Julie Flynn, Head of Primary Care, Perth Kinross CHP

1. Julie Flynn, Head of Primary Care, Perth & Kinross CHP �Delivering for Remote & Rural Health Care One Year On� Kinloch Rannoch Emergency Response

3. POPULATION SIZE AND DISTRIBUTION Population approximately 140,000 (GRO 2008) Largely rural area covering 5,000 square kilometres Relatively elderly population Highest projected growth rate in Scotland Predicted 10.6% increase in children of school age (5-15) Predicted 75% increase in the over 65s and almost 130% in those in the over 80 age group by 2031.

4. North West Locality Aberfeldy and Pitlochry Community Hospitals. Largest Geographical locality with smallest population in P&K Population approximately 11,850 Relatively high over 65 population Has predominately rural/remote classification �Kinloch Rannoch Practice: List size 620 350 in village Remainder in surrounding areas Tummel Bridge Rannoch Station Trinafour Struan Bridge of Gaur

5. Significant Data

6. History

7. In 2007 GP retires Some applications demonstrated limited OOH proposals Awarded to existing Aberfeldy Practice

8. Meanwhile� Some members of the local community unhappy since original decision to allow opt-out in 2006. New �merged� arrangements of Aberfeldy and Kinloch Rannoch practices and continuation of OOH provision from NHS Tayside, escalated the concerns of some of the community.

9. CHP Response To undertake a consultation exercise with the local community of Kinloch Rannoch. Initial meeting with contractors, service providers and stakeholders held. 3 Public, open-space events held with community, councillors and providers. Concerns focus on �Emergency Response Services�

10. Options Presented to Community October 2008 Status quo Provision of GP OOH service 24/7 located in Kinloch Rannoch Provision of community paramedic for OOHs located in Kinloch Rannoch Support to establish a First Responder Scheme for OOHs Emergency Response (whilst awaiting the attendance of an emergency ambulance). Three Key Criteria Safe Sustainable Economically Supportable

11. Photos from Public Meetings

12. Measures for Improvement Improve ease of access to local, responsive emergency services. Reduce potential risks to patients awaiting emergency services response. Compliment safe and effective out of hours services. �NHS Tayside committed to improved emergency response services through collaboration with the SAS and local communities�

13. NHS Tayside Board Paper The Chairman concluded 22nd October community event by continuing that the �Board� would consider the options discussed together with the public comments on 13 March 2008. The consideration of the options will focus on emergency response. � the business case seeks to recommend to NHS Tayside Board safe, sustainable and economically supportable solutions to improve emergency response within the community of Kinloch Rannoch. Any proposals to be taken forward will be done in collaboration with a reference group as part of a 1 year pilot to test the change.�`

14. Outcome Option 4. Improved emergency response recommended and supported by the board. Multi-agency reference group established to take forward the preferred option to include community representatives. Comprehensive and independent evaluation to be an integral part of the process.

15. Evaluation Desk based review of existing literature in the U.K. and beyond on first responder schemes, methods of engaging rural communities and innovation in the delivery of services

16. Evaluation

17. Challenges

18. Where are we now? Reference Group established and have met 6 times since December 2008. Community updates circulated to every household, 6 publications. Community First Responder scheme established and commenced with 8 volunteers in August 2009. Full, comprehensive evaluation* being carried out by the Centre For Rural Health. BASICS Scotland provision within Aberfeldy & Kinloch Rannoch Practice areas, in-hours. *Contributions received from both RRIG and SAS towards funding of evaluation

19. Community Update

20. And finally�