Chamber and committees

I am interested in the national treatment centres in relation to winter planning. Pamela Milliken mentioned that, after people fall on ice, they occupy an emergency orthopaedic bed space. The national treatment centres are intended to keep bed spaces sequestered for elective approaches. The NHS Golden Jubilee National Hospital site has the national eye centre, and Fife has the orthopaedic centre. Will such centres help with planning organised approaches to beds in secondary care?

Because of my background in orthopaedic surgery and working in the operating room, I am curious about the flexibility of staff and the ability for them not to work in isolation. It is important that people know that we have the national treatment centres with the goal of challenging waiting lists for hip or knee replacements and ophthalmology, for instance.

I am interested in digital care. We have Near Me. When I was reading my papers for the committee, I found out about Connect Me, which seems—so that people feel more connected, rather than feeling remote—to have evolved because of use of language that was remote. We have telehealth and telemedicine—all this telestuff—and now we have Connect Me, but none of my nursing colleagues has heard about Connect Me.

What work do you think needs to be done to help people to understand what Connect Me is all about? I understand that technology enabled care is beneficial, especially, as John Burns mentioned, in cases of chronic obstructive pulmonary disease, through chronic respiratory early warning scoring—CREWS—in the community to keep folk out of hospital. I am very familiar with that, but I am interested in how we get info out to people about what digital solutions are out there.

Technology enabled care in Scotland has a Twitter—or X—account, but folk in Dumfries and Galloway dinnae do Twitter, thank goodness; they do Facebook. Should we use different social media platforms to help to raise awareness about the work that the Scottish Government is doing on digital tech solutions, for instance?

Good morning to panel number 2. I will pick up on what John Burns said about national treatment centres. Pamela Milliken, who was on the previous panel, said that winter planning includes having to think about slips and trips on ice, which can lead to orthopaedic injuries for which people need emergency surgery. However, the national treatment centres are for elective approaches, such as tackling ophthalmic or orthopaedic issues and performing upper gastrointestinal endoscopies.

John-Paul Loughrey, who was on the previous panel, said that staffing those centres would be like robbing Peter to pay Paul. However, my understanding is that our First Minister, when he was Cabinet Secretary for Health and Social Care, said that 1,500 additional staff would be used for the centres. Can you give us an update on whether we will be robbing Peter to pay Paul? What is the status of the recruitment of new staff for the centres?

Do you welcome the fact that paediatric ambulatory care nurses are trained in mental health first aid? Going to hospital can provoke anxiety, and the training can also help to deal with some young people who have mental health challenges.

I welcome the opportunity to speak in this debate and congratulate my friend and colleague Christine Grahame MSP on securing it. What an excellent contribution the member made in speaking to her motion.

I also start by thanking all the staff at NHS Borders for the work that they do every day but, in relation to today’s debate, I particularly thank those staff who are working in the paediatric ambulatory care unit at Borders general.

As a registered nurse myself, I have experience in adult ambulatory care and a wee bit of paediatrics, so I know about the vital importance of ambulatory care. It bridges the gap between the hospital and community children’s services, concentrates on areas such as accident and emergency and out-patients, works at improving communication with families and the primary health care team, and, importantly, works with the home care nursing services to develop new services such as day units.

The unit at Borders general is a fundamental part of the wider innovation of children’s healthcare at NHS Borders, with a focus on keeping children at home and avoiding time in hospital where possible. The paediatric ambulatory care unit was set up 20 years ago in May 2003, to allow children to get treatment and go home rather than needing to be admitted to a ward as an in-patient. In the past 20 years, more than 8,000 children have attended the ambulatory care unit to have a range of assessments, procedures, investigations and treatments.

As Dr Andrew Duncan said,

“Over the past 20 years, the backbone of the service has been our amazing paediatric nursing team.”

It is worth mentioning that again. Dr Duncan went on to say:

“They have shown huge amounts of flexibility and imagination in development of the service.”

We know that new skills such as intravenous interventions, blood tests and psychological support, which I mentioned in my intervention, have been developed. It is important that we help to support and address mental health in young people when they come to us through any service, including the ambulatory care service.

The work that has been carried out by the exceptionally dedicated and specialist healthcare professionals has meant that many children have been able to have treatment locally, rather than having to travel outside the Borders. We know that staying at home makes a huge difference to the lives of children and families and all the team at NHS Borders, both past and present, should be proud of the service that they have created.

Ambulatory paediatrics is an exciting and challenging area to be involved in, with much scope for development. I was interested to read that, during the past 10 years, there has been a 30 per cent increase in the number of under-fives attending emergency departments. That compares to an increase of 15 per cent for all children and young people seeking urgent care in the same time period.

Those figures are due to changes in demographics and in carer behaviour that have arisen for a number of reasons. I swithered about whether to include more detail about attendance issues at emergency departments, but I will say that lack of paediatric experience in primary care and in the assessment of risk play a role in the increase in referral rates to secondary care services, which demonstrates why paediatric units, such as the one in Borders general, are so important.

The investment in virtual hospital care models in paediatric medicine is increasing as acute settings struggle to manage the pressures caused by increasing demand. I ask the minister what learning can be taken from the unit at Borders general and replicated across other health boards, both to alleviate pressure on those boards and to improve outcomes for children and young people.

I place on record my thanks to all the staff at NHS Borders for leading the way with the paediatric ambulatory care unit and congratulate Christine Grahame on securing the debate.

I welcome the announcement, which will certainly alleviate Galloway fishers’ concerns and will be welcomed by fishing communities across Dumfries and Galloway. As the Scottish Government continues its plans to enhance marine protections for the environment, can the cabinet secretary reiterate how the voices of fishers, such as those in Galloway, are at the centre of those discussions? Can she confirm that she will meet Galloway fishers at the earliest opportunity so that their voices can be heard from the outset of any future proposals?

I should probably remind everybody that I am a former NHS Dumfries and Galloway employee and am still a registered nurse. I should have said that at the start.

Healthcare is so wide ranging that there is loads that we could cover today. I am interested in community pharmacy, which is valuable, and pharmacy first is amazing. The feedback that I have had from community pharmacies is that they sometimes feel undervalued in their work. I am interested to know whether data has been gathered on pathways for referral to pharmacy first and whether pathways are appropriate.

Community pharmacies can be great at things such as checking inhaler technique or checking that people who have chronic obstructive pulmonary disease or asthma have the right inhaler, which helps to keep them out of hospital. That is a matter of people having the right inhaler and the right technique for them.

Community pharmacies should be valued, but do we track whether appropriate referrals are made?