Barabel Mckay is a former superintendent of physiotherapy in Mid Argyll and has her own physiotherapy practice. She is passionate about getting patients’ and health care users’ voices heard by the Argyll and Bute Health and Social Care Partnership as the public representative on the Locality Planning Group, and as chairperson of the Mid Argyll Health Care Forum. Below she talks about the importance of making those voices heard and how services appear to work in other parts of NHS Highland.
Health care is always on the move. Big questions are being asked about the future, and I have managed to listen in to different bodies discussing their views and findings.
There was one hosted by the health lead in the Guardian. All the experts agreed on the importance of public voice and participation, but no one directly represented that group.
As our views come from the lived experience, it seemed a shame. Our voice is said to be vital, but top down decision-making has been the norm for so long it is a struggle to implement change.
I have heard it said that the public do not understand the issues, but where is the strategy to give us the tools for informed decision making?
The Argyll and Bute Health and Social Care Partnership locality planning group (LPG) has put out a request for new members.
I agree it is not for the faint hearted, but there are people reading who are familiar with this sort of structure, and could very soon see past the shop window to evaluate the goods inside.
At the first meeting the head of social work wrote an excellent paper on co-production. In it he made it clear that it would demand a degree of attitude change from all that would be painful before productive.
Are we willing to put in the work now? We would benefit ourselves in the present, and make a difference to others in the future. We need to get rid of barriers because we are two sides with the same aims.
It does seem to work better in other places under NHS Highland. I have talked about the ‘can-do’ attitude in Sutherland, the amazing stroke unit in Golspie, and the seamless discharge protocols.
The National Institute for Clinical Excellence guidelines for post stroke care say that people left with a disability after stroke should be treated in a designated unit.
That does happen here, and Oban and Campbeltown do have follow-up facilities. But what about the next bit, “and subsequently from a specialist stroke team in the community”?
Sutherland can provide this continued service, with a designated physiotherapist, occupational therapist and nurse. What riches! Our community services, while excellent if you can get them, are severely time and staff limited.
As a physiotherapy manager I dealt with these problems in the past, and there are ways of disseminating knowledge and encouraging motivation by sharing skills with community groups.
You can’t overestimate the difference skilled care can make in understanding of the issues.
The friends who brought me back a holiday present from Skye know me well. It was a post-pandemic copy of the Health and Wellness North Skye and Raasay newsletter.
I can only give a glimpse of the goodies on offer in yet another part of NHS Highland.
We could start with the “Near Me” appointments, either in your own home or a designated community venue. All GPs can offer them, the leaflet said, and they could include a family member, friend or relative, even one in another country. They can save travel time and money to a consultant unit and an interpreter can be provided.
For many of us, even English speaking, the idea of someone helping both sides to understand would seem wonderful!
At our last LPG meeting I asked about this facility. Although we had in the past heard about a very successful maternity services trial, it does not seem to have been progressed here, where these issues are a continuing problem.
There was also a mental health charity offering help by self referral, appointments in person or by telephone. Even a charity set up to help people who wished to start community groups or specific charities.
That facility here would have saved our diabetic support group from closing down. We ran into the problems with which they offer support. They anticipate and advise on areas we had never considered in our startup.
Most of all, the newsletter demonstrated collaboration and co-production throughout between professional and voluntary groups.
At our last forum meeting there was discussion about community resilience in a time of climate change. We were told that the council were in charge, but in North Skye and Raasay they have progressed to having key community resilience representatives.
At that meeting we had a small but very enthusiastic attendance. We reported on the LPG meeting, which had largely focused on the aspects which make a place to live that supports your health and wellbeing.
This work has been years in the making, and is part of the essential future planning, the responsibility of the Health and Social Care Partnership.
It is perhaps unfortunate that Covid has given many of us the sharp realisation that life is finite and we need to make the most of the present. It adds a certain urgency for change for the better NOW.
There is talk of a move to prevention and self help. We asked for representation at our next meeting to talk about “Realistic Medicine”.
This has been a favoured concept for some time, and you may have noticed NHS appointments now ask you to question: why this treatment, what effects might it have, are there alternatives, what will happen if I don’t have it?
About 50 years ago an American visitor asked our GP just these questions, and we were so conditioned to the “doctor knows best” attitude we were horrified.
I wonder what time our health providers have been allocated for this. End of life care involves preferences, full disclosure and family involvement, but at earlier stages, when things aren’t so critical, and outcomes might be changed for the better, the pressure on services is acute.
Public pressure makes a difference to provision. Becoming involved is not a criticism of hard working staff, it can be a support.
We are free to speak, they may find it difficult. When we are well, or our problems have ready solutions, life is good.
But it is becoming apparent that people, and the communities that support them, are going to have to do more.
Will you come and join the discussion in the morning of Saturday April 20 in the Snowdrop Centre in Lochgilphead’s Campbell Street?
Barabel Mckay (sign up by emailing barabelmck@gmail.com)
Yes! I would like to be sent emails from West Coast Today
I understand that my personal information will not be shared with any third parties, and will only be used to provide me with useful targeted articles as indicated.
I'm also aware that I can un-subscribe at any point either from each email notification or on My Account screen.