Northern Clinical Networks & Senate Name of Group Date: Time: Venue: Present: Apologies: 1. North of England Cardiovascular Network Steering Group 03/09/14 9:00am Evolve Business Centre, Houghton-le-Spring Peter Dixon, Senior Local Specialised Services, NHS England Helen Douglas, Network Admin & Support Officer, NESCN Alison Featherstone, Network Manager, NHS England Kevin Fitzpatrick, Area Development Manager, BHF Mikki Golodnitski, Senior Delivery Manager, North Yorkshire & Humberside CSU Sue Gordon, Consultant Public Health, PHE Robin Mitchell, Clinical Director, NHS England Peter Moore, Regional Head of Operations, Stroke Association Douglas Muir, Consultant Interventional Cardiologist, South Tees Rahul Nayar, Diabetes Lead, Sunderland Gerry Stansby, Professor of Vascular Surgery, Newcastle Liz Bailey, Business Manager, Newcastle Tim Cassidy, Stroke Lead, Gateshead Gert Gammelin, DDES CCG Mark Hudson, Consultant Hepatologist, Newcastle Roy McLachlan, Associate Director, NHS England Nigel Rowell, GP Lead, South Tees Dilys Waller, DDES CCG MINUTES INTRODUCTION a. Welcome & Apologies RMi welcomed all to the meeting and apologies were noted. RMi particularly welcomed RN and KF as new members. Introductions were made. b. Previous Minutes – 09/05/14 The minutes of the previous meeting were accepted as a true record. c. Action Points from Previous Minutes • Clinical Leadership Development Event RMi discussed the recent event which was facilitated by Tony Woods. It was reported that this was a good event and a follow up event is planned. RMi encouraged all to attend if possible (flyer attached to these minutes). AF informed the meeting that she is in the process of arranging media training as this was highlighted as a need following the leadership development event. AF will circulate the details to those concerned shortly. • Steering Group Membership - update The group discussed membership and agreed that engagement with provider trusts and CCGs needs to be increased. Members also felt that clinical leads attended this meeting to represent their particular clinical area and could not also represent their respective trust. PD HD AF KF MG SG RMi PM DM RN GS LB TC GG MH RMcL NR DW ACTION Enc 1 AF A series of one to one meetings are to be arranged between AF, RMi and the Chief Executives of the network provider trusts. The aim of these is to highlight the role of the networks in general and, more specifically, projects which are ongoing. It is hoped that this will encourage engagement, particularly with this group. The existing membership list was discussed. Members are asked to review this and to contact AF with any appropriate amendments. 2. ALL SPECIFIC ISSUES ARISING 2.1 Implantable Devices The question has been asked as to whether the new NICE guidance regarding implantable devices will lead to an increase in demand. DM reported that implant centres across the network have been following ESC guidelines which already include cases highlighted by the new NICE guidance. However, improvements in case-finding would lead to a need for increased capacity. A scoping exercise looking at models and provision of service is currently underway. Evaluation of this information should help to inform whether further capacity is required and where this should be situated geographically. NHS England is ensuring that implant centres are fully compliant with the service specification. Members discussed the issues and agreed that this should remain as an agenda item. 2.2 2.3 Oversight Group update The first meeting of the Oversight Group will take place on Friday 5 September 2014. This will be chaired by Mike Prentice, Medical Director, CNTW Area Team. RMi will update this group in due course. Updates: AF introduced the work plans and explained that some of these are in draft form as they have not yet been ratified by the groups concerned. The working document will be published on the individual group pages on the NESCN website to ensure that only the most up to date version is available. • Cardiac DM discussed the cardiac priorities including Primary PCI, FH services, TLOC services and cardiac MR. The group noted these priorities. • Stroke AF discussed the stroke work plan 2014 – 16. This includes equitable access to rehabilitation and support, early intervention and management and access to psychological support. The group noted these priorities. Members also noted the national RMi RMi priority to improve services which is mainly centred on models of service delivery. • Vascular GS discussed the vascular priorities including improved access to carotid endarterectomy, reduced AAA mortality by improving screening rates, reducing hospital mortality following amputation and service delivery models. The group noted these priorities. • Renal AF discussed the renal priorities including earlier identification of patients developing acute kidney injury and management of chronic kidney disease, ensuring coordinated service and improving the patient experience for those with chronic kidney disease. The National Clinical Director for Renal Services, Dr Richard Fluck, is to attend the next Renal Advisory Group meeting at Waterfront 4 on 9 September 2014, 2.30pm. The group noted these priorities. • Diabetes RN discussed the diabetes priorities including insulin pump therapy, insulin safety, and diabetes management, reducing amputation by 50% and improving education. The group noted these priorities. • Primary Care AF discussed the priorities of the primary care group. This includes work on atrial fibrillation and novel anticoagulants. The group noted these priorities. • Liver AF discussed the liver priorities including management of abnormal LFTs, developing pathways for viral hepatitis and decompensated cirrhosis, improving the treatment for patients with acute alcohol related hepatitis, improving access to intensive care for patients with liver disease and developing end of life care. The group noted these priorities. 2.4 SCN Priorities Moving Forward Members discussed the work plans and in particular noted that some of the priorities appeared on one work plan but were cross cutting and involved other clinical areas. Concern was expressed that network priorities could be priorities of other organisation such as CCGs and that projects would be duplicated. AF explained that the Network is collaborating with organisations such as NECS and the AHSN to avoid this. There was a group discussion about MR and radiology capacity in general. It was noted that increases in demand for some services can lead to delays for other specialties. AF informed the group that there is a project underway which is looking at radiology services across the network. 2.5 Senate Update RMi informed the group that the National Clinical Advisory Team has been disbanded, and the task of independent scrutiny of reconfiguration has been given to the Senate. 2.6 Network events • Rehabilitation Event – 5 November 2014, Stadium of Light. This is a cross cutting event looking at rehabilitation. • Parity of Esteem Event – 15 October 2014, Stadium of Light. This event will consider psychological distress in the physically ill and physical ill health in the mentally ill. AF encouraged members to attend. • SCNs – 2 years on – AF asked members to note this event which will take place in May 2015. 2.7 National SCN priorities update The SCNs meet nationally approximately three times per year. The next meeting is in September 2014. There was a national cardiac meeting in July and the diabetes meeting will be in September. Arrangements are underway for a stroke meeting for the Northern region. Nothing has been organised yet for vascular or renal. REGULATORY a. Risk Register and Clinical Governance Issues An example of a risk register was tabled. Members discussed the use of the risk register and what should be included and whether this was an appropriate format for the steering group. The group suggested an exemption report against the work plans may be more informative. AF to discuss with SCN colleagues. 4. b. Any Other Business There was no further business. c. Date of next meeting Members agreed to keep the next meeting as 7 November 2014, 10 – 12, Evolve Business Centre MEETING CLOSE AF ALL to note