Situation in Scotland


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Situation in Scotland

  1. 1. PGHN Services in Scotland Michael Bisset for SPGHANG <ul><li>Regional planning experience </li></ul><ul><ul><ul><li>North of Scotland </li></ul></ul></ul><ul><li>National planning </li></ul>
  2. 2. Regional PGHN Services North 1.2 million (24%) 61% of area East 1.4 million (27%) 10% of area West 2.5 million (49%) 29% of area
  3. 3. North of Scotland <ul><li>Acute services review (1998) </li></ul><ul><li>Meeting of Consultant Staff (1999) </li></ul><ul><li>Local drivers </li></ul><ul><ul><ul><li>Need for critical mass for services </li></ul></ul></ul><ul><ul><ul><li>Need for critical mass for training </li></ul></ul></ul><ul><ul><ul><li>Two Health Boards actively wanting to work together </li></ul></ul></ul><ul><li>Formation of Regional Planning (Paed.) Group 2002 </li></ul><ul><li>HDL (2004) 46, Empowering Regional Planning </li></ul><ul><li>‘ Delivering for Health’ Nov 2005 </li></ul>
  4. 4. Staffing Paediatric Gastroenterologist 1 + Paediatric Gastroenterologist 2 Dundee Consultant with an interest Paediatric Dietitians GI nurse Consultant with an interest Paediatric Dietitians Paediatric Dietitians Nutrition nurse Aberdeen Inverness 9 General Paediatricians 4 Paediatric Surgeons 5 General Paediatricians p/t Paediatric Surgeon 8 General Paediatricians p/t Paediatric Surgeon Outreach (Peripheral Clinics, Community Nurses, CCH,)
  5. 5. Patient Pathway (L.L.) Aberdeen Diagnosis & initial treatment Inverness Initial referral & specialist review Skye Home Peripheral clinic
  6. 6. Remaining Issues <ul><li>No additional funding to create Network </li></ul><ul><ul><ul><li>MCNs are not cost neutral </li></ul></ul></ul><ul><li>Attempts to fund Network Manager unsuccessful </li></ul><ul><li>No additional AHP and Nursing posts created </li></ul><ul><li>IT infrastructure not well integrated </li></ul><ul><li>No financial incentives for smaller HB to fund MCNs </li></ul>
  7. 7. National <ul><li>Scottish PGHN group started meeting (circa 1999) </li></ul><ul><li>Health Minister sets up Child Health Support Group (2002) </li></ul><ul><li>HDL (2002) 69, Promoting development of MCNs </li></ul><ul><ul><ul><li>First NHS Paediatric GI appointment in Glasgow (West) </li></ul></ul></ul><ul><ul><ul><li>No regional planning activity in Edinburgh (East) </li></ul></ul></ul><ul><ul><ul><li>Formation of Paediatric Regional Planning group (North) </li></ul></ul></ul><ul><li>HDL (2003) 43, Review of Specialist Paediatric Services </li></ul><ul><li>New Consultant contract (2004) </li></ul><ul><li>Review of PGHN services. National meeting (2004) </li></ul>
  8. 8. Paediatric Gastroenterology, Hepatology and Nutrition Services in Scotland A report commissioned by the Child Health Support Group, Scottish Executive as part of their Review of Specialist Paediatric Services, May 2004 http:// Specialist involved in initial diagnosis (Sawczenko et al, 2003)
  9. 9. Scottish Specialist PGHN Services RACH, Aberdeen Dundee - clinic and endoscopy Inverness - clinic 1.3 WTE PGHN Consultants 1.5 WTE Specialist Nurse 0.75 WTE Specialist Dietitian North 1.2m RHSC, Edinburgh No outreach services 1.5 WTE PGHN Consultants 2.0 WTE Specialist Nurse 0.8 WTE Specialist Dietitian East 1.4m RHSC Glasgow No outreach services 2.1 WTE PGHN Consultants 2.0 WTE Specialist Nurse 0.5 WTE Psychologist 1.0 WTE Specialist Dietitian West 2.5 m Service
  10. 10. Paediatric Gastroenterology, Hepatology and Nutrition Services in Scotland Proposed Service Model <ul><li>Develop: </li></ul><ul><ul><ul><li>National PGHN service for Scotland with the proper staffing and resourcing of each of the three regional services </li></ul></ul></ul><ul><ul><ul><li>Outreach to cover all of Scotland’s children with support for the clinical workload of DGHs and the promotion of the Consultant ‘with an interest’ role. Staff in Dietetics and Nursing are essential to this development. </li></ul></ul></ul><ul><ul><ul><li>24/7 telephone advice service for consultant with a national telephone on call service </li></ul></ul></ul>
  11. 11. Paediatric Gastroenterology, Hepatology and Nutrition Services in Scotland What progress have we made ? <ul><li>National Grid training programme </li></ul><ul><li>Teaching programme via video conferencing </li></ul><ul><li>Research network ( Wellcome Trust for £682,723) </li></ul><ul><li>Working on Treatment Guidelines and National on call </li></ul><ul><li>SPGHANG meet 3 or 4 times per year (1 residential) </li></ul><ul><li>Staffing: </li></ul>Locum Post in Edinburgh has been advertised Funding for new consultant in Glasgow agreed Hope to have three fully functional Regional Networks within a National Service in the next 2 to 3 years