Chamber and committees

I forgot to remind the panel that I was a clinical educator in a remote and rural area delivering what you are talking about—ECG, blood draw and things like that. It was part of my job. I forgot to remind colleagues and the panel about that. Thanks.

I was going to ask about the numbers of OTs who are employed by local authorities and by the NHS, but we can get that information later.

Thanks, convener. Good morning to you all. I have a brief supplementary for Neil Carnegie. You talked about pockets of good practice. I know that we have heard from the CEO of NHS Borders, Ralph Roberts, about prehab and also reablement. Is that part of good practice? Can you give us an example of what OTs can contribute on the ground that makes a difference?

I am interested in continuing professional development. I think that one of the witnesses has already alluded to the importance of it. The committee has taken evidence on the clinical skills managed educational network, and we have heard about the mobile skills unit that goes out to rural areas to provide simulation training and so on. I am interested in your thoughts on the requirements to value education. I say that as a former clinical educator, and I am still a registered nurse. My job was to work with allied health professionals and nurses in teaching clinical skills across NHS Dumfries and Galloway. What needs to be valued when it comes to continuing professional development?

Okay, thanks.

I will pick up on what Sharon Wiener-Ogilvie said about travelling a great distance to engage in education, whether it is paramedic training or other skills learning. I am aware of a reduction in relation to spirometry. That can be delivered by nurses, GPs and physios, but the quality and outcomes framework reduced the spirometry payments for general practices, so it is now not conducted there. That means that, in remote and rural settings, there will be a reduced ability to assess whether someone needs a chronic obstructive pulmonary disease or asthma diagnosis. That is just one issue that has come up. What is NES’s role in supporting education and continuing professional development?

You mentioned Turas digital training. I am familiar with that and know that it is valuable for some things, but face-to-face training is also valuable.

You made the point that integration means that work is patchy. You said that OTs are employed by local authorities. That probably needs to be investigated, so that the silo approach doesnae happen.

Does the new national centre for remote and rural health and care need to have an advocacy role to address some of the challenges that people might have with their healthcare, no matter whether we are talking about adult, child or maternity services? I am interested in how we advocate for patients when they feed in to the system to ensure that the system reacts.

Just to pick up on that suggestion of a whole-system approach, Professor Smith, I was reminded of some of the challenges that we have experienced in our local casework. For example, the bus from Stranraer to Dumfries doesnae have a toilet on it, and people have been feeding back to me that they avoid taking their diuretics on the way to hospital appointments, which they shouldnae be doing. At this point, I remind everybody that I am a registered general nurse in Dumfries and Galloway, which is quite remote and rural in many places.

When you talk about a whole-system approach, it makes me think of that example: we have asked for a toilet, but the bus company or the regional transport partnership are not even on the integration joint board or part of the health and social care partnership. Obviously, part of the system is not connecting if people are having to avoid taking medicine on the bus, just because the journey might be two hours and there is no loo available. That is an example of how part of the system is not working right now.

Good morning. It has been interesting to listen to the discussion and to hear colleagues’ questions. I am interested in looking at how the Government will develop policy in the future.

In preparing for this inquiry, I accessed loads of papers and research related to remote and rural healthcare, whether for adults, children or maternity services. I have in front of me a 2007 report from the remote and rural steering group. There have been discussions with Lewis Ritchie, there have been Derek Feeley papers and I remember Jason Leitch talking about the Nuka healthcare system in Alaska being used to develop rural healthcare in Scotland—that was in 2000. We have been talking about how we deliver healthcare in remote and rural areas for decades now. I know that the issue is complicated; indeed, that is why so many policy papers have been discussed.

What current issues must the Scottish Government address in order to deliver remote and rural care? The situation has been challenging after Covid, but we learned from the pandemic when we immediately switched to the Near Me platform. I am interested in hearing your thoughts about current Government policy and what we need to do as a matter of urgency.