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Background Info

While the Guidance for Integrated Joint Boards is clear in its requirement for engagement with communities, it is less specific as to how and when this takes place. If the Guidance stated that all consultation and engagement concerning redesign of services should be carried out prior to approval and implementation by the Boards, then the process would be more acceptable to all concerned. This is important in view of the pressures on Integrated Joint Boards across the country to review adult care services and would lead to a more acceptable process for change.

Recent decision-making about aged care in Argyll and Bute serves as an illustration of this. In January/February 2013, Argyll & Bute Council decided as part of its budget setting process to close Struan Lodge (a 24-hour elderly care facility in Dunoon) within six months. Following a public meeting sponsored by Dunoon Community Council, the Struan Lodge Development Group (SLDG) was formed to fight the Council's decision. In June 2013, the Council Leader resigned and shortly after a new Council Administration was formed and the earlier closure decision was reversed. The Struan Lodge Development Group then published a long-term strategy document setting out its vision for Struan Lodge, which was submitted to the Council.

Despite efforts to meet with Council staff, no meetings took place and early in 2014 an Interim Joint Board was formed with the responsibility of effecting the integration of the Council and NHS adult health and social care operations. The SLDG attempted to meet with this new body and eventually in mid-2015 a brief meeting was held and we were advised that our strategy document would be considered in the preparation of the Argyll and Bute HSCP's Strategic Plan. No further discussions took place.

On 1st April 2016, the Argyll & Bute HSCP assumed responsibility for health and social care in Argyll and Bute. On 22nd June 2016, the Integrated Joint Board of the Argyll and Bute HSCP considered a Quality and Financial Plan, which consisted of 68 cost saving measures, among which were the cessation of 24-hour care at the Struan Lodge facility within six months and a reduction in bed availability at the adjacent Dunoon Community Hospital. The report containing these proposals was made available to IJB members some 2 days before the meeting. The report was approved and within a week the staff were informed and letters were sent to the residents of Struan Lodge causing much heartache and confusion. This was done with no prior discussion with any community groups, the residents' General Practitioners or any other organisations involved.

In view of the history surrounding Struan Lodge and now the effect on the Community Hospital, there was outrage amongst the Dunoon and Cowal Communities. The Bute and Cowal Area Committee of Argyll and Bute Council passed a motion asking the IJB to reconsider and asking the full Council to consider the same motion a the next Council meeting. This was done and the Council called for a meeting involving the IJB, the Council, the NHS, and the Scottish Government to find a way of reversing the decision to allow proper consultation of the proposals.

Dunoon Community Council called a public meeting, which was attended by representatives of the IJB and our MSP. The meeting was totally unanimous in backing a call for the rescinding of the June 22nd decision to allow meaningful consultation to take place. The matter remains ongoing and the IJB appear intent on the implementation of their proposals with no prior consultation. We have reached the stage where our Community has no confidence in the IJB.

The IJB recently agreed to pause the implementation of their Plan in respect of two facilities, Struan Lodge and Thomson Court, to allow public engagement. While this is welcomed locally, the clients at these facilities have been subjected to unnecessary stress, which could have been better dealt with by earlier consultation prior to approval and implementation and there remain 66 action points which have not been consulted upon.