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HEALTH MATTERS: NHS Highland north area manager Michelle Johnston on working to serve communities in the best possible way


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More Covid-19 deaths are now occuring in Scotland's care homes than in the country's hospitals.
More Covid-19 deaths are now occuring in Scotland's care homes than in the country's hospitals.

People sometimes see health and care services as a place they go – to see their GP, a specialist at a hospital, or to be looked after in a care home. In fact, we deliver services to people in a huge range of settings, from care at home, to a session at the GP surgery from a physiotherapist, or advice from your high street pharmacist. As our population ages it is more important than ever that we work with people to keep them healthy, as well as treating them when they do fall ill.

That’s why working with communities is so important, and will be a big focus for NHS Highland in coming months, as we ask people to help us shape the organisational strategy. It is you who know which organisations are best placed to support healthy, independent lives. Cycling Without Age, for example, is a fantastic organisation that does wonders for people’s wellbeing by helping them to get out and about with the wind in their hair!

We want to work with organisations like this, providing flexible services that help people to stay well. Having social workers shadow colleagues on wards, and vice versa, is one way we increase understanding between teams. Another is to make sure we engage with those who use our services.

One example of this is the redesign of services for Caithness and the north coast. A consultation group, including local elected members, community representatives and clinicians, has been an integral part of plans for two new hubs and a reconfiguring on Caithness General Hospital. We have completed a new reception area for outpatients with additional clinic rooms, which can be used flexibly. People can also attend virtual appointments here, if they do not have access to the IT needed at home. Work is also under way to remodel the Community Midwifery Unit.

Michelle Johnstone.
Michelle Johnstone.

The hubs will incorporate residential care as a “step down” from hospital or a “step up” from the community to allow more people to be cared for closer to home, and supported back to independent living. We’ll also be able to house social care, social work, Scottish Ambulance Service, occupational therapy, community nursing and local voluntary services under one roof.

Another change being piloted is a rapid response overnight care service. We heard that sometimes people were calling an ambulance or medical services and being admitted to hospital because there was no alternative care available overnight. We are currently recruiting senior health and social care support workers to provide extra care and support that will allow people to stay safely at home. This will be backed by new “step up” beds where people can stay for two or three days while being assessed for any extra care they may need.

Recruitment is a challenge but we are seeing increasing numbers of people applying for training in the sector, and we are working hard to promote job security, career progression and flexibility of roles. This is another area where communities have helped, with local groups and elected members joining us to promote some of our remote and rural areas as great places to live and work. Working together we can find new ways to look out for each other, and move towards health and care being a thing to do, rather than a place to go.

• Michelle Johnstone is NHS Highland north area manager.

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