Chamber and committees

NHS Orkney and Shetland submission of 5 October 2021

PE1845/T: Agency to advocate for the healthcare needs of rural Scotland

Thank you for your letter in relation to an Agency to advocate for the healthcare needs of rural Scotland. I am responding on behalf of NHS Orkney and NHS Shetland in my role as Chief Executive Officer of both Boards.

The steps that NHS boards currently take to address the needs of remote and rural communities. The NHS in both Shetland and Orkney holds its responsibilities for delivering the highest quality of health and care to our community. Presently both Boards are working through refreshed Clinical Strategies which underpin how we intend to deliver NHS services for the coming 5-10 years. Public engagement and involvement in shaping these critical documents has been front and centre to their development. Due to Covid this has had to occur online rather than the traditional in person models, but we feel this has been effective especially for those on ferry linked isles where travel can be a barrier to engagement.

The Community Planning Partnership has proven to be an effective method for communications. This is a joint forum with all key partners across the community who are engaging collaboratively, rather than independently approaching the community separately, as this recognises the inherent links between health, society and welfare. An example of this is the Shetland Partnership Plan and the Shetland’s Islands with Small Populations – Locality Plan, links for each are enclosed below.

Shetland's Partnership Plan 2018 2028

Shetland’s Partnership Plan 2018-2028 Working together to improve the lives of everyone in Shetland Local Outcomes Improvement Plan for Shetland 2018 to 2028

www.shetland.gov.uk

Populations Locality Plan - Shetland Islands Council

www.shetlandpartnership.org Page | 6 Participation People Place Money The Future “The people living within Shetland’s Islands with Small Populations can thrive and are actively influencing decisions on services and the use of resources.” The Shetland Partnership is committed to supporting islands with small populations to develop their www.shetland.gov.uk .

When considering the need to adapt and change care in response to alterations in legislation or sustainability of services, we routinely engage through community councils, user groups and other parties. Most recently in Orkney we have worked closely with a ferry linked island to develop a service profile and recruitment pack that reflected the opportunity for any staff member working there.

Without doubt, Covid has created challenges and our patient engagement groups have been unable to meet, however, we have used alternative methods to keep in touch with our communities so we can hear the needs of the remote and rural community directly. Examples of this include online feedback following the Covid mass vaccination programme that we have built upon to adjust the model for the booster and flu programme. Additionally, the Board established a monthly CEO led Facebook live session that enables the public to directly engage with the Health Board as well as find out more about services they may not be aware of.

Recently in partnership with LGBT Youth Scotland, we shared the excellent work taking place in the Shetland and Western Isles to support younger members of the LGBT+ community, with the aim of helping build a network of good practice that reflects the unique experience of being a member of the LGBT+ community in a remote a rural setting.

As island Health Boards, we also see our role in ensuring the needs of the remote and rural community is maintained in our discussions with the Scottish Government. An example of this was the acknowledgment of the fragility of the island Health Boards during the Covid vaccination programme and the support we received to accelerate this to those aged 18 ahead of the mainland.

Finally, we routinely work together as remote and rural health and care organisations where it makes sense for us to do so. Examples of these include mental health and cancer treatments such as Chemotherapy, by collaborating we are able to strengthen the voice of the remote and rural communities and ensure the access and treatment they receive is as equitable as our geography will allow us.

What further steps could be taken to respond to the concerns raised in the petition. Many of the functions identified in the petition are already in existence, but we as Health Boards may not highlight the work we are doing in these areas. Whilst I have tried to give a flavour of the breadth of our work above there are many more examples that could be shared and whilst Covid has presented real challenges the commitment to our community remains absolute.

It should be acknowledged that the IJB in each area has a clear commissioner remit, and it may be possible to enhance this function through the new proposed Community Health and Social Care Boards.

I hope this feedback proves useful, please do not hesitate to come back to me should you need any further information.