LOTHIAN RESPIRATORY MCN

CORE GROUP

Minutes of the meeting of Wednesday, 18 September 2013, 2.00pm to 3.30pm, SR4 Chancellors Building RIE

Present

Dr Ninian Hewitt / GP and Lead Clinician, Respiratory MCN (chair)
Ms Shena Brown / Respiratory Care Facilitator, WL CHCP
Ms Laura Groom / Clinical Specialist Physiotherapist, Community Respiratory Team (for Ms Lindsay)
Ms Grace Hynd / Clinical Nurse Manager, Respiratory (part meeting)
Ms Katie Johnston / Primary Care Pharmacist, Edinburgh LHP
Ms Alyson Malone / Strategic Programme Manager, NHS Lothian
Apologies
Ms Gillian Cunningham / Service Manager, CTR
Professor Harry Campbell / Professor of Genetic Epidemiology and Public Health, UofE
Professor Andrew Greening / Respiratory Consultant , WGH
Ms Angela Lindsay / AHP Manager, Edinburgh CHP
Mrs Lyn McDonald / Director of Operations, Medical and Clinical Services
Professor William MacNee / Respiratory Consultant, RIE
Ms Anne Ovens / Chief Nurse, RIE
ACTION
1. / Introduction and apologies for absence
Dr Hewitt thanked everyone for attending and apologies were received as above.
2. / Minutes of the previous meeting – 14 May 2013
The minutes of the previous meeting were approved
3. / Matters arising from previous meetings
3.1 Jane Dalrymple
Jane has been seconded and has now got a new post starting in November as assistant programme manager working with Alyson Malone and Rhona (LD)
Gillian Cunnigham
Gillian has a new job for delivery of medicine in RIE and Liberton Hospitals. She will remain involved in the E and P work but Kim Dickson should be approached to replace her in the MCN
3.2 Bronchiectasis patient website
It was noted that work on developing the website was progressing.
JD is still involved in the final design stage. The site will be hosted on NHS Inform / SHOW. This will maintain ability to update and keep functionality while keeping control of the content.
Bronchiectasis SMP work has stalled but is restarting and an new SMP should be available later in the year. / NH
4. / COPD efficiency and productivity workstream update
There have been two meetings in July and August dealing with IP and OPD. The Lean action list is being used as the basic template. An action plan/ list is being constructed and used to progress work.
Invest to Save
This project is moving rapidly. The KPI are in place
Psychology meeting to define input is next week . Interviews for the psychologist post are also next week
( Feedback subsequently; objectives and practical plans agreed and new post filled but name not yet official)
Front of House
GH reports that 2 nurses now involved. Elspeth Christie has joined and is supported through winter funding.
Lisa Carter has identified patients who attend frequently and emergency drugs are being prescribed along with a care bundle. The care bundle is included with discharge procedures from the wards
The Efficiency and Productivity and Invest to Save groups have a joint steering group chaired by the MCN
Progress is good and the model of care is beginning to work.
5. / Update on pulmonary rehabilitation business case
The E and P group met and have approved an investment of £420k for core funding of PR (18th Sept).
This will allow a staff rise from 8.5 staff to 14 wte.
The costings are based on median point salary scale plus 2.
The bid includes time for a manager and A&C support.
There are plans for PR and CRT to work closely together.
The bid includes 3 telehealth posts, one for each CHP area.
All CHP teams will be skill mixed and related to population.
Although professional posts have to be named for the bid the actual skill mix will be tailored to the CHP needs.
Meetings are set up in October to start discussion on how the service will be hosted. E&M and WL happy for Edinburgh to be host. All heads of CHP, clinical and Management have been supportive.
The main benefits will be to WL and E&M. (E&M at a standstill just now as staff have left.)
Susan Goldsmith will now take decision to her Finance committee.
Hopefully the new service may start in January 2014.
SB can inform Marion Christie.
A PR database needs finalising NH is in discussion with JD on getting this work completed. Discussion whether JD can finish the changes or whether we need some outside help.
6. / Asthma Priorities
The NAG has agreed a self assessment template for use by MCNs titled Asthma Priorities. This consists of 8 sections and 54 subsections. An initial attempt at completing the form has been submitted. Lothian needs to prioritise those areas that will give best impact . Agreed that these should include Guidelines / Blue Bay module / SMP / Referral advice (refhelp) / Tagging severe / difficult asthma patients. Not done in GP just now but there is a need to address the risk.
Asthma Death work nearing completion Two files form Lothian causing difficulty out of total 6 problem files in Scotland. TB is working on this. About 40 deaths have been notified in Scotland.
Difficult asthma has stalled but should become a viable project again in 2014 after changes in personnel. The WoS diffcult asthma work has been sent to key consultants in the meatime and they are happy that their work can be used by Lothian.
Occupational Asthma is being dealt with at National level by the NAG. / NH
7. / Core group members
Agreed after canvassing present members and those who are leaving or retiring
NH; AM; SB (WL); LG (city); HC (Public Health); GC/ Kim Dickson management; and GH nursing; NH (RIE) PR (WGH) DN (SJH); Plus rep from RNS KB (WL) DR(WGH) Gillian Sidey(RIE) ; KJ prescribing/ Jen Scott; prof WMcN; AL management PR and CRT Edinburgh;
Include Pat McIntosh / LMcD / Anne Ovens for minutes
Contact ML Hamish Reid and EL Jon Turvill / NH
8. / Nebuliser Guide
A national guide including patient information is being written by NH for the Resp NAG. First drafts have been returned and a draft will be presented to the next NAG meeting. / NH
9. / Learnpro spirometry module
This project is now in the final stages. All video work has been done. This includes good and poor practice examples. All exam content and informational content has been submitted.
All the information is now with Learnpro
4 modules have been developed; Basics; Performing ; Interpreting; calibration and instrument maintenance.
The moduels are aimed at GP and PN but will be made vailable nationally and to other prof groups.
Launch date ? Jan 2014 / NH
10 / Digital postcard
This project led in Lothian by LG, is part of the ‘Living it up’ project.
Filming is now completed and the results are being edited.
The aim is to use this at the point of diagnosis. It could be linked to Blue Bay.
Available for community and Hospitals. Content also include patient voices ; expert patients and patient involvement workers. / LG/NH
11 / Oxygen advice for Lothian GP
NH has contacted the LMC and agreed that a local guide is needed, to supplement the national guide.
Agreed O2 essential for GP as it is part of the BNF advice.
Advice will include how to get supplies and tubing and use O2 safely.
Use of high and low flow oxygen.
LMC will consider guide in draft form in October / November / NH
12 / AOCB
There is a need to tag DNAs in GP and target for prescribing. This can occur by stopping prescriptions till assessment/ review done. This will help prescribing initiatives.
Medicines management needs to be emphasised esp
inhaler technique;
Noted that Flutiform is on the formulary
Seretide 250 not licensed for COPD only accuhaler 500
Poster for all inhalers from Glasgow work / NH / KJ
Dr Phil Reid has been seconded to SJH He should be approached in place of Dr Noble
9 / Date and time of next meetings
The next meeting of the group will be held on Wednesday 23RD October 2013, 2.00pm to 3.30pm, SR6, Chancellor’s Building, RIE

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