NHS Grampian
Formal consultation paper
OLDER PEOPLE’S SERVICES, DIAGNOSTIC & TREATMENT SERVICES AND
MATERNITY SERVICES IN ABERDEENSHIRE
1. Background
Aberdeenshire Community Health Partnership (CHP) is responsible for the
organisation and delivery of healthcare for the population of Aberdeenshire.
Aberdeenshire CHP is part of NHS Grampian. In Grampian there are three CHPs
(Aberdeenshire, Moray and Aberdeen City) and an Acute Sector. Together these
comprise the four operational units of NHS Grampian.
Aberdeenshire CHP has been considering whether there are better ways to deliver
some services to the population it serves. In particular it has concentrated on three
areas – older people’s services, diagnostic and treatment services and maternity
services.
In 2005 Aberdeenshire CHP developed options for changes to these services. An
extensive consultation exercise took place about the options and a great deal of
feedback was received from the public and community groups etc. The CHP has
now developed recommendations that will go to Grampian NHS Board for decision in
August.
Before this happens NHS Grampian would like to give interested parties in
Aberdeenshire a further opportunity to have their say on these recommendations and
therefore a further formal consultation process is being undertaken.
This paper explains the recommendations that the CHP is making to Grampian
NHS Board and explains how you can have your say.
2. Introduction
NHS Grampian would like to hear the views of interested parties in Aberdeenshire on
a range of health projects designed to create a modern local health service to meet
the changing needs of Aberdeenshire’s population.
Aberdeenshire CHP has developed a series of proposals to redesign local services.
These proposals are part of Healthfit and the Grampian Health Plan – the plan that
sets out how health services should be delivered in future years to meet the demand
for health services and take into account factors such as an ageing population,
advances in technology and a declining birth rate.
Aberdeenshire CHP would like to deliver as much care as possible in community
settings using community staff, including doctors and nurses who have undertaken
1
specialist training to enhance their skills. For example some nurses have been
trained in the management of chronic diseases such as diabetes and asthma while
some GPs have been specially trained in dermatology, cardiology and minor surgery.
This means that patients are seen close to home wherever possible.
3. What are older people’s services, diagnostic and treatment services and
maternity services?
Older Peoples Services
NHS Grampian has an Older People’s Strategy called Ageing with Confidence. This
talks about redesigning services for older people, including services for people with
dementia. This strategy includes preventing unnecessary admission to hospital and
ensuring that older people are discharged from hospital as soon as they are able to
be.
Diagnostic and Treatment Services
Diagnostic and treatment services help NHS Grampian deliver services as close to
people’s homes as is possible, provided this is safe, sustainable and affordable.
Services that were traditionally delivered in acute hospitals can be provided in local
community hospitals. Some hospitals deliver some services whilst others deliver
different services.
Maternity Services
Maternity services include all community-based midwifery services, such as
antenatal and postnatal care, throughout pregnancy and the early months of
motherhood, as well as the delivery of babies
4. Why are changes being proposed?
The population of Aberdeenshire is predicted to alter a great deal over the next ten
years. These changes need to be planned for. For example, the number of people
aged over 85 is predicted to grow by 40% in the next decade. At the same time there
will be a drop of 15% in the working age population.
Long-term illnesses, such as diabetes and asthma, have replaced infectious
diseases as the main work of the health service.
Developments in technology, for example in the type of equipment that is available
and the use of telemedicine (connecting people in rural areas to a doctor in a centre
using a camera and a television screen) means that more can be done in the
community, closer to the patient’s home.
More people are living alone and in single-adult households. More women go out to
work. This means there are fewer family carers to look after the increasing number of
older people.
2
5. What are the proposed changes?
Older People Services





The implementation of the Older People’s Strategy, with more shift away from
long stay hospital care to community based support and rehabilitation at home
and in hospitals.
The planned closure of long stay beds, including the closure of Campbell
Hospital in Portsoy and Maud Hospital.
The development of a new hospital and health centre in Banff by 2010.
The move of psychogeriatric beds from Maud Hospital to Fraserburgh
Hospital.
The development of a community-based “housing with care” facility for older
people in Central Buchan, with Communities Scotland and Aberdeenshire
Council.
Diagnostic and Treatment Services



Services delivered locally by doctors, nurses and other community staff with
special training.
Ten community hospitals acting as a network to increase the range of services
across Aberdeenshire. For example the following services will be provided in
local settings – dermatology, minor surgery, orthopaedics, chemotherapy,
diabetes, ENT (ear, nose and throat), endoscopy, ultrasound, cardiac
assessment, rehabilitation and X-ray. Aberdeenshire CHP proposes to group
these services so that most areas will have local access to most services.
Other services currently delivered in acute hospitals, such as Aberdeen Royal
Infirmary and Woodend Hospital, to transfer to local settings in Aberdeenshire,
for example a six-bedded stroke rehabilitation unit in Fraserburgh and laser
surgery for varicose veins in Huntly.
Maternity Services








More antenatal and postnatal care across Aberdeenshire, including 24 hour
advice and support.
More support for community based home births.
An increase in the public health programme for mothers, for example by
supporting those who wish to stop smoking, those who suffer domestic abuse,
those who abuse drugs or alcohol or those who need extra help to establish
breastfeeding.
Flexible local access to postnatal beds for mothers who need medical care
once they have given birth to their baby.
Development of a redesigned North Aberdeenshire maternity unit at
Peterhead, with an aim to increase the number of deliveries to 150 per year by
2008.
The maternity unit in Huntly, which is currently closed, should remain closed.
Deliveries (intrapartum care) should stop at the maternity units in Aboyne,
Banff and Fraserburgh.
The staff from these units should be redeployed to provide and give more
support for home births, antenatal and postnatal care.
3
The three elements of the Aberdeenshire Plan – Older People’s Services, Diagnostic
and Treatment Services and Maternity Services are linked and need to be
considered together to ensure that the best use is made of staff, buildings, equipment
and money.
6. What consultation has already taken place?
A great deal of pre-consultation and formal consultation work has already taken
place. The formal consultation was launched in July 2005. It included a series of
public meetings across Aberdeenshire, focus groups, a questionnaire to members of
the Aberdeenshire Citizens Panel, written feedback, face to face meetings and
submissions from groups such as the Save Aboyne Maternity Group and the
Fraserburgh Maternity Action Group.
7. What did people say?
A great deal of feedback has already been received. Most people thought that the
changes would be a good idea. However there were differences in opinion depending
on where people lived and between different services.
People who responded were generally very supportive about diagnostic and
treatment services. The main perceived benefits were their potential to reduce
waiting times and reduce the need to travel to Aberdeen for treatment.
People were also positive to the proposed changes to older people’s services,
although there were concerns and questions about whether enough communitybased services were in place for an increasing older population and a reduction in
long stay beds.
The area of greatest concern during the consultation was maternity services, with
strong views expressed about wishing to retain local delivery units, particularly in the
communities of Fraserburgh and Aboyne.
A full report of the consultation to date and supporting information is available on
request.
4
8. What are the recommendations that we want to hear your views on?
The recommendations that Aberdeenshire CHP is making to the Board are:
a) The closure of Maud Hospital and the associated development of
community-based services for older people including a Community Health
Resource Centre.
b) The development of an enhanced community-based housing with support
facility for older people in Central Buchan in partnership with Communities
Scotland and the Local Authority as part of this model.
c) The closure of Campbell Hospital Portsoy as part of the redevelopment of
Chalmers Hospital Banff.
d) An increase in rehabilitation beds and the withdrawal from long stay
hospital based services across Aberdeenshire for older people.
e) The development of locally based Diagnostic and Treatment Services.
f) The development of enhanced community-based homebirth, ante and
postnatal care whilst ceasing maternity-unit based intrapartum care (the
delivery of babies) in Banff, Huntly, Fraserburgh and Aboyne.
g) The development of intrapartum care (the delivery of babies) in Peterhead
as part of a redesigned North Aberdeenshire midwife led maternity service,
merging the existing services at Fraserburgh and Peterhead.
h) An increase in the number of deliveries in the redesigned North
Aberdeenshire midwife led maternity service to 150 per year by 2008 to
ensure long term sustainability.
i) To provide regular reports on progress to the Board.
j)
That any decision of Grampian NHS Board in relation to the future
configuration of health services in Aberdeenshire be referred to the
Minister for Health and Community Care for approval.
These are the proposals on which NHS Grampian would like to hear your views.
9. Other information that is available to you
A great deal of additional information is available to you, if you are interested and
would like to know more. The following documents can be provided electronically or
in paper. Please call the free healthline 0500 20 20 30 if copies are required.

NHS Grampian’s Health Plan 2006/07

Papers that were submitted to Grampian NHS Board in April 2006:I.
NHS Grampian Aberdeenshire Community Health Partnership
Change & Innovation Plan
5
II.
III.
Aberdeenshire Community Health Partnership Redesign Project
Maternity Services Background Paper
NHS Grampian Aberdeenshire Community Health Partnership
Older Peoples, Diagnostic & Treatment Services and Maternity
Services Public Involvement, Engagement and Consultation

Detail of the consultation process to date and feedback received (many
documents are available – contact us for more details).

Letter received from the Scottish Health Council in May 2006, giving some
feedback and advice on this formal consultation.
NHS Grampian would like to hear the views of the people of Aberdeenshire on
these proposals
If you would like:

to give us your views during this formal consultation period

to have more detailed information

to have this information in another format (e.g. large print, Braille, audio cassette)
or another language

to get involved in working with NHS Grampian to continually improve local health
services
Please:

telephone the free healthline 0500 20 20 30

email us at [email protected]

write to Laura Gray, Director of Corporate Communications, Room 9, Ashgrove
House, Foresterhill, Aberdeen, AB25 2ZA

call in at Healthpoint at Aberdeen Indoor Market, 8 -10 Market Street, Aberdeen
or Denburn Health Centre, Rosemount Viaduct, Aberdeen or 239 High Street,
Elgin

get in touch via our website www.nhsgrampian.org
All responses must be received by 19 July 2006. The Grampian NHS Board will
then discuss the views expressed by the public on this proposal when it meets on 1st
August 2006.
Thank you for taking the time to read this consultation paper.
6