Approved Minutes of Upper GI/HPB Regional Group Meeting
Wednesday 9th January, 2008 NICaN
NICaN Upper GI/HPB Regional Group Meeting
Wednesday 9th January, 2008
9.30am – 12.30pm
Park Plaza Hotel, Belfast International Airport
Record of Attendees
Ms Sally Campalini / Dr Michael MitchellDr Graeme Crawford / Mr John Moorehead
Ms Joanne Cullen / Dr Neil McDougall
Dr Gerard Daly / Mr Jim McGuigan
Ms Eileen Deery / Mr Lloyd McKie
Dr Martin Eatock / Mr Damian McManus
Mr Manos Epanomeritakis / Ms Lisa McWilliams
Ms Norma Evans (Chair) / Mr Myles Nelson
Ms Julie Hanna / Mr Tony Tham
Ms Liz Henderson / Ms Bridget Tourish
Dr Sheila Kelly / Mr Chris Thomas
Mr Eamon Mackle / Ms Sarah Williamson
Mr Inder Mainie
Apologies: Ms Clare McGartland; Mr Essam Ghareeb; Dr John Watson; Mr Andrew Kennedy; Ms Mary Waddell; Mr Declan Carey; Ms Janis McCulla; Mr Abraham Varghesse; Mr Gary Spence; Dr Colin Rogers; Mr Kourash Khosraviani; Ms Sarah Liddle; Mr Barry Clements; Ms Alison Porter; Ms Sarah Jayne Faloon; Ms Lorna Nevin and Mr Roy McMullan.
Welcome and Introductions
Ms Norma Evans welcomed everyone to the meeting, introductions were made and apologies noted as recorded above.
Ms Evans introduced herself as Chair of NICaN Board and Chair for the Upper GI/HPB regional group. Ms Evans stated her confidence in the ability of the cancer network to deliver on its work programme.
Mr Moorehead raised the issue of potential confusion and conflict between the Service Delivery Unit (SDU) and NICaN. Ms Evans clarified that there were clear roles for both, with SDU focusing on targets and performance management, whilst the networks role was around harnessing clinician, patient, commissioner (etc) expertise in developing equitable standards and evidence based pathways of care. The network also had a monitoring function in the form of audit and potential peer review.
Ms Henderson advised that Mr Hugh Mullan is now a member of the Network Board and thus this should provide a means towards alignment of agendas.
OEG_0708_A26 Minutes and Matters Arising from Meeting, 18/9/07
The minutes of the meeting held on 18th September were agreed as accurate without amendment.
Regionally agreed Care Pathway
The requirement for a regionally agreed care pathway to ensure equity for patients was highlighted to the group. Ms Henderson discussed the process noting that the overall aim is development of a high level pathway, with protocols and guidelines elaborating at relevant points.
It was noted that Mr McDougall, Mr Kennedy and Mr McKie have already local pathways developed.
Action: Mr McDougall, Mr Kennedy and Mr McKie to present these at a meeting with core members and work towards agreement of regionally agreed pathways for Upper GI/HPB Cancers.
OEG_0708_A27 Selection of Clinical Lead
Ms Evans advised the group that the selection of Clinical Lead had been discussed with the NICaN Board, and a revote determined and hence the process of a revote had been initiated prior to the meeting.
Mr McGuigan challenged thinking as to this decision and why it was decided that the proposal of Mr McGuigan and Mr Kennedy providing joint leadership was not accepted.
It was noted that there was no contingency for a ‘joint vote’ and thus a decision was taken to revote on this basis.
Ms Evans reiterated the need for agreement on a Clinical Lead and if no agreement can be reached, she would make the decision in order to enable the various areas of work to be progressed.
Ms Evans reminded the group of the process thus far and noted that some core members had advised a nomination prior to the meeting and that an opportunity would be afforded at the meeting for remaining core members to nominate.
The group agreed that following nominations being received, core members should be asked to vote on their preferred Clinical Lead from the nominations received.
Action: Ms Evans to send out e-mail asking for Core Members to vote on the nominations received and responses should be received within 1 week.
It was agreed that if there is a ‘joint tie’, Ms Evans will decide who the Clinical Lead will be.
Once a Clinical Lead has been identified, the group will be advised of the outcome via e-mail.
OEG_0708_A28 Diagnostic Protocol
Dr Daly reminded the group of the process of consultation for the diagnostic protocol and the confusion caused. Ms Tourish reminded the group of the document history of the protocol and highlighted that confusion had arisen when a different version of the protocol had been circulated via the Inter Trust Transfer Group.
Dr Daly proposed that an amended protocol be circulated to the following representatives for wide consultation:
· Mr Tony Tham (Ulster Hospital)
· Dr Michael Mitchell (Belfast City Hospital)
· Mr Andrew Kennedy (Royal Hospitals)
· Mr Manos Epanomeritakis’ (Craigavon Area Hospital)
· Mr Lloyd McKie (Mater Hospital)
· Mr William Dickey (Altnagelvin Area Hospital)
· Dr Colin Rogers (Antrim Area Hospital)
Action: The following key action points were noted.
· Amended protocol to be circulated to the above named for consultation requesting comments to be returned within a 1 week period.
· Sarah Williamson to include the protocol on agenda for discussion at Inter-Trust transfer meeting.
· Agreed protocol to be issued to the Service Delivery Unit (SDU) by Chair and Clinical Lead of Upper GI/HPB group.
· Agreed protocol to be copied to Lead Cancer teams; MDMs; and to Executive Leads for cancer for circulation within the trust.
OEG_0708_A29 Framework Standards for Upper GI/HPB Cancers
Dr Daly led discussions in relation to the development of standards for Upper GI/HPB cancers for inclusion in the Cancer Services Framework. He gave a short presentation detailing the background for development of the Framework and the requirements to meet a finalisation date of 31st March 2008.
Dr Daly reminded the group of discussions at the meeting in September where the group had considered what are the key standards which would make a difference to the Upper GI/HPB service. The need to consider this question from the patient and professional perspective was highlighted and reference made to working towards the aim of achieving an integrated service and what informs this need i.e. audit reports, Improving Outcomes Guidance etc.
The two areas for consideration in developing the Upper GI /HPB standards were agreed as:
§ effective multi-disciplinary team working and
§ the provision of a 24/7/52 service
Ms Evans highlighted to the group that there were concerns following the results of the Cancer Registry report and much discussion followed in relation to the challenges and requirements of a 24/7/52 service provision.
Sub-group to develop standards
The following were agreed as sub-group members to work alongside Mr Jim McGuigan and Mr Andrew Kennedy (Lead Authors) in the progression of this work.
· Mr Lloyd McKie
· Dr Neill McDougall
· Mr John Moorehead
It was noted that Ms Tourish will provide support to this group.
It was agreed that wide consultation should take place in the development of the standards and consideration be given to a cross reference to other generic standards e.g. supportive and palliative care.
Action: Ms Tourish to arrange a meeting of the above sub-group to progress this work.
Meeting Close
Ms Evans closed the meeting by thanking all those in attendance for their contributions and advising the group that key action points from the meeting will be circulated from NICaN as soon as possible.
Dates for future meetings
Dates to be confirmed.
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