London Adult Critical Care Operational Delivery Networks

North East and North Central London Adult Critical Care ODN Clinical Oversight Group Meeting

Minutes of Meeting 15th March 2017

Chair: Marie Healy

Minutes: Rose Tobin

Present / Role / Organisation
Chris Hill / (CH) / NENC Nursing Lead / NENC ODN
Nick Macartney / (NM) / Clinical Director ICU / Royal Free London NHS Foundation Trust
Olivera Nikolic / (ON) / Senior Data Analyst/Administrator / NENC ODN
Rose Tobin / (RT) / NENC ODN manager / NENC ODN
Jeremy Cordingley / (JC) / Consultant / BARTS Hospital
Ugan Reddy / (UR) / Consultant ICU / Queens Square Hospital
Simon IIlott / (SI) / ICU Consultant / Whipp’s Cross Hospital
Heather Byers / (HB) / Senior Nurse / BARTS Health
Joao Bastos Da Fonseca / (JF) / Clinical Educator / The London Clinic
John Goldstone / (JG) / Clinical Director / The London Clinic
Afonso Varela / (AV) / Lead Nurse / The London clinic
Keira Tubridy / (KT) / Service Manager RLH Critical care / Royal London Hospital
Helen Hewitt / (HH) / Matron Adult Critical Care Unit / Royal London Hospital
Bryan O’Farrell / (BOF) / Senior Pharmacist / Royal Free London
Marie Healy / (MH) / Clinical Director / Barts Health
Beverly Thomas / (BT) / Matron ICU / Queen’s Hospital Romford
Sarah Turle / (ST) / Consultant ICU / Royal Free London
Apologies
James Napier / Clinical Lead Newham / Barts Health
David Howell / Clinical Director ICU / UCLH
Ashok S Raj / Consultant ICU / Whipp’s cross
Banwari Agarwal / NENC London ACC Medical Lead / Royal Free London NHS Foundation Trust
Rob Shulman / Head of Pharmacy / UCLH
Meena Patel / Acting General Manager CCU / UCLH
Prabhahar Thaventhran / Consultant CCU / North Middlesex Hospital
Louise Ma / Post CCT fellow / UCLH
Andrew Badacsonyi / Consultant in Anaesthesia and Intensive Care Medicine / Whittington Hospital
Peter Shirley / Lead Consultant ICU / Royal London Hospital
Victoria Jones / Physiotherapist / Homerton Hospital
Mike Potter / Lead Nurse ICU / Homerton Hospital
Ferenc Kovari / Consultant ICU / North Middlesex Hospital
Abdul Nazar / Lead Consultant ICU / Whipp’s Cross Hospital
Tomas Jovaisa / Clinical lead and Consultant in Intensive Care / Queens Hospital Romford
Jo Carter / Clinical Educator / Whipps Cross Hospital
Susan Jain / Consultant CCU / Homerton Hospital
Jane Woollard / Head Nurse for Emergency and Urgent Care / Royal Free Hospital
Anthony Bastin / Consultant ICU / Barts Hospital
Lorna Donegan / Lead ODN / NHS England
Minutes of the last meeting and matters arising.
Actions from previous meeting;
Funding is now confirmed from NHS England for 2017/18.The letter confirming this will hopefully go to the Network, before the end of March. Any underspend will be carried over into the next financial year.
Actions from this meeting
Agenda Items;
Learning from Serious Incidents
Two serious incidents were presented by Royal London Hospital team.
These will be circulated to the network.
DOLS (Deprivation of Liberty) update
Outcome of the consultation is that there is now a reduced need in adult CCU’s to apply DoLs. There need to be discussions locally on how to implement this change. Paper to be re circulated.
Zero Organ support days
Jeremy Cordingley updated the group regarding a discussion at NHS England steering group meeting. The Clinical Commissioning Groups (CCG’s) were concerned where zero organ support was recorded throughout the patient stay on ITU. The CCG plan is to pay the high rate bed days only for the 1st calendar day. This is yet to be finalised as there may be extenuating circumstances, and a list of exclusions to be discussed. There are ongoing discussions with commissioners.
Regulation 28
MH highlighted the outcome of the response of the coroner’s report on managing patients who need neurosurgery and the need to immediately transfer patients irrespective of the CCU bed situation.
7 day NHS service
Dr Susan La Brooy who is the seven day working service lead in North west London CCG gave an update on the progress against the 4 priority standards that all trusts had been asked to self-assess on. Paper to be circulated.
Senso App
Dr John Goldstone presented an app and video on a tool that can be used for patient’s rehabilitation. The idea is to find more information about patient’s life, interest, hobbies and to provide the patient with pictures, music, smell etc. according to their interests and liking. The App would be used as a Diary as well as guidance for patients and relatives. It would show times for the physio sessions, booked CT’s or theatre. There is a six month pilot happening and if anyone is interested please contact Dr John Goldsmith.
AOB
JC reminded the group that the consultation on Sepsis management from NICE was now out for comments.
CH told the group about Capital Nurse from Health Education England who were looking at the following issues
·  Recruitment into nursing training
·  Guaranteed job
·  Nurse retention
They were also looking at the possibility of rotation of nurses to community and rehab nursing, urgent care services and specialist nursing for training purposes. So far CCU nurses have not been involved in this process, so he suggested that units talk to their nursing directors to look at including their units in this development.
HH asked for information regarding the number and roles of any band 7 nurses that were working in the Network units. RT to circulate this question again to the network.
SI raised an issue that was occurring at Whipp’s cross regarding inter hospital transfers and who goes with the junior Doctor in the ambulance on these transfers. The group felt that it was important that two people always went but SI was concerned sometimes due to lack of recourses this was not always the case. RT to send the Network transfer guidance policy.
RT told the group an evaluation of the work of the network was being planned in order to find out what impact the Network was having on practice and services and for other ideas around what the Network could do differently .This could also feed into the work plan.
RT also talked about the Network patient rep being now ready to be on the panel if she is available for the next network peer review. She would look at the unit form the point of view of the patient and if possible speak with relatives.
NM mentioned the changes to the operational structure at the Royal Free hospital. It will affect all staff in clinical divisions employed in clinical leadership, operational management, nursing operational leadership and site management at hospital director level roles.
Dates for COG meetings 2017
17th May 2017 The Whittington Hospital
12th July 2017 Queens Hospital Romford
26th September The Royal London Hospital
21st November Newham Hospital
/ MH
RT
RT/MH
RT
MH
MH
JG

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