Health Professionals In Scilly Praised For Groundbreaking Work
The NHS board met in Scilly at the Old Wesleyan Chapel yesterday.
Dr Garman explained that health and social care staff and providers here meet regularly to discuss what they can do better.
They’ve invited patients to explain what they expect of health services and John says this one-to-one feedback has altered how they care for frail and elderly patients at night.
The regular healthcare worker meetings have helped break down organisational barriers and it means that all professionals share responsibility for patients and nobody says, “that’s not my job.”
This joined-up approach puts patient needs first, addressing underlying problems, and it’s reduced average hospital acute care stays from 25 to 6 days.
John told the board that a GP’s role in Scilly is “a tale of two seasons.”
Many visitors undertake exercise that they wouldn’t consider at home and that means ankle and wrist fractures are common in summer.
In the winter, there are challenges which can affect some islanders’ health, “the Co-op sometimes has no fresh food” and travel is “very difficult,” John said.
Dr Garman shared two stories to illustrate this. The first concerned a patient who postponed an urgent cancer specialist appointment until summer because they didn’t want to risk being stranded on the mainland due to the short flying hours and weather disruption.
That’s not an isolated incident.
A chemotherapy patient spent the winter weekdays lodging in a Cornish caravan park because of similar travel concerns.
John says that was “soul destroying and difficult” and he believes more services should be delivered on the islands for patient comfort and because medical flyouts are costly for the NHS.
More web camera use could reduce trips upcountry for some diagnoses. The practice is being used in dermatology and a “virtual” fracture clinic will start soon, but John says take up is down to “enthusiastic individuals” within the NHS on the mainland.
It’s “a big shift,” he said.
Scilly’s doctors have been inspired by the work of remote doctors in the Australian outback, but John says red tape has led to slow progress in some area.
It’s taken a lot of work to gain approval for GPs to take their own patient X-rays.
They’ve managed to get past governance issues and Scilly’s doctors are now taking university courses so they can use the equipment.
John says that will be a “game changer” because patients currently have a different experience if they have an injury, for instance, outside the Monday to Wednesday period.
There’s been a similar challenge over the use of ultrasound. The Health Centre has the equipment but mainland clinicians currently come over to use it each month, with the League of Friends funding their travel.
John says the GPs will soon ‘upskill’ so they can use it.
Chairman of Kernow CCG Dr Iain Chorlton asked John whether he had documented his success.
John confirmed that he maintained detailed records and the chairman suggested that the experiences and notes of the St Mary’s Health Centre team should be shared and “rolled out” across the region.