the Scourie/Kinlochbervie/Durness area. A drop-in event, similar to those held in Melness, Bettyhill and Melvich was held in Kinlochbervie. The respective community councils were contacted on a regular basis throughout the consultation period and local councillors were also communicated with as part of the process. Time was spent with pupils in the high school. However, she conceded that of those who included an address in their response, only 4.5% were from the Scourie, Kinlochbervie and Durness area. There were no attendees at the drop-in event held in Kinlochbervie on October 12.
Given the geographic spread involved, it is surprising that the consultation report divides responses into only two broad locations: Area 1, which combines the community council areas of Scourie/ Kinlochbervie, Durness and the Kyle of Tongue, and Area 2, covering Bettyhill, Strathy/Armadale and Melvich. As might be expected, views diverge even within these areas. The NHS feedback on the preferred location for a new-build reveals that the Area 2 response was much more split, with Bettyhill the most favoured option, but with Melvich and the Kyle of Tongue also attracting a significant share of the vote. On the face of it, the unity of Area 1 may have more to do with the fact that most responses came from the Tongue area, which understandably supports the replacement or enhancement of Caladh Sona.
Views have also differed on whether a single new-build is indeed the right option, especially from the more easterly parishes which have most to lose if an upgraded facility is located further west. In October, Strathy and Armadale Community Council argued for the retention of services in Melvich alongside the renovation of Caladh Sona, to keep services on that side of the coast. Summarising the views of the community council, chairwoman Janette Mackay said that centralising all services to a new hub is only of use to those living close to it and would spoil what is at present available in our local doctors surgeries.
A significant concern for all is staffing. Although Melvich Community Council issued a statement in support of a new, single hub facility, on the grounds that retaining two separate units was unsustainable, there were worries about the recruitment and retention of nursing and social care staff. Strathy and Armadale were likewise uneasy about staffing a new build if it were to be located around Tongue, stating that workers from the Melvich side often covered shifts at Melness due to staff shortages further west and that nursing staff resident in Caithness would be reluctant to travel the distance to Tongue. Asked how the NHS might tackle this issue, Christian Nicolson acknowledged that these concerns were still a factor: We plan to consider this internally and to commission some external review. We will ask staff their views about where they will be willing to work, compare how long it has taken to fill posts in the different care homes and look at how some of the challenges might be addressed.
On a more reassuring note, consultation feedback revealed overwhelming support for the retention of day care facilities as they stand. Gill McVicar, director of operations for NHS Highlands north-west operational unit, confirmed that there are no plans to change existing arrangements for day care services in Kinlochbervie, Tongue and Melvich.