NICaN Nursing Network
Clinical Nurse Specialist Forum
9th June 2009
Present:Anne Treanor (Breast) ST
Joanne Oakburn (Haematology) SET
Cherith Semple (Head & Neck) SET
Sheena Stothers (Complex Skin) SET
Mandy Bradley (Palliative Care) WT (Alt)
Roisin Mackle (Early Skin) SET
Iona McCormack (Dermatology) BT (BCH)
Elaine Heaney (Breast) NT (Antrim)
Marguerite Greenhill (Colo-rectal) BT (RGH)
Fidelma O Connor (Community) BT (NW Belfast)
Jenny Kelly (Urology) BT (BCH)
Jennifer Knox (Bone & Soft Tissue Sarcoma) BT (MPH)
Eilish McColgan (Gynae) BT (BCH)
Anne Robinson (Lung) BT (RGH)
Susan Piggott (Haematology BMT) BT (BCH)
Ruth Thompson (Haematology) BT (BCH)
Jackie Quinn (Haematology ) BT (BCH)
Edel Aughey (Oncology NP) BT and WT / Apologies:
Jenny McMahon
Louise Gribben
Joanne Ogborn
Sylvia Cole
Debra Butler
Caroline McCaughey
Wilma Boyd Carson
Sally Campalani
Medb Bradley
Julie Hanna
Item number / Summary of key points / outcomes/ action / Identified Party & date
CNSF_0609_01
CNSF_0609_02
CNSF_0609_03
CNSF_0609_03
CNSF_0609_04
CNSF_0609_05
CNSF_0609_06 / Minutes of planning meeting
The minutes of the planning meeting were agreed as a true record.
Remit of CNS Forum
This was discussed at the planning meeting and Liz Henderson had summarised the discussion into a Terms of Reference (tabled). This was discussed and agreed.
With regards to the chair of the meeting, Liz asked if someone would co-chair with her – which would enable planning for the meeting, provide a steer as to where it should go and help ensure an appropriate focus. Those interested to email Liz by 8th July (If more than one Liz will discuss with nominees)
Liz to get copy of forum remit on
Members roles and responsibilities
All present agreed that for now the group should be an open one, with representations from across NI, and each of the cancer sites (rather than restricted to core members). To be kept under review.
Members were responsible for bringing issues of relevance to the group, communicating outwards the discussions arising from within the group, and contributing to the work programme of the group.
Holistic Assessment Tool
Ruth Thompson and Anne Robinson reported back on the work programme of the group which had been formed following the last CNS meeting.
Minutes of the HAT group to be forwarded to CNS Forum members, along with a copy of the holistic assessment tool.
All CNS agreed that it would be very beneficial for holistic assessment to be linked to CAPPS. This would enable comparison and communication.
Register of CNS
Jenny Kelly and Fidelma OConnor reported back on this workstream. They had engaged with Danny Sinclair from NICaN team, who had set up a spread sheet to collate the CNS data.
Following much discussion, it was agreed that the information was for professional use only. It will be held on the NICaN web site but be password protected. To keep this process as simple as possible it was agreed to begin by collating in the names and contact details of site specific CNS, and to use existing networks to do this.
The following CNS agreed to act as conduits to disseminate to their respective networks
Breast: Elaine
Colorectal: Marguerite
Gynae: Eilish
Urology: Jenny
Skin: Iona
N&N Cherith
Haematology: Ruth T
Sarcome: Jennifer
Palliative Care: Mandy
Anne & marguerite will share with colleagues for Oesophageal and Neurology
Implications of the Cancer Service Framework
Liz had circulated the template which summarised discussions between the lead cancer nurses with regards to implications for service, for workforce and for education.
It was agreed that the work programme of the CNS forum should align to standards within the CSF (which would ensure strategic fit)
A meeting with key stakeholders is being planned for October 09.
New Models of follow up
This is one of the key standards of relevance to CNS within the CSF. A three pronged model is advocated – a consultant led follow up for complex cases, a nurse led collaborative follow up for those requiring chronic disease management, and a health and well being assessment and intervention at the end of treatment to support individuals to move from sickness mode to return to living mode.
Whist this is on each tumour groups work programme for this year, it will require significant CNS input, influence and coordination.
Members who undertook nurse led follow up were invite to give a brief resume of their clinics.
Edel outlined her outreach oncology review clinics in Enniskillen and Omagh. She stressed the need for holistic assessment, communication within the medical team and clearly developed protocols to enable diagnostic requests etc.
Iona outlined her dermatology nurse led clinic which spans the patient pathway from assessment, diagnosis, surgery, to follow up. She emphasised the role in education, prediction and prevention. Protocols drawn from the British Society of Dermatology proved a useful resource (clear evidence base)
Elaine reported on her breast surgery nurse led follow up involving clinical examination and ordering mammograms.
Jackie & Ruth undertake nurse led clinics within haematology endorsing the necessity for protocols, local and national guidelines.
Jenny carries out nurse led clinics for urology patients, and suggested that when developing business cases it was important to align same within the modernisation frame – quoting how it will help targets. Liz emphasised the need for political astuteness when seeking to develop practice.
Iona suggested that separate clinics with clinical codes and secretarial support was essential, as otherwise the nurse led work remained invisible (being credited to medical consultant workloads)
Liz mentioned the recent Macmillan Study Day and the excellent presentation given by their medical director Dr Jane Maher which looked at the need for new models of follow up, moving from sickness to health and well being frame of reference. The current models were not effective in meeting patient need (being further evidenced through work ongoing in relation to late effects)
All nurse led developments in this front would need to be subjected to a cost benefits exercise, and include patient experience feedback.
It was agreed that a working group would produce a brief paper pulling together the Benefits, challenges and potential pitfalls in establishing nurse led clinics
(based on current practice).
The group will share draft one of the paper with all group members for comment and suggested amendments
Cherith and Eilish suggested that it would be useful if each of the CNS explored alternative models of follow up from within their specific area of practice.
Liz mentioned that Moyra Mills in QUB was interested in a research study evaluating where we are currently at in NI in relation to review.
Cherith suggested inviting her to the next meeting
Meeting evaluation
Is this forum meeting your needs?
Iona: Its an excellent opportunity for networking and getting business done
Roisin: Its very supportive especially for folks like me in a new CNS role – there are shared learning opportunities
Joanne and Jennifer agreed with Roisin
Fidelma: its raises our awareness of the need to be politically astute, we can develop a shared focus and direction
Liz: I don’t want it to become simply a talking shop, it need products, and evidence of influencing change, bringing about development. We will continue to evaluate our effectiveness.
Cherith: It needs to be outcomes led, have clear agenda items or work programme with clear timeframes. Its important to have the link (through Liz) to strategic meetings with key stakeholders, that way there is a real opportunity for us to influence change
One suggestion made was to consider a combined NICaN Nursing Conference next year to share good practice and report on progress.
Members were encouraged to consider joining UKONS (UK oncology nursing society), as this not only affords national networking, but helps shape the cancer nursing agenda.
Date and time of next meeting:
2pm, 16th September 2009
Venue: Seminar Room 3 Cancer Centre, BCH / Interested CNS
Liz Henderson
Liz Henderson
Elaine
Marguerite
Eilish
Jenny
Iona
Cherith
Ruth
Jennifer
Mandy
Marguerite
Anne
Edel
Jackie
Iona
Elaine
Liz
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