NATIONAL ADVISORY GROUP FOR RESPIRATORY MANAGED CLINICAL NETWORKS Chair: Attending: Apologies: Wednesday 23 rd November, 2011 @ 2pm Cheat Heart and Stroke Scotland, Boardroom, Rosebery House, 9 Haymarket Terrace, Edinburgh. Ms M Carroll(MC) Steve Banham(SB), Isobel Baxter(IB), Jenny Boyne(JB), James Cant(JC), Elaine Carnegie(EC), Lorraine Cooper-King(LCK), Paul Currie(PC), Shona Haslam(SH), Ninian Hewitt(NH), Duncan MacIntyre(DMacI), David Munro(DM), Phyllis Murphie(PM), Josie Murray(JM), Lorna Murray(LM), Colin Selby(CS), Peter Slane(PS). Apologies: Alison Anderson(AA), Craig Bell(CB), Gordon Brown(GB), Christina Cameron(CC), Karon Carson(KC), Jane Dalrymple(JD), Gill Dennes(GD), Jakki Faccenda(JF), Hans Hartung(HH), Stuart Little(SL), Sandra Pratt(SP), Margaret Swankie(MS), Soong Tan(ST). 1. Telehealth Pulmonary Rehabilitation The Chair welcomed and introduced guest speakers Morag Barrow, NHS Lothian and Christine McClusky, NHS 24 inviting them to provide a presentation on the Telehealth Pulmonary Rehabilitation Project The presentation covered aims of the project, models of care, evaluation and results from October 2010 March 2011 The talk also provided an overview of Phase 2 and the COPD Work Programme Following a lively discussion, noted that: Information was also available in other languages on the website People must have broadband to be able to participate either via tablets (ipad), PC or Cable TV A risk assessment would be carried out for all patients before enrolling in home exercises with the option to involve Red Cross volunteers within the patient s home for health & safety reasons A trial of the home link encouraged patients to use the exercises at home as well as in a class setting A significant proportion of the exercises were chair based Telehealth provided a visual contact between the trainer and patient It was suggested that Digital TV, the Health Channel and local maintenance groups should be considered Agreed that: Members should provide feedback on the website The NAG RMCNs would support the content development of the website via the Respiratory Patient Toolkit project Provide feedback on website Link project with Respiratory Patient Toolkit workstream All CMcC/MB/ MC 12/11 1
2. Minute Minute of meeting held on 25 th August, 2011 was approved as an accurate record subject to the following amendments: Record apologies received for Peter Slane and Jane Dalrymple 3. SAS: COPD Alerts Dr Edward Duncan, Senior Research Fellow at University of Stirling had circulated some additional information prior to the meeting Noted that: The draft paper Improving ambulance clinician use of oxygen therapy for people with COPD in pre-hospital emergency setting had been accepted by Journal of Paramedic Practice for publication in February, the draft copy being embargoed until this time The Research Team had submitted an expression of interest to NIHR/HTA for funding to support the cluster randomised controlled trial and awaited notification of the outcome If successful, the research team would engage directly with NHS Boards interested in participating in the trial NHS Lanarkshire and NHS GG&C had already expressed an interest NHS Tayside were currently considering the matter Agreed other NHS Board areas interested in participating should notify Ms Carroll Amend minutes accordingly Expressions of interest to Ms Carroll MC 11/11 All 02/12 4. Primary Care Quality Action Plan Item deferred to next meeting 2
5. Patient Representation A short paper was submitted from the Voluntary Organisations requesting further clarification in relation to the aims, purpose, remit and experience of a Lay/Patient Representative Following consideration of comments submitted from areas not present and extensive discussion of the original request, the issues outlined below were raised: BLF, CHSS and Asthma UK represent and have direct links with a vast network of patients and carers across the spectrum of respiratory medicine RMCNs all have local structures in place to obtain patient / carer participation for their developments, and if necessary, national initiatives Linkages with a wider forum of patients and carers would provide a more robust mechanism to obtain views than a single representative on the group This could be achieved by a variety of mechanisms utilising structures already in place across VOs and RMCNs However, there was a view that voluntary organisations don t always speak for the total patient and carer population Likewise, trying to identify one or two individuals to achieve this would also be difficult It was suggested that guidance be sought from SGHD on identification and recruitment of professional patient / carer representatives with an overall perspective Agreed that, as an interim measure, the voluntary organisations would represent interests of the patients and, if required, RMCNs would utilise their own internal structures to engage with patient / carers on individual topics Seek guidance from SGHD on their process to identify and recruit patient / carer representatives MC 02/12 3
6. National Review of Asthma Deaths (NRAD) Elaine Carnegie reported that: 14 Local Co-ordinators / Champions had been identified, but the project team still needed another 14 volunteers The role would involve several meetings in Edinburgh with all travel expenses being paid Some concern had been raised in relation to the communication strategy, which may be contributing to poor uptake across all areas The Department of Health in London is leading on the project in collaboration with a variety of organisations Consequently, contact may come from a variety of sources Individual RMCNs to ensure that participation had been confirmed and local coordinators/clinical champions identified All 12/11 7. BLF COPD Case Finding Noted with delight that BLF have received funding from SGHD to support the BLF COPD Case Finding campaign James Cant reported that: A new Project Manager was being appointed Materials will be generic at a national level, but tailored to local needs Expressions of interest in being involved in the campaign were welcome from RMCNs Expressions of interest to BLF RMCNs 02/12 4
8. Workplan Learning Forum: Delighted to note that: 100 delegates attended the Learning Forum on 2 nd September, 2011 Evaluation had a 50% response rate 96% respondents considered the conference to be Useful & Extremely Useful Satisfaction with the accommodation was slightly down from last year, which would be raised with the management Overall the evaluation was very positive with the strengths considered to be: Varied and relevant topics Sharing best practise and development across Scotland Interactive element to the workshops and masterclasses Opportunity to network Focus on service development and delivery Noted the following suggestions for future improvement: Linkages with Paediatric Interest Group Reinforcement that workshops should be hosted by RMCNs for RMCNs More emphasis on Poster Presentations The following topics were suggested for future events: Case finding Management of breathlessness Palliative Care Management skills Problem solving Influencing change Educational initiatives Costing tools (RP) Psychological therapies 5
8. Workplan (cont) Learning Forum (cont) Expressed thanks to the Learning Forum Subgroup for all the hard work involved in organising the event and agreed that: Consideration should be given to establishing linkages with the Paediatric Respiratory Networks Learning Forum should be organised for September utilising the same process to identify workshop/masterclass topics as this year with an emphasis on developments and initiatives within Scotland NAG RMCNs to take forward the development of national guidance for Nebulisers Explore linkages with PRN Organise event Develop Nebuliser Guidance LF Sub LF Sub TBA 12/11 Patient SM Toolkit: Josie Murray submitted the outcomes of Direct Access to Internet questionnaire commissioned by the RMCN Managers Group, the results of which identified: 56% response rate covering 9 NHS Board areas 11% respondents had access to internet on handheld device and at home 53% of respondents had access to internet at home Total of 64% of respondents had access to internet with remaining 36% not having direct access Two respondents (4%) had added comments in favour of maintaining the status quo Noting that current access to the internet for the age profile of this patient group was higher than envisaged and was expected to increase over time, agreed that a dual approach should be adopted Further noting that NHS 24 and SGHD were happy to help fund the project agreed that it should be taken forward in the new financial year with representatives from RMCNs across Scotland being invited to participate in the content development process Progress toolkit development MC 6
8. Workplan (cont) Respiratory Health CoP: Matter deferred to next meeting Oxygen: Phyllis Murphie reported that Draft 11 of the National Guidance for Oxygen Therapy was being amended following the consultation process and thanked everyone for their contribution Following discussion in relation to the instillation and response times for hospital discharge it was agreed that local solutions should be put in place if the national contract was not sufficient to support ESD Maureen Carroll reported that: BLF & CHSS were developing a joint patient information sheet to assist local RMCNs with initial notification Noted that both charities also had a variety of publications CHSS were developing a new fact sheet in relation to withdrawal of oxygen therapy Sleep: James Cant reported that: The 18 weeks Referral to Treatment workstream has been a positive lever to move situation forward Consideration was being given to development of SCI-gateway referral protocol to help target the service to the right people Expressions of interest would be sought from four NHS Boards areas to help trial the referral pathway NHS Lothian, NHS Tayside and NHS Highland all immediately expressed an interest 7
8. Workplan (cont) COPD Standards: Matter deferred to next meeting Asthma Guidelines & Standards Noted that SIGN and SRIG were working in collaboration to organise regional workshops to consider the way forward in relation to the Asthma Guidelines Agreed that NAG RMCNs should also participate in the organisation of the events and agree a measured approach to identifying the priorities for asthma over the coming year However, influence of local RMCNs in relation to HIS Clinical Standards: Asthma Services for Children and Young People was variable Consequently, agreed that an information request be circulated to all RMCNs to identify remit in relation to Paediatric Respiratory Medicine Participate in Regional Asthma Workshops Prepare information request re Paediatric involvement in local RMCNs MC MC 12/12 National Dataset Matter deferred to next meeting Respiratory MCN Sustainability Matter deferred to next meeting 9. Terms of Reference Agreed that draft Terms of Reference should be circulated for consideration at the next meeting Draft new Terms of Reference MC 02/12 8
10. Trainee Doctors Colin Selby outlined the SGHD plan to reduce number of trainee doctor by 50%, which would have a significant impact on delivery of Respiratory Medicine Noted that representations had been made by Royal College and Scottish Thoracic Society Following extensive discussion, it was agreed that it would not be appropriate for the NAG RMCNs to formally write to the government on this matter Some NHS Boards reported that difficulties in securing trainee doctors had adversely affected Consultant Job Plans, however this was considered an issue for local management teams James Cant offered the assistance of the BLF to campaign on behalf services experiencing difficulties Suggested that, as the remit of the NAG RMCNs did not include such activity, the BLF should liaise directly with individual services as it deemed appropriate 11. GP IT System Item deferred to next meeting 12. Date of Next Meeting Thursday 9 th of February, at 2pm in Glasgow, venue to be confirmed Confirm venue BLF 12/11 9