1. Skye, Lochalsh and South West Ross Health & Care Services: planning for the future

3. How Many Services are provided in Skye and Lochalsh and South West Ross? Can you guess? Can you guess? Hospital Services = ? Hospital Services = ? Community Services =? Community Services =? Visiting Services = ? Visiting Services = ? Total = ? Total = ?

4. Answers Hospital Services = 31 Hospital Services = 31 Community Services = 46 Community Services = 46 Visiting Services/Clinics = 28 Visiting Services/Clinics = 28 Total = 105 Total = 105

5. Hospital Services Acute Medical Acute Medical Acute surgical Acute surgical Acute Medical - Nursing Acute Medical - Nursing Rehabilitation Rehabilitation Terminal Care Terminal Care GP-led beds GP-led beds Day Cases Day Cases Medical Investigations Medical Investigations Midwifery/obstetric care Midwifery/obstetric care Outpatients Outpatients Primary Care Emergency Centre/Out of Hours Primary Care Emergency Centre/Out of Hours A & E Department A & E Department Blood Transfusion Blood Transfusion Detoxification Service for Alcohol Dependant Patients Detoxification Service for Alcohol Dependant Patients Re-ablement services Re-ablement services Occupational therapy services Occupational therapy services

6. Hospital Services (2) Podiatry Podiatry Orthotics Orthotics Chemotherapy Chemotherapy Recognised site for Management and Treatment of Major Incidents Recognised site for Management and Treatment of Major Incidents Temporary place of safety for patients detained under the mental health act Temporary place of safety for patients detained under the mental health act Community Treatment Orders Community Treatment Orders X-Ray X-Ray Physiotherapy Physiotherapy Occupational Therapy Occupational Therapy Dietetics Dietetics Care of the Elderly Care of the Elderly Colo-rectal service Colo-rectal service Tele-care training facility Tele-care training facility Telehealth Clinics e.g. neurology, oncology and diabetes Telehealth Clinics e.g. neurology, oncology and diabetes Hospice link nurse Hospice link nurse

7. Community Services Community Nursing Community Nursing District Nursing District Nursing Midwifery Midwifery Health Visiting Health Visiting School Health Nursing School Health Nursing Family Health Nursing Family Health Nursing Macmillan Nursing Macmillan Nursing Learning Disability Nursing Learning Disability Nursing Marie Curie Marie Curie Psychiatric Nursing Older Adults Severe & Enduring Addictions Social Care Services Social Workers Care @ Home Care Homes Day Care Services Tele- care services

8. Community Services (2) Allied Health Professionals Allied Health Professionals Physiotherapy Physiotherapy Dietetics Dietetics Occupational Therapy Occupational Therapy Speech & Language Therapy Speech & Language Therapy Podiatry Podiatry Radiology Radiology Sonography Sonography Re-ablement Re-ablement Lymphoedema Clinic Breast Prothesis Clinic General Practitioners x 7 Practices S & L General Practitioners x 5 West Ross Dental Services Public Health Primary Mental Health Guided Self Help Smoking Cessation

9. Visiting Services/Clinics Child & Adult Psychiatry Child & Adult Psychiatry Mental Health & LD Mental Health & LD Child & Adult Psychology Child & Adult Psychology CBT, Mental Health & LD CBT, Mental Health & LD COPD COPD Cardiac Rehabilitation Cardiac Rehabilitation ENT ENT Renal Renal Orthopaedics Orthopaedics Care of the Elderly Care of the Elderly Sexual Health Sexual Health Opthalmics Opthalmics Occupational Health Occupational Health Medical Surgical Retrieval Service Urology Aneurysm Screening Paediatrics Orthotics Audiology Ultra-Sound Chest Rehabilitation Stoma Oncology

10. Not Fit for Purpose! Portree and MacKinnon Memorial Hospital buildings are outdated in modern healthcare terms Portree and MacKinnon Memorial Hospital buildings are outdated in modern healthcare terms Infection Control Standards – HEI/HAI Infection Control Standards – HEI/HAI Decontamination for Theatre and Diagnostics Decontamination for Theatre and Diagnostics Fire Safety Fire Safety Patient Safety Patient Safety Site Constraints Site Constraints Public Expectations Public Expectations Financial constraints Financial constraints NHSH report on state of premises identified costs to maintain buildings NHSH report on state of premises identified costs to maintain buildings Portree = £100,000.00 Portree = £100,000.00 MMH - £500,000.00 MMH - £500,000.00 Approx £3million spent in recent years to improve fabric of buildings Approx £3million spent in recent years to improve fabric of buildings High risk that we may lose services! High risk that we may lose services!

11. Modern Healthcare means… Ensuite rooms Ensuite rooms Totally cleanable Totally cleanable Layout to allow staff to do their jobs Layout to allow staff to do their jobs Work and Rest facilities Work and Rest facilities Improved Communications Improved Communications Telehealthcare Telehealthcare Improved diagnostics Improved diagnostics Video Consultations Video Consultations Wifi Wifi Sound Proofing Sound Proofing Hearing Hearing DDA compliant DDA compliant

12. Modern Health Care (2) Access Access DDA compliant DDA compliant Car Parking Car Parking Transport Links Transport Links Fire Safety & Evacuation Fire Safety & Evacuation Energy Efficiency Energy Efficiency

13. Where are we now? Steering Group established Steering Group established Programme for community engagement – 31.3.13 Programme for community engagement – 31.3.13 Agreeing the vision Agreeing the vision Developing the case for change Developing the case for change

14. Scottish Government Process Scottish Government Investment Manual Scottish Government Investment Manual Option Appraisal Option Appraisal Initial Agreement Initial Agreement Outline Business Case Outline Business Case Full Business Case Full Business Case Project support agreed from April 13. Project support agreed from April 13. Project Manager will support the delivery of the option appraisal and initial agreement. Project Manager will support the delivery of the option appraisal and initial agreement.

15. Our Vision Statement!

16. The Principles! Realistic and Achievable Realistic and Achievable Ambitious and Creative Ambitious and Creative Consistent with national and local policy Consistent with national and local policy Presumption:- that we are clinically safe and cost effective – services will be delivered within S&L and SWR Presumption:- that we are clinically safe and cost effective – services will be delivered within S&L and SWR Financially realistic and deliverable Financially realistic and deliverable Supported by a broad consensus of stakeholders Supported by a broad consensus of stakeholders

18. What are the Alternative Options? We would like you to help us develop the options? We would like you to help us develop the options?