Name of Group / Meeting: Healthy Lifestyles – Harm Reduction - Tobacco Date: 08.09.14 Time: 12.30 – 2.00 pm Venue: Durham Centre, Belmont Industrial Estate Present: Joanne Dark, Public Health Registrar, PHE – JD Paul Goldsmith, Neurological Clinical Lead, – PG (teleconference) Carole Johnson, Head of Health Improvement, Hartlepool Borough Council - CJ Carol Mayes, Network Delivery Facilitator, SCN - CM Jo Preston, Network Team Manager, SCN – JP Catherine Scott, Joint Commissioning Manager, Gateshead Council - CS Suzanne Thompson, Network Manager, SCN – ST Michelle Turnbull, Joint Commissioning Manager, Sunderland CCG (teleconference) Martyn Willmore, Performance Improvement Delivery Manager, Fresh – MR Dianne Woodall, Public Health Portfolio Lead, Durham County Council - DW Angus Bell, Mental Health Clinical Lead, SCN - AB Christine Jordon, North Tyneside Council – CJ Damian Robinson, Northumberland Tyne and Wear (NTW) NHS FT - DR Matt Rowett, Lead Clinician for Teesside Liaison Psychiatry - MR Claire Sullivan, Public Health Consultant in Health Improvement, PHE - CS To progress with the work programme to tackle the physical health needs of those with mental health problems. Focusing initially on smoking/tobacco for both patients and staff in acute mental health services Apologies: Brief Summary of Meeting: Page 1 of 11 KEY NOTES/ACTION POINTS: Agenda Item 1 2 2.1 Subject Key Notes/Actions Welcome and introductions Updates/action points from last meeting 28.07.14 Smoking cessation examples Introductions were made and members gave a brief summary of their job role and interest in this project. Notes agreed as a correct record. Feedback provided by MW: • Langdon Mental Health (MH) Trust – gone smoke free; supportive of e-cigarettes and developed policy for these • Director of Tobacco Control centre (TCC) – stop smoking services training provide for MH staff; Stop smoking services (SSS) integrated for staff and patients; Director of TCC offered to attend one of our future meetings • South Maudsley – to go smoke free by October 2014; to provide support for staff, including nicotine management; MW to follow up for further details • Australian example presented at UK national conference – leadership from senior members of staff; all staff to have SSS training/support, including free nicotine replacement therapies; potential for staff to undermine SSS if not trained and supportive of policy Feedback provided by MT: • NTW smoking cessation group – support patients to access community services – only Target date Person responsible Next meeting MW Page 2 of 11 Agenda Item Subject Key Notes/Actions those with complex needs to access NTW service; staff trained to deliver appropriate levels of SSS; 2 nurses trained had recently quit smoking; also training health champions; 25 patients referred to service in last 8 months - 7 completed programme NTW report has been shared with Tees Esk and Next meeting Wear Valley NHS FT; MT to ask if report can be more widely shared MT advised of MH programme board meeting on 09.10.14, 11.30 - 1.30 pm at Pemberton House, Sunderland – open invite to all; presentation on MH programme board to take place Amendments made and group signed off ToR, as attached. Group signed off PPV request form, as attached. 2.2 NTW CQUIN 2.3 Sharing of Sunderland/Tyneside MH Programme Board 3 6 Draft Terms of Reference (ToR) Patient and Public Voice (PPV) Request Form Strategy to improve smoking cessation/reduction services Stoptober Campaign 7 Sharing of PHE report Members agreed that this could be shared. 8 Any Other Business MW advised of A PHE national tobacco control seminar on smoking and mental health to be held 4 5 Target date CM presented ‘strategy ideas’ and the group made the following suggestions, as attached. Person responsible MT Enc 1 Enc 2 Enc 3 Enc 4 MW reported that meetings had been arranged with NTW and TEWV to plan for the Stoptober campaign. Page 3 of 11 Agenda Item 10 Subject Key Notes/Actions Date of Next Meeting towards the end of January, to include national speakers and evidence base. Post meeting, discussion took place regarding future dates of meetings; email to be circulated to coordinate availability. Target date Person responsible Page 4 of 11 Enc 1 U Healthy Lifestyles – Harm Reduction - Tobacco Task and Finish Group - Terms of Reference Chairperson: Chair: Suzanne Thompson Vice Chairperson: Frequency of Meetings: Admin: Vice Chair: Claire Sullivan The Group will meet at 6 week intervals at a venue in the Durham area. Overall Purpose: The task and finish group will be multi-disciplinary with representation from across Northern England and will involve patients and/or carers in the planning and review projects/issues. Key notes/action points to be taken. The aim of the group is to bring the health outcomes of people with mental ill health in line with those of the general population and reduce premature mortality. As smoking is the largest direct cause of avoidable death in the UK and smoking amongst people with mental illness remains high, we are focusing on a tobacco approach including tackling issues of culture and nicotine management, recovery based holistic approach, as our initial priority. The purpose of the group is to ensure that all patients with mental health (MH) problems in the region have access to appropriate smoking cessation and to work specifically with the MH Trusts to take forward action. Accountability: Membership: Chair and Vice Chair Minutes will be provided to the Task and Finish group • • • • • • • • • • • MH Clinical Lead for the Mental Health, Dementia and Neurological Conditions (MHDNC) Network Strategic Clinical Network (SCN) Public Health England Health Education North East MH Providers Local Authority Tobacco Commissioners (representatives) CCG Lead Patient/ Public representation FRESH NECS North Cumbria link The Chair has authority to co-opt other members on the Group or to invite others to attend specific meetings. Quorum: The quorum for the group’s meetings is a minimum of one-third of the total number of members plus one. Page 5 of 11 Enc 1 Specific Responsibilities: These relate to the harm reduction tobacco project and will be amended as appropriate depending on the topic. 1. To work with providers to address staff health as part of a culture change on tobacco. 2. To agree a nicotine management programme for MH patients to include: a. Nicotine management to be part of everyone’s business b. Levels of training for staff c. Clinical leads to raise nicotine management with all patients and to increase referral in to smoking cessation services d. Monitoring/evaluation of nicotine management in people with mental ill health e. Access to nicotine management to be readily available to staff and patients. Ownership of Group Projects and Initiatives: No member of the group will use the projects and initiatives of the group and the outputs there from solely for the commercial gain of their respective member company. The projects and initiatives of the group and the outputs there from will be owned jointly by each participating member of the group that has participated in the corresponding group project of initiative. Group members may make any use of the outputs from any group project or initiative with the prior written consent of all of the other group members owning that particular group output (as explained above). Communication Arrangements: 1. The group will: • Meet at 6 weekly intervals or as required to support specific projects • Provide regular reports to the group will provide regular reports to the MHDNC steering group • Provide regular reporting/feedback links for the physical health agenda, to include: i. Directors of Public Health, local authorities, Fresh, CQUIN groups aligned to physical health, Stop smoking groups, ie Trust, commissioners 2. It will be the responsibility of the MHDNC steering group to ensure that relevant issues are disseminated to the appropriate bodies 3. Members should provide at least 1 weeks notice for requests for items to be considered for inclusion on the agenda Declaration of Interest: The general principle is that all potential or perceived conflicts of interest should be declared. Version Control: Version 1 Date 8 September 2014 Purpose/ Comment Signed off at group meeting Page 6 of 11 Enc 2 Patient and Public Voice Request Name of Lead: Carol Mayes Tel: 011382 52971 Email: [email protected] Background As an initial work stream for mental health (MH), the Mental Health, Dementia and Neurological Conditions (MHDNC) Steering Group agreed to focus on Reducing Premature Mortality for People with Serious Mental Illness. A task and finish group has been established. The purpose of the group is to: 1. Bring the health outcomes of people with mental ill health in line with those of the general population and reduce premature mortality 2. To ensure the work of the group reflects national and local priorities of patients and carers and to ensure their involvement in development projects. As smoking is the largest direct cause of avoidable death in the UK and smoking amongst people with mental illness remains high, the group will focus on harm reduction for tobacco. Further work streams will be agreed in due course. The group will aim to ensure that all patients with MH problems have access to appropriate smoking cessation and to shift culture within acute MH trusts on tobacco. Role To provide a public and patient voice into the work of the group. This will include: • to champion the diversity of patient and public views (not to only represent their own experience). • to champion and advocate for increasing patient and public awareness of the programme outcomes and achievements. • to review programme plans and documentation. • to comply with the Standards of Conduct, and to respect the confidential nature of discussions when it is made clear by the Chair that this is a requirement. • to report back to the organisations to which they represent as well as Network & Senate. • to prepare for meetings by reading all pre-circulated papers and forwarding comments where necessary. • to ensure the views and experience of hard to reach groups are sought and represented. Skills and Experience • Experience of speaking in groups. • Able to represent the views and needs of patient, the public and carers. • Interacting with multiple stakeholders at various levels. • Ability to understand and evaluate a range of information and evidence. • Experience of working in partnership with healthcare organisations or programmes. • Can display sound judgement and an ability to be objective. • Able to listen and respect the views of others. Page 7 of 11 Enc 2 • • Have an awareness of, and commitment to, equality and diversity. Understand the need for confidentiality. Duration and Time Commitment • 6 months with review after that • Minimum term of 1 year preferred. Time Commitment Must be able to attend meetings during working hours and at different locations across the network areas. It is anticipated meetings will be held at 6 weekly intervals in the Newcastle area (Waterfront 4, Newburn) for approximately 1 and a half hours in the first six months (to begin in July 2014). Standards of conduct and conflict of interest All group members will be asked to subscribe to an agreed code of conduct and confidentiality agreement, and to declare any potential conflicts of interest. Support for Patient and Public Voice members • A named link will be provided. This person will be able to support Patient and Public Voice (PPV) members with background or context material that they may require. • If necessary pre-meeting briefings will be provided either by email, post or telephone call. • Meeting documents will be emailed and/or provided in an accessible form as requested by the PPV member. This will include printed versions and (if requested) A4 paper, postage stamps and envelopes for submitting written responses. • For individual patient/carer patient members – NHS England will reimburse out of pocket expenses and provide a named contact for expense claims to and discuss any queries that arise. Expenses usually cover travel and any accommodation or subsistence requirements that arise, but would also seek to address any barriers to participation, for example covering the costs of a carer that may need to accompany PPV representatives. Please get in touch with your named contact to discuss any support requirements that you might have. • Out of pocket expenses incurred as part of the work will be reimbursed in line with NHS England’s Patient and Public participation expenses policy. Version Control: Version Draft 0.1 Date 1 July 2014 Purpose/ Comment For discussion at next meeting Draft 0.2 11 August 2014 For sign off at next meeting Page 8 of 11 Enc 3 Page 9 of 11 Enc 4 STRATEGY IDEAS Board level support • All agreed that this was crucial to the success of achieving smoke free organisations • Group to provide support for board paper. Assessment against NICE • Meetings to be held with Northumberland, Tyne and Wear (NTW) and Tees and Esk Wear Valley (TEWV) to discuss this • Post meeting note – Jo Dark (JD) confirmed that North Cumbria (NC) will not be part of mapping exercise, support to be provided to NC if they can identify someone to undertake mapping Stoptober 14/15 • Martyn Willmore (MW) meeting with NTW, TEWV and 23red re resources • Emphasis on staff this year • Encourage everyone to get involved • To identify champions in Trusts initially with possible extension to champions in each unit/site • Screensavers • Need pathways in place • To link with work place health leads and Trade Union Communication re awards • To extend programme to patients Bank of research on what works • CM to update information and upload to website (link to be provided) • Dianne Woodall (DW) advised of previous work with Durham and Darlington Trust – plans in place to train stop smoking advisers but did not achieve results due to not having board level support, • Different systems used for recording smoking status which currently do not link up with GP practice systems. Links to MH Trusts complicated: o Durham, Darlington and Tees Local Authorities (LA) - use Quit Manager o Gateshead – bespoke package, exploring new system - possible link up with GP systems o NTW – variation across area. Newcastle, North Tyneside – use Quit Manager o Crucial that all staff receive training on recording systems to ensure that referrals and results can be monitored • JD to look at monitoring systems in NICE mapping • Need to identify monitoring metrics, ie how many people have received stop smoking services, length of time people remain ‘quit’ etc Training programme • CM advised of the NHS Yorkshire and Humber stop smoking on line service, offering very brief advice and brief advice - 20 minutes to complete. Confidence levels on talking to someone about their tobacco use rated at beginning and end of on line training Page 10 of 11 Enc 4 • • • • National centre for smoking cessation training (NCSCT) – on-line and special modules for mental health County Durham – 2 day course followed by level of NCSCT before they can provide training Tiered training – very brief advice (everyone should do); further training for specialist advisors, physical health link nurses To also take into account weight management and alcohol physical health leads and link nurses Tools to be part of practice • DW reported on an effective package developed for primary care – DW to get further information and bring back to group • Return on investment tools, to include sickness levels, medications etc What’s the baseline? • JD to look at what is being collected as part of NICE mapping, ie do they record staff/patient smoking service, CQUIN • JD to distribute anonymised secondary care report previously undertaken and measured against the NICE guidance How are we going to measure? • Culture of organisation, eg number of smoking shelters – how can we measure this? Service users/champions • Representative from North East Together • Stop smoking champions for future event • Trust board members attending induction days to promote healthy behaviour and endorse culture Keep up to date with polices • E-cigarettes forum – currently for LA but will be extended to include NHS Clear pathways • To create and embed Page 11 of 11