Minutes of the Council meeting held on Wednesday 20 January 2016 at Ormond House, 27 Boswell Street, London WC1N 3JZ

Present: Phil Smith (President, Chair), Mary Reilly (President Elect), Jacqueline Palace, William Gibb, Trevor Pickersgill (Honorary Treasurer), Joanne Lawrence (Executive Director), Paul Worth, Tom Hughes (SAC representative), Wojtek Rakowicz, John Paul Leach, Ralph Gregory (Chair SSC), Kevin Talbot (Honorary Secretary), Geraint Fuller (Immediate Past President), David Burn (Honorary Assistant Secretary), Richard Davenport (Chair TEC), Huw Morris (Chair CRAC), Alasdair Coles, Alexander Foulkes (Chair, ABNT), Andrew Goddard (Registrar, RCP), from 11.30 - Stanley Fink (Lay trustee), Elisabeth Baltay (Lay trustee).

  1. Apologies for absence. There were no apologies for absence. Phil Smith (PS) welcomed all council members. Mary Reilly (MR) asked if council members to receive Exec telecon minutes weekly.

Action: JL to organise.

  1. Matters arising: Minutes of the Council Meeting 9.09.15 were accepted as an accurate account of the meeting with the following notes.

Item 4.6 AAG nominations to guidelines committee have been made.

Action: Kevin Talbot (KT) to update Paul Worth (PW) offline.

Item 4.5: Irish connection. MR had approached the Irish Neurological association, they were keen to work more closely but no specific actions to date.

Item 8: Justgiving.

Action: JL to set up. Had been delayed pending fundraising consultancy report.

  1. Standing Items
  2. SSC minutes: 5 vacancies for SSC regional representatives. Standard Operating Procedure (SOP) OP required for SSC members’information, including a list of regional representatives’ obligations. It was noted that the SSC had a role to play in finding new council and advisory group (AAG) members.
  1. Services and Standards Committee
  2. Acute Neurology Survey to be completed by AGM. Review of consultants has identified up to 100 UK consultants who are not ABN members. These will be contacted with the survey, also a good opportunity to advertise the benefits of ABN membership. It was suggested that the survey should also be sent out via Special Interest Groups (SIGs).
  3. Commissioning Toolkit: 1st draft prepared in 2014.

Action: Council to review latest iteration and feedback to RG by 25 January Executive telecon.

4.3.Public Accounts Commmittee: Geraint Fuller (GF) represented ABN in a prepanel of 3 with Arlene Wilkie, Neurological Alliance, and Paul Morrish, Neurology Intelligence Network. During the main panel it was made clear that the role of National Clinical Director (NCD) was unlikely to continue. PS subsequently wrote to Bruce Keogh, NHSE Medical Director, expressing ABN concern at the change.

4.4.ARC minutes: ARC chaired by Nick Silver. M&M template discussed. Wojtek Rakowicz noted its current importance within NHSE. Kevin Talbot, acknowledged as good document but queried whether ABN has national remit in this instance. Most trusts have their own documents however MR suggested there may be a role in collating information, possibly via the acute neurology survey, 'how many hospitals have M&M process?'

4.5.RG suggested a summary of NS document to be placed on ABN website.

Action: RG to liaise with NS.

  1. Training and Education Committee
  2. David Nicholls has accepted the role of TEC deputy chair.
  3. There is a new East of England representative, Josef Alawneh.
  4. Undergraduate prize had a record 72 entries (previous year's less than 20). It was noted that scorers found some difficulties in determining the extent to which the undergraduates contributed to the studies discussed. MR recommended that the entry form should request information about the amount of time/input contributed by student, countersigned by their supervisor.

Action: RJD/JL to amend entry form.

5.4.Australasian fellowship: some issues with recruitment in 2015.

Action: Tom Hughes will send to Training Programme Directors and via SAC network.

5.5.MR suggested that current LATs issue could act as a deterrent to taking time out of programme. It was suggested that the 2016 programme should continue as arranged and subsequent years should have at least one fellow. Alasdair Coles suggested developing a reciprocal arrangement

5.6.Self assessment questions: AAGs have agreed to provide questions.

5.7.Shape of Training: Andrew Goddard (AG) advised that, although responses still awaited from all 4 nations it looked like HEE would probably agree a 3 years plus 4 years programme. There is still support for a national exam. Tom Hughes identified issues:

1:Locum Appointments for Training (LATs) and out of programme. Training Programme Directors’ (TPDs) biggest problem is maintaining the programme of training.

2:rewriting the curriculum to accommodate 3 years of medicine and 4 of specialty.

3:recruitment twice each year.

GF suggested that the LATs should be brought into the public domain. AG noted that the out of programme issues relating to maternity leave had evinced no sympathy from the Medical Director of HEE (Wendy Reid). However 60% of neurology LATs were in a substantive post one year later. Neurosurgery LATs did not follow this trend.

70% of neurology trainees go out of programme to do research - higher proportion than most other specialties. Andrew Goddard noted that there is a mismatch between the number of people in training and consultants needed.

PS proposed to raise with representatives of other specialties at RCP council. AG due to attend meeting at House Of Commons and agreed to mention to MPs. Tom Hughes commented that, whilst surgical LATs being in post for up to 6 years might not be ideal, a one year neurology LAT was reasonable.

Action: One page briefing to be prepared for Stanley Fink to take to the House Of Lords.

  1. Clinical Research and Academic Committee
  2. Martin Turner has agreed to take on role of deputy chair.
  3. Fellowship: 5 appointed in 2015. 19 have applied in 2016, the highest number so far and interview date set for 23 March. Two issues:
  • application received from non-neurologist.
  • 2 applicants already have funding in place through WCAT scheme.

Agreed that terms and conditions to be made more clear for 2017, in particular that the fellowships are targeted at neurologists wishing to conduct research.

PS thanked Huw Morris for his work in making the ABN fellowship a success.

  1. ABN Trainees committee
  2. Tim Yates is new ABNT representative on TEC
  3. Alexander Foulkes (AF) reported concern regarding new JRCPTB criterion for ST3 applications requiring CMT sign-off more recently than 1st January 2013, ie excludes anyone doing a 4-year PhD. Anyone failing to meet this will be required to get core CMT competencies, including central lines, ascitic drains, etc, signed off a second time via a convoluted “alternative pathway” (attached document). AF has forwarded to Tom Hughes, as SAC chair, to clarify with JRCPTB. A check with ABNT members resulted in 10 immediate responses from people affected by the changes in 2016 (PhD, maternity leave, LATs all risks). GF noted that this was a matter of urgency and a topic for RCP council the following week. AG asked how many people were affected in the current round. AF estimated about 15. AG noted that AF’s points were very valid and that he would take back to RCP to find a way forward.
  4. Research Initiative. Three of the six junior doctors who were keen to pilot have been matched to supervisors. They have been encouraged to submit abstracts for the ABN Annual Meeting.
  5. E-learning. All topics allocated. Two now online and a further two are finished and being formatted for uploading. Thirteen more have been peer-reviewed and returned to the authors for final edits and re-submission.
  6. ACNR. E-learning article in Sept-Oct edition. Articles planned on social media, job-planning and stroke.
  7. Twitter. Over 800 followers. Research updates, NeuroGems, course/job notifications.
  1. Meetings Committee
  2. Brighton: Full programme of speakers now confirmed
  3. London 2016: neurology study day for students to be scheduled the day before main autumn meeting.
  4. EAN and WFN: EAN and WFN both planning future international congresses and asking for indication of ABN interest for 2019 and beyond. ABN keen to be involved but agreement needs to ensure that the ABN does not suffer financially in the process.
  1. Honorary Secretary
  2. Advisory Groups: Meeting of AAG chairs held 19 Jan 2016. Good attendance and engagement.
  3. Reviewed the roles of AAGs and management of consultations. AAGs agreed to help prepare questions for self assessment exercise and will contribute to guideline development.
  4. Alasdair Coles (Chair MS and Neuiroinflammation AAG) had suggested an open meeting for pharmaceutical medical directors, possibly at Annual Meeting with objectives of discussing pre-commercial issues and facilitating and open discussion re guidelines.

Stanley Fink (SF) expressed concern that structure of meeting would require presence of a competition lawyer. Elisabeth Baltay (EB) noted that individual companies might not want to attend an open meeting and that invitations to meeting might usefully include a set of basic rules confirming that there would be no request for information in specific drugs, no agreements, no pricing discussion, just an exchange of ideas.

9.2.Rule changes: KT presented proposal to modify ABN rules, addressing issues including the difficulty in recruiting sub committee chairs from a pool limited to sub committee members. It was agreed that a proposal should be put before the AGM to allow chairs to be recruited from outside of existing committee members. The newly appointed chair would serve a term as ‘chair elect’ before taking over as Chair. Also that the reference to ‘he’ throughout the rules should be modified to ‘he/she’.

9.3.Risk register: presented and approved.

9.4.Elections: nominations for Honorary Secretary and 2 council places close at the end of January.

Action: JL to contact previous candidates to encourage them to stand again.

  1. Honorary Treasurer
  2. Presented draft 2015 accounts with caveat that significant work still required as part of year end procedures.
  3. Practical Neurology: Profit share estimate indicated that £15,000 payment would accrue to ABN. ABN representative on the Practical Neurology management committee has requested increased proportion of profits to be allocated to the ABN. % of JNNP bundle will increase to 7 % in 2016 and BMJ is considering a retrospective payment for 2015 in 2016.
  4. Fellowships: good meeting of fundraising committee 19 January. Fundraising strategy report presented by consultant, funded by Patrick Berthoud Charitable Trust. A key recommendation of the report was that ABN invest in professional fundraising support. Council agreed to £50,000 for initial year fundraising support with objective of raising £250,000. SF offered to underwrite £20,000 of the total. PS thanked SF for his generous support of the fellowship.
  5. External courses: ABN had been asked by ABNT representative if the ABN would fund attendance at external courses which would support work undertaken on behalf of ABNT. Council noted that funding was appropriate if ABN had requested the member to attend the course on its behalf but not otherwise.
  6. Staff salaries: JL left the room whilst 2016 staff salaries were discussed.
  1. Items for Discussion
  2. ABN Strategy – development: progress against the 2013 ABN strategy document was reviewed and approved.
  3. Practical Neurology: BMJ typically conducts reader surveys. Practical Neurology survey to be forwarded to all ABN Ordinary and Associate members.
  4. International relations:
  5. Mary Reilly reported on formation of International committee. Membership consists of President Elect, Honorary Secretary, Honorary Assistant Secretary, Honorary Treasurer.
  6. ABN currently awards up to 5 international travel bursaries of £1000 each per annum. Council agreed that management of bursaries should be tightened up. Agreements with other national and international organisations should have a time limit of 2-3 years. Stanley Fink noted that government and charitable funding might be available for some international interactions.
  7. Sri Lanka: agreed to continue support for 3 more years. 3 members would attend 10th anniversary in 2016, 2 members thereafter.
  8. Honours update: process is now in place for nominating and supporting nominations for honours.
  9. Any Other Business: It was agreed that council papers would no longer be distributed in paper format ahead of the meeting.