Event on 25 October 2019 Report:Dec 2019 Collaborators On The Day - - PowerPoint PPT Presentation

EAHSCP Developing Cumnock Hub

Event on 25 October 2019

Report:Dec 2019

Third sector DNs AHPs Members of the public Specialist Nurses Public Health Social Care Managers Public ANPs Independent sector Respiratory Nurse Specialist Carers Locality Planning Group Vibrant Communities Community Hub CPN Person-centred Care Contracts / Commissioning Smart Supports GP Practice Manager Digital Services Transformation Team Dental Services Diabetes Specialist Nurse Neighbourhood Coach (Housing) Sensory Impairment Team Children and Families Homecare Management Independent Housing Clinical Director Economic Development Charge Nurse (EACH) I.T Security Early Years Intermediate Care Team Acute Service Manager Community Workers Nursing Assistant Homecare Support

Collaborators On The Day

Experience Knowledge Skills Views

Models of f Care

Virtual Patient Engagement making best use of technology

Health & Wellbeing Hub Acute Hospital Health & Wellbeing Centre

Home MDT

Current Services Composition

Home Care Homes Rothesay House Ochiltree Community Hub Netherthird Clinic Ballochmyle Medical Practice

Addiction Services AUCS Addiction Services Health and Wellbeing Addiction Services Addiction Services AUCS Carers' Support Carers' Support SAS CAMHS Carers' Support Befriending Dietician Digital Services SW C&F Digital services CLDMH Carers' Support District Nursing Equipment & Adaptations SW CLDMH Learning Disability Digital services Community Alarm GPs ICT SW Front Door Mental Health Services District Nursing Dentist Inpatient beds Learning Disability SW Locality Services SALT GPs Dietician Mobile and Screening Services Mental Health Services Third Sector SAS Health Visitors Digital Services Optometry Occupational Therapy Visiting Services MH Services District Nursing OT PEOLC Mobile and Screening Services Equipment & Adaptations PEOLC Pharmacy PEOLC GPs Pharmacy Physiotherapy Pharmacy Health Visitors Physiotherapy SALT Physiotherapy ICT Podiatry SDS Podiatry Learning Disability Respite Smart Supports SAS Mental Health Services SALT SW C&F TEC Optometry SAS SW Care at Home Visiting service OT SW Locality Service SW CLDMH PEOLC Third Sector SW FDS Pharmacy Reviews Visiting Services SW Justice Service Physiotherapy SW Locality Service Podiatry Visiting Services Rehab Facilities Respite SALT SAS SDS Smart Supports SW C&F SW Care at Home SW CLDMH SW FDS SW Justice Service SW Locality Service Visiting Services

Current Services Composition (cont’d)

Tanyard Medical Practice Valley Medical Practice Catrine Health Centre Auchinleck Health Centre Boswell Centre Ellisland Court Day Centre

Addiction Services Addiction Services Addiction Services Addiction Services Carers' Support AUCS Carers' Support Digital Services Digital Services Carers' Support Day Services Care at Home CLDMH District Nursing District Nursing Dentist Digital Services Community Rehab Dentist GPs GPs Digital Services Justice Services Day Services Dietician Health Visitors Health Visitors District Nursing Learning Disability District Nursing Digital Services MH Services MH Services GPs Respite GPs District Nursing Mobile & Screening Services PEOLC Health Visitors SAS Health & Wellbeing GPs PEOLC Pharmacy MH Pracitioner Mobile & Screening Services Health Visitors Pharmacy Podiatry MH Services OT MH Pracitioner Physiotherapy PEOLC Podiatry Mobile and Screening Services Podiatry Pharmacy Respite MSK Service SAS Podiatry SAS Optometry Pre-School SW CLDMH SALT SW Locality PEOLC Visiting Services SAS Visiting Services Pharmacy SW CLDMH Physiotherapy Visiting Dietetic Service Podiatry Visiting Services Respiratory Nurse Specialist SALT SAS Third Sector Visiting Service

Current Services Composition (cont’d)

Afton Court Day Centre East Ayrshire Community Hospital (EACH) Other (specify)

AUCS AUCS Mobile & Screening Service Addiction Services Care at Home Carers' Support OPD Podiatry Community Rehab Community Alarm OT Day Services Cumnock Breath Easy Group Outpatients District Nursing Day Services PEOLC GPs Dementia Services Pharmacy Health & Wellbeing Dental Physiotherapy Older Peoples Services Diabetes Specialist Nurse Podiatry Optometry Diabetes Support Group Pulmonary Rehab Podiatry Dietician Rehab Respite Digital Services Respiratory Consultant SAS District Nurse Evening Service Respite SW Locality Service District Nursing SALT Visiting Services GPs SAS & Bariatric Ambulance Health & Wellbeing Hub Social Work Health Visitors Stroke Specialist Nurse ICT SW Care at Home Inpatient beds SW Justice Unpaid Work

Mental Health Services Visiting Services

What is working well?

"Ask my GP" Online Resource Digital & TEC MDT working - MH, Pharmacy, Physio easing GP workload Communication at cluster mtgs Clinical and Outpatients 7 day ICT DN admitting access to pal care bed Mental Health discussions/counselling Community Connectors District Nursing Advanced Nurse Practitioners in GP practices EACH cafe accessible to all No delayed discharges Community led centres e.g. Ochiltree hub Falls Work Alzheimer Scotland presence/dementia groups within EACH EACH good links for discharge planning OPD Community run MDT Alzheimers’ support delivered Early Intervention and Prevention PEOLC at home and in EACH District Nursing Care MH Services for Elderly Befriending service Education programme for Type 2 Diabetes Prompt access to Xray Doctors know patients/families Rehab Broad range of services at home Engagement events Re-introduction of patient focus groups Getting people home from hospital SALT with Schools/Early Years CAPA Good location Respite in care homes Medical care at all practices Care at Home staff keeping people at home Good standard of medical care Rothesay House MDT working MH, Pharmacists, Physio coming into practices Carers' support worker GP with special interest in diabetes School links with day services in EACH Minor ailments service Co-location of DNs with GPs Greater range of technologies Self management Nursing care at EACH Community Connectors HEPMA Smart Supports Open to services utilising space Community Engagement in EACH Home visiting from dentists, opticians, dementia advisor Some Smart/IT Tech works well Optician - Eyecare Ayrshire Community Hub ICT Sufficient DN and good joint working Pharmacy First Day care for elderly Integrated working Third Sector Social activities run by local groups Day hospital hub Marchburn Ward is effective Vibrant Communities Volunteers at community hubs Day services MDT attendance at Hub meetings Well used by community members

What’s not working well?

Accommodation/property (GP & EACH) doesn't match service pressure or ambition Lack of GPs in rural communities Clinic in New Cumnock not fit for purpose Access to MH Services for children & adults Awareness of the financial inclusion team Lack of support for people with young on dementia & stroke Dementia activities in Kilmarnock - no equality

• t south

Empty ward could be utilised Care homes could be closer Lack of telecare GP appt allocation Layout of wards/showers/toilets Community Pharmacy meds not always ready Medical cover not available after 5pm at EACH GP waiting times No storage space Communication and information Missed appointments - needs to be tackled Level of Home Care time - quality No visible awareness of addiction services in the area Community alarms can't always respond quickly Morale of staff Local CAMHS are overwhelmed Pharmacy waiting times at Cumnock Surgery Contract disputes between PC & Health Board More capacity for befriending service MH service provision Seeing people in isolation Don't address social isolation work well enough More engagement with communities No peri natal MH services Duplication More MDT Staff recruitment delays Dynamics of workforce and flexible working Not all residents can access EACH Support for dependency issues Early supportive discharge form hospital Not consistent with access to local services e.g. Phlebotomy Transition between adult/child services Equipment delays or access to adaptations Not enough private home care providers Transport - real issue and affects whole community Filling consultant posts for specialist services OPD services limited GP availability Palliative care bed Home care resource and not enough staff PFI is expensive/ownership of building ICT not 24hrs PFI lack of flexibility to adapt building Info online not helpful for elderly Physio only 3 days per week IT issues Respite availability Joint working Rural areas - transport issue for appts resulting in DNA Lack of consultant Signposting to other services Lack of counselling services for young people Under utilised (2 closed wards)

How can this be improved?

7 day working across all services Keeping people informed Access to information Better transport All services in single hub Link SAS with GPs Adapt current buildings & agreements i.e. Sharing of premises, use of rooms Discharge prescriptions coming from

• ne pharmacy

Awareness raising of where to access services More access to internet Focus on what can be done locally Increase use of leisure services Better IT systems More capacity for befriending service Increase outreach initiatives Making use of empty ward for clinics Creating community hub in EACH More community hubs in small villages Increase utilisation of digital technology MDT teams based within schools Deliver phlebotomy in community buildings or EACH More home care capacity Link with transport providers/improve timetables Proactive approach to addictions Digitalisation options More IT consultations Make posts more attractive/recruitment campaign EACH has scope for more services More palliative care beds in the community More care workers Early discussion with patient/family members More respite at care homes More complimentary services GP practice open at weekends One electronic record for all More resources Hospital at home model OPD could be expanded Ochiltree Hub model Identifying the team around the person at earliest

• pportunity

Pharmacy on site at EACH Rural access If rebuilt, bigger car park Poor peer mentor navigator Shifting balance of care If rebuilt, dont need 4/5 wards Porters at night at EACH Utilise care homes for medication Improve diabetes education with MDTs Rep for SAS at discussions Improve discharge planning Similar approach in each village Improved communication for people being discharged from hospital Single point of contact Improved transport links Solve contract disputes Increase self management skills & abilities and resilience Staff awareness of health inequalities Increase stroke rehab in communities Support tackling loneliness Joined up services Utilising property, hubs to have multi purpose rooms

Deliver at Home

Equipment & adaptation

Rehabilitation

Care at Home

Palliative & end of life care

Self-Directed Support Pharmacy

AHP: Occupational Health AHP: Physiotherapy AHP: Dietitian AHP: Podiatry Front Door Services Intermediate Care Team Community Alarm

District Nursing Carers Support Be-friending Virtual Patient Engagement: Making best use of technology

Community / Extended Hub

Third Sector Pharmacy Community Hub Model Community Connector MDT AHP Services Mental Health GP Practice Palliative Care Screening Services Social Care Dental Virtual Patient Engagement: Making best use of technology

GP practices and MDTs Care homes Third sector assets Community assets Primary Care HSCP assets

New Build / EACH

In-patient services

Wider range

• f Locality

Services

Mental Health Services

Scottish Ambulance Service

Range of Third Sector Organisations

AHP services Dentist

Palliative care and end of life care

On site pharmacy GP Services

Range of out- patient services including clinics

Addiction Services Mobile screening X-Ray Services Ayrshire Urgent Care Services

Intermediate Care and Rehabilitation

Virtual Patient Engagement: Making best use of technology On site Porters at night

Comm Alarms, SDS, Smarts supports

Space for Mobile Unit

Pulmonary Rehabilitation

Suggested Improvements for Future Care

 More access to overnight carers  Additional Care at Home  Diabetes Nurse Specialist Service  Increased utilisation of technology  Respite.