Lothian RESPIRATORY MCN CORE GROUP Wednesday, 19 th March 2.00pm to 4.00 pm The Chancellor s Building Seminar room 6, RIE

Transcription

1 Lothian RESPIRATORY MCN CORE GROUP Wednesday, 19 th March 2.00pm to 4.00 pm The Chancellor s Building Seminar room 6, RIE Present: Dr Ninian Hewitt - GP and Lead Clinician, Respiratory MCN (Chair) Ms Alyson Malone - Strategic Programme Manager, NHS Lothian Ms Grace Hynd - Clinical Nurse Manager, Respiratory Professor William MacNee - Respiratory Consultant, RIE Ms Katie Johnston - Primary Care Pharmacist, Edinburgh LHP Ms Laura Groom Clinical Specialist Physiotherapist Community Ms Jenny Scott Pharmacist RIE Miss - MCN Coordinator for Respiratory Care, NHS Lothian (Minute) Apologies: Ms Shena Brown - Respiratory Care Facilitator, WL CHCP Ms Gillian Cunningham - Service Manager, CTR Prof Harry Campbell - Professor of Genetic Epidemiology and Public Health, UoE Ms Angela Lindsay - AHP Manager, Edinburgh CHP Ms Kim Bracher - RNS St John s Hosp. 1. Introduction and apologies for absence Dr Hewitt welcomed those attending the meeting and introductions were made. 2. Minutes of the previous meeting Feb 2014 All suggested amendments made to minute previously. Minute was accepted as accurate record of discussion. 3. Matters arising from previous meetings 3.1 Bronchiectasis/SMP With advice from the project group, Cat is currently updating the bronchiectasis website with a view to having an initial site ready by 25 th March - just in time for a bronchiectasis support group meeting. Cat is looking for any feedback especially around format, image, and content. She will speak to James Wildgoose about the possibility of expanding the support section to include presentations and supporting materials from the support group meetings. Once feedback has been collated and further updates made the group will meet to agree a timeline for launch. It is hopeful this will take place early summer and will have some parliamentary coverage. Please find link to site below. Group to take a look at site and feedback any comments Cat to speak to James around adding presentation from support group 1

2 3.2 Educational Events Ninian advised all dates and venues have been agreed and the prescribing PLT events will take place: Location Date Venue Edinburgh (North) 20 August 2014 Norton Park Mid Lothian 10 September 2014 Will be decided by CHP West Lothian 24 September 2014 St Johns Lecture Theatre Edinburgh (South) 26 November 2014 NRIE Auditorium B East Lothian 04 February 2015 Doughty Centre Herdmanflat Ninian and Cat are working on putting together a program of the day which will include input from a consultant and practice nurses. There will also be a short demonstration on the use of inhalers The Good, the Bad, and the Ugly, and an interactive session. The group felt it would be a good opportunity to promote some current initiatives including the CRT and PR. The programme will be put into draft form and circulated to the group for comment. The team are also producing a postcard style resource of fast-facts to include 6 key facts on subjects such as Asthma, COPD etc. Any ideas around this are also welcome. Ninian noted that the pharmacy reps were interested in helping supply inhalers for the day and that he has written to clement-clark regarding flo tone. Circulate draft programme to group for comment 3.3 Efficiency Productivity Work Stream Invest to save project Ninian informed the group that feedback from the projects had been very positive and that they were progressing well. Laura advised there are two new starts which will help support the extended hours service (8am 6am Mon-Fri, and 9am 4pm Sat/Sun). The initiative is to begin at the Western on a monthly basis. Ninian is still working on outpatients, and trying to define exactly who should be seen. He suggested this requires further work with GP s, and may require development of protocols. It was noted they are waiting on further data from Kim Dickson on where people go to. Once this is received they may be able to look at identifying a nominal data set. 4. Pulmonary rehabilitation business case Ninian described a slight set back to the project due to agreement having to go back to CHP level. It is hoped this will not take long to rectify. He advised there are small pockets of money available for admin and clerical support. Ninian spoke to the draft evaluation which had been circulated. He noted data is based on referral numbers, and quality of life data, as well as a risk theoretical framework, and community audit. 2

3 Katie raised a concern around if savings are to be forecast what budget this would affect. Ninian emphasised this should not affect any budget as he has highlighted this as new monies and savings could not be directly linked to a specific budget. Bill highlighted a concern around using a risk measurement of 50% in terms of post exacerbation rehabilitation and felt more substantial evidence may be required. The group discussed the possibility of giving a student the opportunity to do an audit for this. In relation to student projects Ninian will forward the list he received from Amanda Steers which suggests a number of project titles. Ninian to forward list of potential study projects to Bill 5. Learnpro Spirometry Ninian advised the modules are in their final stages of completion, and just need to review the assessment questions. The group asked if they could see the modules. Please find password and link below to access the draft modules. Once complete a suggestion was to offer it to GPs as a GMS action to encourage uptake of the programme. Directions to access LearnPro modules: To login to the test site: Username = lothian.test Password = lothian Once you have logged in, click on the LEARN button (top left) then click on the blue DEMO AREA bar. Double click on the Lothian: Spirometry 2014 icon and click on the Launch module link. 6. Cough, cancer, DCE and refhelp Ninian gave a brief recap on past activities around Detect Cancer Early (DCE). He noted that all up to date information is available through Refhelp. He will be working with the cancer MCN to produce generic pathways. 7. Asthma Ninian suggested the MCN need to revisit the Asthma priorities and identify what are the key priorities for NHS Lothian. He noted a large amount of work had been done but there were still significant pieces. It was agreed a sub group should be convened to take this forward. Those to be invited to be part of this include Tracey Bradshaw,,a community nurse (to be agreed with Tracy),Jenny Scott, and a representative from St John s. Ninian highlighted a concern around difficult asthma and the lack of progression with producing a local pathway/protocol for this. He felt this may need escalated. Alyson suggested taking it to Alex MacMahon, Director of Strategic Planning who is also the executive sponsor for the Respiratory MCN and therefore may have some influence over proceedings. 3

4 Cat/ Ninian to send invite to potential members to the Asthma Sub Group 8. Exacerbation/COPD Guideline 8.1 Exacerbation Guide Ninian asked for sign-off of this paper. He noted that if no further comments are received by Wednesday 26 th March then he will take it that the group are happy with it. Actions: Group to take final look and paper and make comments by 26 th March 8.2 COPD Guideline It was noted that due to changes in the combinations of inhalers this paper would not be able to be finalised imminently. The group are also awaiting feedback from SMC around the accepted FEV level. Ninian suggested he will hold off until all new information is available from SMC/ LJF around FEV and inhalers. He suggested to Laura that if she felt it required further information around CRT to let him know. Katie/Jenny to feedback from SMC when decisions have been made around FEV and inhaler combinations 9. Sleep Ninian advised this has been raised by Gillian Cunningham who has asked the MCN to get involved with some work around sleep. Ninian has approached the strategic director who feels this piece of work would be of benefit and would also be a fitting time. Therefore Ninian has asked for a consultancy to be put in place which will be supported by Phyllis Murphy NHS Dumfries and Galloway, Respiratory Nurse Consultant. Ninian will keep the group up to date with progress on this. 10. MCN Workplan The group had a general discussion around the current workplan for the MCN. Ninian advised this needed updated in terms of current projects and timelines. He asked the group to review it and feedback any comments, and to ensure there wasn t anything missing. He noted he will add in Asthma, Asbestos, and Sleep. Alyson noted the new strategic plan will be out for consultation during April to August and suggested the activities should be cross referenced with the multi morbidity action plans. It was noted that the workplan did not reflect past work activities/outcomes and that this should be added to show the development stages. Cat and Ninian will add this to the workplan. 4

5 Group to review workplan and feedback any comments or ideas Cat and Ninian to update MCN workplan 11. AOCB Patient Rep Alyson asked for some ideas around who could be approached to represent respiratory on a NHS Lothian patient pathway group, which is being led by Rachel Hardie, Public Health Consultant. The group suggested following this up with Susan McNarry or Laura Groom. Twitter for Bronchiectasis As a form of patient engagement Ninian and Cat have suggested setting up a twitter account for the Bronchiectasis site. Cat will explore the idea further and will feedback to the group. 12. Date of Next Meeting Date: Wednesday 16 th April 2014 Time: pm Location: Seminar Room 6, Chancellors Building, RIE Future Meetings All are in the Chancellors building All are timed for May 14 th Seminar 1 June 18 th Seminar 1 July 16 th Seminar 6 September 17 th Seminar 6 October 15 th Seminar 6 November 12 th Seminar 1 December 17 th Seminar 6 February 18 th Seminar 6 March 18 th Seminar 6 5

6 Summary of Actions: Item Action Who When Complete 3.1 Bronchiectasis/SMP take a look at site and feedback any comments All speak to James around adding presentation from support group Cat 3.2 Educational Events 4. Pulmonary rehabilitation business case Circulate draft programme to group for comment Cat/Ninian When complete forward list of potential study projects to Bill Ninian 7. Asthma send invite to potential members to the Asthma Sub Group Cat/Ninian 8.1 Exacerbation Guide Take final look and paper and make comments by 26 th March All By 25 th March 8.2 COPD Guideline feedback from SMC when decisions have been made around FEV and inhaler combinations Katie/Jenny When available 10. MCN Workplan review workplan and feedback any comments or ideas All update MCN workplan Cat/Ninian 6