Health chief warns of age timebomb facing the Hebrides

Exclusive: Mike Merritt

30 May 2010

The Western Isles’ director of public health is warning the Outer Hebrides faces a population timebomb, with the young leaving in droves and the area becoming an enclave for the elderly.

In her annual report, Dr Sheila Scott says that of all 40 community health partnerships in Scotland, the isles have the lowest percentage of men and women of working age.

And it has the second highest percentage of those aged 65 and over.

Over the last decade, the isles have lost nearly a sixth of their young and those up to early middle age – and even greater falls are predicted.

Latest projections from the General Registrar’s Office Scotland predict there will be an overall 5% decrease in the population between now and 2031.

This will include: a decrease of 23% in the population aged 0-16 years; a decrease of 18% in the working age population plus an increase of 47% in the population aged 65 and over.

Dr Scott said the isles’ population had fallen to just 26,200. In the last decade there has been a decline in the number of people aged 0-14 and 25-44 years – drops of 16% and 15% respectively – while the number of those aged 45-plus has risen by 8%.

Looming job cuts in the dominant public sector on the islands would exacerbate the population problems.

There are fears 450 jobs could be lost due to council cut-backs, and NHS Western Isles has to make over £13m of savings in the next five years. A further stress is the lack of cheap housing, with the isles having one of the highest totals of holiday homes.

An Outer Hebrides Migration Study predicted a decline in the number of women of child-bearing age from 4,500 in 2004 to 3,500 by 2019, a fall in the numbers of primary school-aged children from 2,100 to 1,800, a secondary-school population drop from 2,100 to 1,900 and an increase in the average age of the population from 42.4 to 45.3.

Follow the link to read the full article about age timebomb facing the Hebrides

Plans to replace consultants with nurses in NHS Scotland

  • Medical staff
    Nurse in A&E

Exclusive: Kate Foster

30 May 2010

Patients will be assessed by nurses instead of consultants and spend less time in hospital under controversial cutbacks to meet waiting time targets in Scotland.

Many follow-up appointments will be scrapped altogether and patients could be discharged from hospital at weekends under the scheme.

The groundbreaking plans to “streamline” the NHS have been revealed as hospital managers prepare to meet an ambitious target that no patient should wait longer than 18 weeks from a GP referral to the date of their operation.

The move will allow thousands to be treated faster but last night doctors and politicians raised fears it could compromise patient care.

The sweeping changes have emerged in official advice to NHS managers from the Scottish Government’s 18-week Referral to Treatment Time Programme, staffed by doctors and health officials.

Key changes proposed by the experts, revealed in a briefing to health boards, include using specialist nurses and health professionals such as physiotherapists to “reduce consultant appointments” by assessing whether the patient needs a specialist or just requires advice.

Nurses will also be trained to carry out some follow-up appointments and many outpatients will be seen at weekends.

The advice also states day surgery should be “the norm” rather than traditional overnight stays and patients discharged “as soon as they are ready”, including weekends which previously hospitals have avoided due to scarce community services. Health boards are also told to eliminate unnecessary follow-up appointments by scrapping them or replacing them with phone calls.

The move applies across all specialties for non-urgent patients as part of a £230 million three-year scheme to improve NHS infrastructure.

Managers must consider making the changes to free up consultant appointments and hospital beds.

Follow the link to read more about plans to replace consultants with nurses in  NHS Scotland

Marty Cooper, the "Father of the Mobile Phone"

Marty Cooper, the “Father of the Mobile Phone”, did a fantastic job on his 60 Minute Interview tonight (Sunday, May 23, 2010).

During that interview, Marty pointed out that one of the obvious future direction of Mobile Phone technology was in Healthcare.

[mc src=”” type=”youtube”]Marty Cooper, the “Father of the Mobile Phone”[/mc]

If you want to see the full interview Follow this link

Neil's Urbanathlon for Chest Heart & Stroke Scotland

Neil’s Urbanathlon for Chest Heart & Stroke Scotland


I am raising money for Chest Heart & Stroke Scotland by doing the Edinburgh Ubanathon on the 30th of May – an urban 10k  race with a twist!

As the Urbanathon is “only a 10k” I thought I would add some Bonus runs to give you value for your sponsorship

Bonus RUNS…

1. On 24th of April I ran the Highland Fling 53 miles on the West Highland Way from Milngavie to Tyndrum. I completed the Fling in about 13.5 hours. Very tough and took a lot to finish.

For some Photos of the Highland Fling on Flickr Click Here

2. Ben Lomond Hill Race. 12.6 km and 980m climb. I ran a PB in this tough Hill Race Details and photos here

3. Goatfell Hill Race 15th May. 9.63 miles with 856m climb. I PB’d again this week details and photos here

4. Cape Wrath marathon 22nd May

I have had the privilege to work with Chest Heart and Stroke over a few years now and they are a fantastic charity that makes a real difference in peoples lives.

If you have found this site useful please Make a donation to Chest Heart and Stroke Scotland.



Neil Campbell
Scottish Healthcare
Improving Patient Care through Technology

UK better placed than the US to manage chronic disease: lessons from the US

A major new report published today by Healthcare at Home Ltd explores which technologies and models used in the US for chronic disease management could successfully be adopted here in the UK.

The report – Lessons from the US: using technology and homecare to improve chronic disease management – is based on the observations of a US study tour of NHS and Healthcare at Home representatives who visited colleagues in Kaiser Permanente and HealthTech to look at how they use remote technology to manage chronic disease. Whilst they found there to be some exciting hi- and lo-tech innovations and lessons to glean, the group found that the US was not as far ahead in this field as expected.

Ruth Poole, Group Clinical Director, Healthcare at Home Ltd, says: “We were pleasantly surprised to find that the UK is in many ways better resourced and structured than the US to overcome the challenges related to increasing demand for services and chronic disease management. Specialist out-of-hospital care providers like Healthcare at Home Ltd are well established in the UK, and the NHS is already embracing innovation and major transformation in service design in certain areas, but we need to see this progress on a much wider scale if the NHS is to achieve the significant benefits that can be gained.

”The report found that in the “[US] healthcare follows the money, not the population’s health needs. The UK has an opportunity to look beyond this and concentrate on longer term benefits”.

One of the key recommendations is that the move to deliver more care closer to the home has to be underpinned by new models, technologies and systems: “If we simply transplant the same model of care used in hospitals to another setting we will not achieve the changes needed”.

Other reflections and recommendations from the report include:

  • The UK must concentrate on longer-term benefits and consider the population’s health needs as much as the return on investment
  • The NHS set-up allows it to look beyond immediate costs and benefits to start developing more innovative solutions that will lessen the cost of future services.
  • Technologies delivered through everyday devices such as TVs and mobile phones will encourage greater compliance
  • SHAs have access to innovation funds and should therefore take the lead in system development
  • Transplanting the same model of care to another setting closer to home will not achieve the necessary changes
  • Enabling an efficient flow of information between different health organisations is essential to effective disease management
  • Capital investment should not just be about buildings
  • Commissioners need to look beyond their usual providers and pathways and embrace more imaginative commissioning
  • GPs and other primary care staff will play a key role in providing care closer to home
  • The NHS must place more emphasis on managerial analytical competency

The overall purpose of the study tour was:

  • to explore how diagnostics and care are delivered in the home
  • to see how clinical interventions are managed using technology and support workers for increased value, and
  • to glean any lessons for the UK from how the US is addressing these issues.

Activity-based Payments and Pay-for-performance Initiatives Step up the Need for Effective Business Analytics Solutions in the European Healthcare Sector

LONDON – 12 May, 2010 – Business analytics solutions are considered the face of business intelligence (BI) for healthcare providers, as they assist healthcare managers and hospital management to compile, arrange and manage clinical, financial and administrative data in a defined protocol, thereby facilitating informed business decisions. The European healthcare sector has mostly adopted activity-based payments. The current trend is that of diagnosis-related groups (DRGs), which help hospitals minimise patient visits to their premises, increasing the need for efficient analytics solutions. Pay-for-performance initiatives have further fuelled the demand for business analytics systems in the European healthcare sector.

New analysis from Frost & Sullivan (, European Markets for Business Analytics in Healthcare, finds that the markets earned revenues of $205.4 million in 2009 and estimates this to reach $462.1 million in 2016. The segments of the business analytics solution markets covered are the financial and administrative module analytics solutions.

“Business analytics solutions provide a substantial return-on-investment (ROI) for healthcare organisations, thereby driving the adoption rates of these systems in Europe,” says Frost & Sullivan Industry Analyst S. Priyan. “These solutions allow the user to control operating costs and streamline revenues.”

Effective healthcare business analytics solutions, along with BI solutions, provide ROIs ranging from 100-300 per cent. This is extremely significant to the already cost-sensitive healthcare sector. Furthermore, it enhances the overall workflow efficiency of healthcare management.

However, stringent hospital budgets towards information technology (IT) deployment challenge the growth of the European markets for business analytics in healthcare. Hospitals’ IT budgets spent on infrastructure and devices reduce the investments in IT systems.

“On an average, the IT budget of a hospital is about 1.5 per cent of its total annual expenditure which is extremely low when compared to the budgets allocated towards devices and other hospital infrastructure,” explains Priyan. “IT continues to be considered as expenditure rather than an investment.”

Hospitals should increase their investments in IT and procure more cost-effective systems that provide greater value for money.

“The IT expenditure of the hospitals should be stepped-up to at least to 3.0 to 3.5 per cent of their total annual expenditure,” concludes Priyan. “Additionally, the vendors should enhance the value proposition provided by the systems so that the hospitals get value for the expenses incurred.”

NHS Grampian board's "Texting or Talking?" scheme aims to cut binge-drinking

Text message plan to curb binge drinking among young adults

Published Date: 13 May 2010
By Frank Urquhart

SCOTTISH health professionals are turning to text messaging in a radical bid to curb binge drinking among young adults.

NHS Grampian researchers have been chosen to carry out a year-long project in which people in their twenties seen as “hazardous” drinkers will be sent text messages, it was revealed yesterday.

Before they set out for pubs and clubs in Aberdeen at weekends, the texts will urge them to drink in moderation.

The tactic has proven effective in previous initiatives designed to help people quit smoking and to exercise more.

Dr Steve Baguley, sexual health specialist at the city’s Woolmanhill Hospital, who is heading the Scottish Government study, said the aim was to recruit more than 1,000 volunteers, mainly in their twenties, to take part in the pilot scheme and compare three different methods of intervention aimed at curbing excessive drinking.

One group will given be advice leaflets. The second group will be dealt with through a “brief intervention” – a short structured interview with a health professional which is the most common initiative currently used to encourage moderate drinking. The third group will receive text messages.

Those taking part in the so-called Texting or Talking study will be selected for the three groups at random.

Dr Baguley said: “Binge drinking is very common among people who come to sexual health clinics and we found in one study that 50 per cent were hazardous drinkers.

“Hazardous drinking – or binge drinking – is associated with poor sexual health: catching sexually transmitted infections, getting pregnant when you don’t want to and being sexually assaulted.”

He said the aim was to send the texting group a series of messages to their mobiles every Friday night before they leave home for a night out.

The messages will urge: “If you’re drinking this weekend, take it easy.” There will then be an additional text, containing various messages, including: “Make sure it’s you making the decisions. Eat before and while you drink. Use soft drink spacers.”

They will also be warned: “You’re more likely to be sexually assaulted if you’re drunk. Alcohol provokes the desire but takes away the performance.”

Dr Baguley added: “We are not trying to say don’t drink. We would just turn people off if we tried to insist on that. It is really to try to help people gain control of the situation when they are going out drinking.

“Texting has never been tried for alcohol before. Texting has been tried internationally and found to be effective for smoking cessation, weight loss and for promoting exercise and in the control of diabetes.

Click the link for more on text messaging scheme

NHS Fife & Tayside battle to reduce missed health appointments

NHS TAYSIDE and NHS Fife have brought in a number of initiatives to drive down missed hospital appointments, which are costing the region’s health services over £2 million a year.

Other schemes are also being explored in a bid to reduce the drain on NHS resources.

Over 20,000 new patients last year failed to turn up for their first hospital appointments in Tayside and Fife.

The figure included 1422 appointments for general surgery.

A spokesperson for NHS Tayside said, “We are currently exploring a range of initiatives which could help reduce the number of patients not turning up for their outpatient appointments.

“One of these is a system called ‘patient-focused booking’ where we write to patients six weeks before they are due to attend an outpatient clinic and invite them to call us to arrange an appointment time and date which suits them.

“We are also currently piloting an automated telephone reminder service in our renal department.”

This pilot will be closely monitored over the next three-six months to assess whether a patient reminder does have a positive effect on missed appointments.

Another project about to start works directly with patients themselves to look at what kind of appointment systems suit them best to help understand why people do not turn up for scheduled appointments.

“We believe all these initiatives can make a difference but we would still urge people to contact us as soon as possible if, for any reason, they are unable to attend the outpatient clinic,” the spokesperson added.

“This allows us to give someone else the original appointment and rearrange a more suitable date and time for the patient.”

Public spending watchdog Audit Scotland puts the cost of an average outpatient appointment at £112.

Figures show 9.5% (12,223) of 128,671 new outpatients missed appointments in Tayside in 2008, costing £1,368,976.

Last year there were 131,491 and 9.2% were skipped (12,097), costing £1,354,864.

There was also a rise in missed appointments on the other side of the Tay.

The figures show 8.6% (7228) of a total of 84,051 new patients missed outpatient appointments in Fife in 2008, costing £809,536 on average.

That went up to 8.8% (7906) of 89,850 in 2009, costing £885,472.

A spokeswoman for NHS Fife said, “The cost of missed appointments varies from specialty to specialty. NHS Fife has implemented a number of schemes to reduce the number of missed appointments.

A ‘patient-focused’ booking system has also been in place for a number of years in Fife and initially reduced missed appointments.

“To reduce the number of missed appointments further, NHS Fife has piloted a text reminder system in a few specialities over the last year and is examining how this can be extended,” she added.

In addition, as waiting times have reduced over the last few years, referral management and outpatient booking systems are being reviewed to ensure they are able to respond to the shorter waiting times.

Last year across Scotland 10.3% (150,502) of 1,461,190 appointments were missed, costing £16,103,714.

The figure has gone down from 10.4% (144,240) of 1,386,929 appointments skipped in 2008, costing £15,433,680.

Click the link to read more about missed healthcare appointments

BMA Scotland warns against victimising whistle-blowers

The BMA in Scotland today [Thursday 13 May 2010] called on the Government to ensure that doctors who raise concerns about patient safety are not victimised by their NHS employers.

The calls came as the BMA published findings of a survey of members Standing up for Doctors; Speaking out for Patients. The survey found that the majority of hospital doctors have, at one time, had important concerns about patient care or staff behaviour. However almost half of these doctors didn’t report their concerns, many because they don’t believe it will make a difference or feared the consequences of doing so.

One in ten doctors who did raise concerns was given some indication that speaking out could have a negative impact on their employment.

Commenting on the survey results, Dr Charles Saunders, Chairman of the BMA’s Scottish Consultants Committee, said:

    • “As clinical leaders, doctors have a duty to speak out when they have concerns. However, as the results of this survey bear out, this is not always possible or effective.

      “We have concerns around the culture of many NHS organisations. Doctors tell us they fear their careers can be affected by speaking out. This is completely wrong. We must move to a culture where every individual in a health organisation can raise concerns that are looked at and acted upon appropriately.

      “The Scottish Government is promoting the concept of a mutual NHS where the patient is at the heart of decision making. But NHS organisations also need to value the staff who are there to deliver and improve patient care. Such a culture change needs to come from the very top. Ministers and NHS Board members need to send a clear message that they want to hear about things they can do better.”

Dr Sue Robertson, Chairman of the BMA’s Scottish Staff and Associate Specialists Committee, said:

    • “Most doctors know and understand that they have a contractual right and an ethical duty to speak out. But many NHS employers make speaking out difficult or dangerous for an individual doctor. Ultimately this will result in staff failing to raise concerns. That is why we are calling for a concerted effort by the NHS to improve on the awareness and implementation of whistle-blowing policies.”

Dr Gordon Lehany, Chairman of the BMA’s Scottish Junior Doctors Committee, said:

    • “Doctors at the very beginning of their career should have confidence in a system that supports them to raise concerns about patient care or staff behaviour. It takes a huge amount of courage and if doctors believe that their career progression could suffer as a consequence, they are less likely to want to speak out.”

The BMA is therefore calling on the Scottish Government and NHS employers to:

  • Raise awareness of whistle-blowing policies
  • Protect the right of doctors to speak out without risk to their employment
  • Provide feedback to staff who have raised concerns about what has happened as a result
  • Involve the medical profession in reviews of national and local guidelines
  • Conduct a retrospective review of responses to cases where doctors have spoken out
  • Encourage and develop a culture of openness within NHS Scotland.

An invention by a Scots doctor has been named one of the top 10 health innovations of last year.

The RhinoPinch nose clip helps stop nosebleeds by placing pressure on the bridge of the nose.

It was the brainchild of Ayr’s Dr Akuafo Agbenyega who works at Crosshouse Hospital. The invention has made it onto the NHS Supply Chain’s Top 10 innovations list – a location for all suppliers who want to register new products for potential use.

Dr Agbenyega said: “For the device to be in the top 10 is the icing on the cake. My wish is for the RhinoPinch to be available in homes in first aid kits and for it to be readily available for the elderly who sometimes have to go through a lot to get to hospital for a simple nose bleed.”

Helen Corner from Scottish Health Innovations Ltd, set up by NHS Scotland to help develop and bring new products or technologies to market, said: “It was great news to hear the RhinoPinch was named a top 10 innovation.”

Link to article