Highland

View our 2013 report for the Highland region.

Region overview:

Service commenced

November 2006

Total board population

310,830

Urban / rural

31% / 69%

Specialist HF nurse WTE posts

4.5 WTE (8 staff)

Further details:

(Actual number of staff)2008 - 3.4 WTE (7 staff)
SIGN Ratio1:69,073 (2008 1:78,385)
Ave. caseload per post60 (community)
Individual patients managed by service (average year)289 patients
Service ProvisionHome visits 70% / Clinic Appointments 30%
Provision for HF-PEFNo
Administration support per week31 hours (across service)
Providing education to non-specialist staffLimited - training programme for community staff
Doctor with specialist interest in Heart Failure2 Consultants with interest
Cardiac Rehabilitation available/number seenLimited – sporadic access from individual physiotherapists
Access to psychological support referral pathwayNone

Notes on current service provision

The service is strong at the moment and we appear to be meeting local and national targets. Due to our geography we frequently provide telephone contact with patients who live in remote and rural areas as we cannot see them as regularly as we would like. We are also working with community teams to provide a more structured approach to their care. Patients not suitable for the service are offered education booklets/ongoing support via the newsletter and forum meetings (in partnership with CHSS). The service within Dunoon and Cowal is in its infancy, Mid Argyll referrals are picking up, but Kintyre has been slow; the reasons are unclear.

Funding in comparison to 2008

Following BHF funding from 2006, we are about to move over to full funding from the Board.

Challenges

Providing an equitable service in the Highlands is challenging. We are often faced with being unable to see patients straight from discharge due to limited time staff have within that area. Obtaining clinic space is hard, transport issues can be a problem; with the need for ferries an island service is challenging.

Development opportunities

Trying to implement the SPSP bundle (2 hospitals), which in theory should help referral rates has been challenging. We are providing training for community nurses in the hope that stable patients can be managed locally. We have also looked at Telehealth filling this gap; unfortunately we have had issues with the NHS server and therefore been unable to progress.