Listening to Good Evening Shetland, followed by the NHS Shetland Speakeasy on Tuesday evening, I was very disappointed with some of the comments relating to the proposal to close Ronas Ward rehabilitation unit which came from NHS Shetland chairman Ian Kinniburgh.
I feel I must set the record straight in relation to his statement that this is not about closing Ronas Ward until the Intermediate Care Team (ICT) (covering Lerwick and central area only) was fulfilling its function satisfactorily. This was not how the proposal was presented.
At the Integration Joint Board (IJB) on 26th September the first question I asked was when would Ronas Ward be closed and I was informed by Kathleen Carolan that closure would be immediate. The reason being that the money to run the unit had already been re-allocated and there would also be a requirement to redeploy a number of the staff to help populate the under resourced ICT. I have to say, having given that answer to the IJB on 26th September, it did come as a surprise when Mrs Carolan concurred at the Speakeasy debate with Mr Kinniburgh’s view on a meeting which he did not witness.
It can only be the case that Mr Kinniburgh did not have a proper grasp of how the report was presented to the IJB as he surely would not be inclined to mislead the public.
He also said that “certain members of the IJB certainly weren’t in a position of knowledge around this” and were at a “different level of understanding” – very derogatory and disrespectful comments.
Any lack of knowledge was due to the unsatisfactory level of information in the report, which is why we deferred to gather further information on how this proposal would affect outlying patient care and also to gain an understanding of the impact on community care.
I would remind Mr Kinniburgh that the IJB’s decision was by consensus; no-one was otherwise minded to approve the recommendation.
Far from having a “lack of understanding” the IJB does understand and supports the strategy of providing more health care and rehabilitation in the home and community setting.
What was raised on 26th September was a note of caution regarding the assumptions made in the report and the intention to close Ronas Ward immediately in the process. This removes any safety net should the ICT and Montfield Support Services provision fall short – which would particularly affect the outlying areas. To launch the strategy on such a fragile basis would be inviting failure from the outset.
Another serious omission in the report was that the Shetland Stroke Support Group had still not been consulted meaning this proposal was being presented without their extremely important input, a gap in the process which I also raised at the IJB.
The fact of the matter is we are now in a process of partnership working between Health and Social Care, something we have been doing informally in Shetland by necessity and for a number of years. The Public Bodies (Joint Working) (Scotland) Act was granted royal assent on 1st April 2014 and has now legalised this process.
However, there is an issue when different cultures combine constitutionally and with common governance and accountability, it is a difficulty we must manage and quickly, working together to improve patient and client care more efficiently is the aim.
It would appear that certain elements of NHS Shetland senior management are having difficulty coming to terms with this, illustrated by Mr Kinniburgh’s reference on Tuesday night to a “done deal” which the NHS senior management team patronisingly thought was a “no brainer”.
This is no longer how it works. I sincerely hope we can move on from here and begin to have adult conversations which recognises the IJB as an entity in its own right and not as two disparate organisations.
SIC councillor and voting member on the
Integration Joint Board