'Horizon' Consultation Report
Over the past winter and spring an investigation was conducted of the services and opportunities that older people in the Aberfeldy area feel would make their lives easier, more stimulating and enhance their physical and mental health.
This was commissioned by the Horizon committee, which manages the highly successful lunch club based in (but separate from) Dalweem. This has been so successful that it became obvious that there is a demand for increased services in the area.
The committee was also aware that Health and Social Work were reviewing their joint strategic approach to the needs older people in Perth and Kinross. |
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Linked to that review process, Tayside Health Board announced in January 2007 that; ‘emergency beds in Tayside would be reduced by 10% this year with further reductions in later years’.
This announcement added a new dimension and urgency to the requirements and implications for community based services if older people are to be adequately supported in their own homes (thus preventing the need for a hospital admission) or on their discharge.
The committee was extremely fortunate that its application to the Big Lottery’s ‘Investing in Ideas’ fund was successful , for it allowed Horizon to appoint an independent consultant to undertake extensive consultations with older people. The purpose was to stimulate and encourage all service providers to think as creatively as possible in order to look for new solutions to old problems.
In the course of the consultation, 200 older people were consulted at visits to various groups. The geographical area studied centred on Aberfeldy but covered Aberfeldy, Kinloch Rannoch, Fortingall, Fearnan, Kenmore, Strathtay, Grandtully and Amulree.
Consensus
There was a remarkable level of consensus among the responses. Eight main issues can be identified as being of most concern. These are:
• Local Solutions to Local problems.
Economies of scale do not work in rural areas. This only leads to an attrition of services with these becoming ever more centralised leading to greater transport problems. Creative and innovative local solutions are required.
• Integration of services.
All public, statutory and voluntary services must work together to provide an integrated continuum of care with good communication between all parts of the system
• Hospital and consultants Services.
The services provided at the cottage hospital were all seen as vital and greatly appreciated within the community. The step down care in particular will become ever more vital with the reduction in emergency beds meaning earlier discharge. More consultants could hold surgeries in the cottage hospital and Dalweem. Ninewells and PRI appointment times need to be allocated with an understanding of the long travel times from Highland Perthshire.
• Long term beds/nursing home.
These are a vital part of any local provision and an important missing part of the local care provision. The loss of the provision at Cruachan is felt deeply. Long terms beds could be available at the cottage hospital or Dalweem. Keeping older people in their communities where friends and family can visit is essential for their well-being.
• Respite care.
This is required both as ‘residential’ and a ‘day care’ facility. It is very important that older people are able to remain within their own community support network. It is essential for the health and well-being of both the service user and the carer.
• Day care/social activities. There is a lot of scope for extending the provision in creative, physical, mental and intergenerational activities.
• Emergency services.
People feel disenfranchised by the reduction in ambulance cover and the reduced level of police presence. NHS 24 received mixed responses but it as generally felt that it was much better deal with people you know.
• Transport.
This is an issue that affects all areas of services for older people in Highland Perthshire. People used to be able to live in rural areas without a car but this is no longer possible due to loss of mobile shops, loss of social structure due to second homes. It is important to make the most efficient use of those transport services that are available through the private, public and voluntary sectors.
Intention
The consultation exercise was aimed at supporting and extending current provision. At no time was there any proposed threat to existing services at the cottage hospital or any other part of the care system.
The Horizon committee thanks everybody who took the time to take part in the consultation exercise and to assure participants that their views will inform the extension of services for older people in the Aberfeldy area.
The full report is available through the Horizon group at Dalweem.
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