THERE still needs to be business cases drawn up and approved by government before “you can put a spade in the ground” for a new hospital in Shetland, says NHS Shetland chairman Gary Robinson.
He told a meeting of the health board’s annual review on Monday evening that there is no definitive timetable on the project.
However, a report is due to be presented to the NHS Shetland board in the near future with the outcome of an investment appraisal.
Once that is approved, it will be passed to the Scottish Government in what Robinson called a “decision point”.
He said he believed this was the third step in the process, adding there was a “further two to go before you can put a spade in the ground”.
Director of nursing and acute services Kathleen Carolan added that a “precursor” business case will go in front of the NHS Shetland board at the tail end of 2024/25.
Meanwhile the meeting also heard:
- there are a number of reasons behind NHS Shetland’s high staff turnover, including fixed-term contracts ending, an ageing workforce and staff deciding to move away from the isles
- pressures at NHS Grampian is continuing to affect services for Shetland patients needing treatment down south
- some performance targets are not being met locally
- work is get underway on improving the askmyGP service
The meeting was held virtually on Monday evening to allow people to hear about work of NHS Shetland in 2022/23.
Some of the targets which have been missed during 2022/23 include A+E discharges, psychological therapy waiting times and the wait between the date the hospital receives an urgent suspected cancer referral and the start of treatment.
However, many of the figures are above the Scottish average, and the small numbers seen locally mean there can be big changes in a short time.
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NHS Shetland said as a result that “all data should be considered in a wider context”.
Robinson also told the meeting that pressures at NHS Grampian mean there can be issues with treatment in Aberdeen, sometimes resulting in longer waits or the health board needing to arrange “other costly visiting options to meet patient needs”.
The health board does use some other hospitals, such as the Golden Jubilee in Clydebank.
However, Carolan said some patients who would have gone to the Golden Jubilee will go to the new National Treatment Centre in Inverness from 2024 instead.
When it comes to high staff turnover in NHS Shetland, health officials were keen to stress a range of reasons behind this.
HR director Lorraine Hall said one aspect was Covid funding coming to an end which enabled NHS Shetland to take on more staff.
She also said the health board receives “a lot of non-recurring funding from the Scottish Government.
“We have a disproportionate number of staff who come on a fixed term basis,” Hall said.
She highlighted that more than 40 per cent of the NHS Shetland workforce are aged over 50, meaning staff will retire, and that some people will take up a job but leave due to other commitments back home on the mainland.
There was also a desire shown for NHS Shetland to “grow its own” staff.
One aspect of the work to develop a new hospital, or health and social care campus, is looking at residential accommodation for key workers.
NHS Shetland chief executive Brian Chittick also said the health board was “well engaged” with the council and Hjaltland Housing Association around the difficulties of staff getting accommodation when moving north.
Dentistry services also got a mention during the meeting.
A new oral health strategy was approved recently which aims to enhance the NHS-delivered service in Shetland over the coming years.
But dentistry director Antony Visocchi said the funding aspect is central to how things progress.
“I’m fairly sure we’re going to have an increase in the amount of dentists within our service within 2024, probably to get us back to pre Covid levels,” he added.
“That will give us a good foundation to build.”
Director of community health and social care Jo Robinson said from the public’s point of view the key thing is how do they get to see a dentist.
She added that there was “probably quite a lot of fear” in the community about dental health and what happens if you do not get to see a dentist, amid the reduced service since the Covid pandemic.
Jo Robinson also stressed the importance of people checking their mouths themselves, but she acknowledged more can be done about informing the public on the signs to look out for.
When it comes to the online consultation askmyGP service, which was introduced during the Covid pandemic, the meeting heard that it is in place in Shetland’s larger practices as the advice was it works better with large numbers of people.
But Jo Robinson said there may be ways of getting it to work in smaller practices.
Director of pharmacy Anthony McDavitt said there is also engagement with the company behind askmyGP to improve the service in Shetland.
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