DELIVERING

1
DELIVERING
Remote RURAL HEALTHCARE
Introduction
The implementation of the remote and rural
recommendations are being taken forwardin NHS
Orkney by the Service Redesign Programme and the
shadow Community Health and Social Care
Partnership Orkney Health and Care. The main
workstreams include Primary Care Redesign,
developing networks of care shifting the
balance of care , redesign of the acute
services at the Balfour Hospital and
implementation of the Long Term Conditions agenda
.

• PRIMARY CARE REDESIGN
• This has included improving and implementing the
  Extended Primary Care Model by supporting
  flexible workforce developments such as the
  introduction of the Primary Care Advanced Nurse
  Practitioner. Other developments include
• Introducing the emergency first response
  scheme to improve community resilience
• Introducing a shared vehicle between NHS
  Orkney and the Scottish Ambulance Service
• Redesigning the configuration of the Northern
  Isles GP and Primary Care services

• Developing Networks Of Care
• The following networks are being developed
• Mental Health and Learning Disabilities
  Obligate Network with NHS Grampian
• Formal networks for anaesthetic service
  currently being planned
• Network to support senior nursing staff in the
  acute ward formalised
• Palliative care network

• Redesign of acute services at the Balfour
  hospitalThe patient pathways and infrastructure
  of the Balfour hospital are being re-designed to
  ensure level 2 care.
• This includes
• Development of an Acute Care Centre to include
  emergency receiving, minor injuries and GP OOH in
  one co-located area
• Improvements in emergency resuscitation and
  stabilisation service

• Long term conditions agendaA multidisciplinary
  Long Term Conditions Operational Planning Group
  set up in Orkney, tasked with
• Developing anticipatory care plans for
  patients with complex long term conditions (using
  SPARRA data to identify most at risk groups)
• Implementing self care pilots for patients
  with heart failure and COPD
• Co-ordinating multi-agency approach to chronic
  disease management in the communities via a
  single Long Term Conditions MCN.
• A new Intermediate Care Service set up to
  deliver rehabilitation and enablement care in the
  community
• Elderly Hospital Day Services moved out to
  community settings i.e community halls and day
  centres

• E-healthNHS Orkney is a National Demonstrator
  Site for Telemedicine to support Long Term
  Conditions
• Telemedicine supports
• Paediatric Intensivists for clinical decision
  support
• Links with Acute Medicine Services in Aberdeen
  Royal Infirmary
• Specialist telemedicine clinics for neurology,
  cancer, diabetes and planned for cardiology
  follow-up

NHS Orkney Sept 2009