RESEARCH COMMISSIONED INTO FUTURE OF HEALTH SERVICES IN HIGHLAND
Independent research into the social and economic impact and
consequences for local communities in Highland of any potential changes to
the pattern of health services is to be commissioned jointly by The
Highland Council, Highlands and Islands Enterprise and NHS Highland
working together as part of the Highland Wellbeing Alliance.
Members of The Highland Council today
(Thursday) agreed to share with Highlands and Islands Enterprise the costs
of the appraisal and to fully involve NHS Highland in the process.
The scope of the independent
appraisal will cover:-
* the impact of any change in service on the local economy;
* the impact on community services as well as the costs; and
* risks to families and individuals.
It will also identify practical
solutions for retaining or improving the current level of health services
in the Highlands, including identifying best practice in other countries.
Chief Executive Arthur McCourt told
the Council that there were no formal proposals for change at this time.
NHS Highland had set up a new West Highland Solutions Group to look at the
future of Health Services in the West Highlands and the research would
consider issues arising from the work of this group. An independent
review of maternity provision in Caithness was also likely to report to
NHS Highland later this month. Any proposals for change would be made as
a result of the work of these groups.
Convener Councillor Alison Magee, who
proposed the research at a previous meeting of the full council, said the
impact of any possible changes in health services was of interest to
everyone in the Highlands
- not just people living in Lochaber and Caithness.
She said: "We are pleased that the
Council is working with HIE and NHS Highland on this important piece of
The NHS is reviewing how it can
sustain current clinical health services in the light of: -
Staff recruitment and retention problems;
Meeting national clinical standards which can be difficult to achieve;
Increased specialisation of doctors and other clinical staff;
New working arrangements for consultants and primary care doctors;
Changes in working conditions and the role of doctors;
European working regulations.
27 February 04
Major Impact Study On Withdrawal Of Health Services
In Highland By Highland Council and HIE
Highland Council Meeting On 4 March Will Be Asked To Agree to £40,000
Highlands and Islands Enterprise Will Contribute a Further £40,000
The serious nature of the possible changes to health
services in Highland particularly in Caithness General Hospital, Wick and
the Belford Hospital, Fort William have been recognised by the
Highland Council and Highlands and Islands Enterprise. Highand
Councillors will be asked to ratify the proposal to carry out this major
Im,pact assessment at their meeting on Thursday 4 March in Inverness
Highland council summarised the research as
Research into the impact and consequences for local communities arising
from the potential withdrawal of NHS Services can be commissioned.
such research would be of use within localities and at a pan-Highland
level. Three areas of enquiry are proposed for the research. HIE seeks to be involved in the research and an involvement from NHS
Highland is required. Contractor capacity and timescales may require
the research to be commissioned by direct placement, with Members
approval. To manage the process a cross-service and partner officers
group is proposed, reporting progress to a consultative group of elected
and appointed members. an allowance of up to£40,000 is required and
is identified within the appropriate budget. Highlands and Islands
Enterprise can fund up to a similar level
(a) Rural Clinical
There is circulated Report No.
HC77/03 dated 26 February 2004 by the Chief Executive inviting the
Council to approve the commissioning of research and development of a
campaign following NHS decisions about withdrawing some rural clinical
The Council is invited to note:
(a) that the research requested at the last full
Council meeting is feasible;
(b) the reasons behind the threat to sustaining
current clinical health services;
(c) the current position in Caithness and
Lochaber and that Area committees are involved fully in local processes;
(d)the interest and contribution from HIE;
(e)the proposed timescale;
(f) that the research may need to be
commissioned by direct placement rather than competitive tender. An
up-date of this position will be provided at the meeting and will have
regard to the Council’s requirements for procurement as set out in
The Council is also asked to agree:
(a) the scope of the research;
(b) that an allowance is made of up to £40,000
for the research in an appropriate budget;
(c) the process for managing the research at
officer level and reporting progress at Member level.
(b) Out Of Hours Services
As Members will be aware, proposals to establish a model for Out of
Hours cover for Primary Care across Highland are currently being worked up
by NHS Highland. In relation to the future provision of this service, NHS
Highland have agreed to provide a briefing for elected Members. This is
being arranged to take place prior to the end of March 2004 and before any
proposal is considered by the Board of NHS Highland. Members will be
advised of the date and venue of the briefing as soon as arrangements have
More Details of Highland Council
Proposal To Be Put To Highland Counc8illors
on 4 March 2004
Research into the impact of Health Service proposals in Highland
Report by the Chief Executive
Research into the impact and consequences for local communities arising
from the potential withdrawal of NHS Services can be commissioned. Such
research would be of use within localities and at a pan-Highland level.
Three areas of enquiry are proposed for the research. HIE seeks to be
involved the research and an involvement from NHS Highland is required.
Contractor capacity and timescales may require the research to be
commissioned by direct placement, with Members’ approval. To manage the
process a cross-service and partner officers group is proposed, reporting
progress to a consultative group of elected and appointed members. An
allowance of up to £40,000 is required and is identified within an
appropriate budget. HIE can fund up to a similar level.
At its meeting on 18 December, the Council agreed that it should
investigate the feasibility of commissioning an independent appraisal of
the impact and potential consequences for local communities should vital
NHS lifeline services be withdrawn. The threat to sustaining current
clinical health services comes from:
• NHS reforms and their local implementation proposals;
• staff recruitment and retention problems;
• rising clinical standards which are difficult to achieve in smaller
• increased specialisation of doctors and other clinical staff;
• European working time Regulations.
Proposals in two areas are of pressing concern, namely the withdrawal of
maternity services at Caithness General Hospital and the withdrawal of
consultant led acute services at Belford Hospital, Fort William. Local
campaigns and action groups exist in both localities. Area Managers and
Area Committees are engaged in the local processes and local Members have
voiced their concerns actively.
The Current position
In Caithness, a review of services is underway and is due to report to NHS
Highland in March 2004. Research to evaluate any proposals for Caithness
would need to begin as quickly as possible for it to be useful to any
consultation on the proposals. Wider regeneration issues exist for
Caithness and it is important that any research can inform a broader
In Lochaber a Solutions Group is
established with a remit to develop ideas to produce a sustainable and
affordable model of service delivery. The solutions group includes NHS
Argyll and Clyde. The West Highland Solutions Group remit includes the
need to have regard to consideration of the wider economic and social
impact of the solution that it proposed, as well as the impact on other
care and service providers. The Council is represented on the solutions
The implementation of proposed NHS
reforms is of interest to the Council at a pan-Highland level as well as
in specific localities.
This is because:
• the services provided by the
local hospitals affect communities in Wester Ross, Skye and Lochalsh and
• changes in local hospital provision are likely to have a bearing on
provided by Raigmore Hospital, with a consequential impact on other
• there are wider strategic issues at stake and the Council is committed
working with communities and partners to improve the quality of life for
Highland residents by delivering services effectively.
The Scope of an independent
It is proposed that there are three areas of enquiry for an independent
appraisal of health service proposals. They are:
1. Two separate locality studies, one for Lochaber and one for Caithness,
the proposals in terms of the local:
a. Current economic impact – e.g. wages and supplies
b. Potential impact on business growth
c. Consequential regeneration issues (e.g. tourism, population, fragility)
Impact on community services
a. Roads maintenance
b. Emergency planning
c. Home care and other social work services
d. Other emergency services
Costs and risk to families and
a. Transport costs
b. Separation from families
c. And others identified through a health impact assessment
2. To identify practical solutions
for retaining or improving the current level of health services in the
Highlands, including identifying what works elsewhere and in other
3. To consider the wider implications
for the delivery of health services in Highland arising from proposals.
This could include considering the impact on the services around Raigmore
Hospital and on the out of hours service. The work could be taken forward
in phases and we would expect the researchers to propose a suitable
methodology for each phase.
HIE has confirmed its interest given their concerns about the economic
impact of proposals and is keen for the research to include work on
finding practical solutions to the delivery of health services. HIE can
If the purpose of the research is to
assess fully the impact of the potential withdrawal of hospital services
and to identify workable and sustainable solutions to health service
delivery in localities, then it requires input from NHS Highland.
Given the proposed scope of the research a range of skills will be
required, including health economists, economists, those with knowledge of
public service delivery in the UK and abroad and social policy skills.
There are few contractors with this range of skills and experience
required. In addition, there is a need to commission the research to start
in April 2004.
With these skills and time
restraints, it is likely that the research will need to be commissioned by
direct placement rather than competitive tendering. An up-date on this
position can be provided at the meeting, drawing on the Council’s
requirements for procurement as set out in the Standing Orders.
It is proposed that the Council commission with work with HIE as a
partner. An officer steering group would oversee the management of the
commission, comprising staff from: the Policy Team (lead); the Economic
Development Service; Social Work; TEC services; both Area Managers; HIE;
and Highland Health Board.
It is proposed also that a
Consultative Group of Members considers progress on the research,
comprising: the Convenor; Vice-Convenor; key Area Members from Caithness
and Lochaber; elected Members appointed to the Health Board; and the chair
It is proposed that the research begins in April, depending on contractor
capacity. Separate timelines will be needed for the local studies
which need to proceed first. Reporting timescales will depend initially on
the availability of the secondary data held by the organisations involved.
Timeline details would be confirmed at an initial scoping session with the
contractor. We would expect the locality studies to be
completed by late summer.
An allowance of up to £40,000 is required within an appropriate revenue
budget. This can be accommodated within the budget set for the Chief
Executive’s Office. HIE has indicated budget provision of a similar level.
Members are asked to note:
1. that the research requested at the last full Council meeting is
2. the reasons behind the threat to sustaining current clinical health
3. the current position in Caithness and Lochaber and that Area committees
involved fully in local processes;
4. to note the interest and contribution from HIE;
5. to note the proposed timescale;
6. to note that the research may need to be commissioned by direct
placement rather than competitive tender. An up-date of this position will
be provided at the meeting and will have regard to the Council’s
requirements for procurement as set out in Standing Orders.
Members are asked to agree:
7. the scope of the research;
8. that an allowance is made of up to £40,000 for the research in an
9. the process for managing the research at officer level and reporting
1. Lochaber Area Committee reports by the Area Manager (October 2003 and
2. The draft remit for the West Highland Solutions Group (February 2004)
3. Highland Council Corporate Plan 2004-07
4. Files held by Head of Policy