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This site is to provide information around the Options Appraisal process which is taking place in Portree regarding the future of health and care services for North Skye and Raasay. This is great opportunity for the communities of North Skye & Raasay to be involved in developing a long term sustainable solution to community beds and services in the area from February to April 2020. The process, which is being hosted by independent facilitator, Norman Sutherland from Higher Ground Health and Care,  comprises of three Information sessions (already complete) followed by four Options Appraisal workshop sessions. (being held Dec '20 - Feb '21) All meetings will give community representatives; local clinicians, care workers, support staff, emergency services’ representatives, the voluntary sector and senior NHS Highland staff a shared platform to discuss, debate and agree a best way forward for these services together.

These sessions will look at, among other things, the opportunities and challenges in providing community services for people living in extreme remote & rural areas. They will also ensure that everyone involved is aware of current services, current challenges and alternative models that may be worth considering for North Skye specifically. (An Options Appraisal is a technique for reviewing options and analysing the costs and benefits of each one. It helps to ensure informed decision making by providing a formal process based on information and objective evidence.)


A verbal update from Norman Sutherland, Independent Facilitator given 6th April '21


The North Skye Option Appraisal process has to date included three multi-stakeholder workshops and a large number of smaller meetings, all conducted using the Zoom VC platform. The process is the most involved and complicated Options Appraisal  currently being progressed across NHSScotland virtually in reflection of the on-going COVID situation.


Following the third meeting of the option appraisal group, a number of concerns were highlighted by community representatives both directly and via the OA Oversight group.


These include:


  • There is a sense that the purchase of Home Farm has fundamentally changed the OA process

  • …and that its inclusion within the options is not welcome/popular from a community perspective…

  • …also that current options mix short and long-term possibilities but lack a real long-term vision or sufficient aspiration

  • Overall, that as a result of this, we are not ready to score options.


In addition, the suggestion that we are not ready to evaluate options has also been raised by NHSH staff but for different reasons.


It is extremely important for me as an independent facilitator to acknowledge all of these concerns – and also recognise that they must be addressed to the satisfaction of all participants before we can successfully proceed.


Higher Ground Health have therefore developed a proposal that attempts to address these concerns and have asked for a meeting of the option appraisal oversight group to discuss this in the first instance before any further action is taken.


There are two key elements to this proposal:


  • The agreement of a long-term vision of the future health & social care model by all parties

  • The evaluation of shorter term options in the form of co-ordinated programmes of change/investment that present these in terms of pathways to this vision – rather than time limited options in their own right


It is important to recognise that none of the work carried out to date will go to waste. Option appraisal is a complicated process – and this is an especially complicated discussion. In so far as we are making decisions that are likely to affect investment and disinvestment decisions for decades to come it is more important, we believe, that we do it right rather than that we do it fast.


Norman Sutherland




Your views are important. Look out for more information soon.

How to get in touch?

Sophie Isaacson, P & B Community Trust – Office 5, Jans, 6 Broom

Place, Portree, IV51 9HL



Higher Ground Health + Care Planning

The Options Appraisal process is being facilitated by Norman Sutherland from Higher Ground Health + Care Planning Ltd (HGHCP). Norman has been involved in the process since January and supported the earlier workshop in March of this year.

Higher Ground was not involved in the original Skye, Lochlash and South West Ross redesign Options Appraisal process (2013/14) or wider public consultation (2014). Nor were they involved with the Sir Lewis Ritchie Review. HGHCP have publicly highlighted their absolute independence in the process and have made it clear that they will not allow this to be compromised by any of the individuals or groups involved in the process.

As well as Norman, HGHCP will be providing a number of facilitators to support discussion at the planned events all of whom are extremely experienced and completely independent.

A quote from Norman now that the first 3 Information Sessions are complete ...


"I'd like to thank everyone who has attended the public meetings and planning sessions to date. I believe these were informative and have helped us all develop a better sense of the challenges facing health & social care services in North Skye as well as some of the alternative options available and how we might measure success. I have been particularly impressed by the willingness of the community across Skye to actively engage in the process alongside NHS Highland and am convinced that this active co-production will deliver an exciting future model that addresses the bed and capacity related issues in Sir Lewis Ritchie's report. I also believe that this demonstrates an improving relationship between NHS Highland and the public and look forward to the option appraisal workshops with genuine excitement."

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