STROKE MANAGED CLINICAL NETWORK (MCN)

STROKE EDUCATION SUB GROUP

Minutes of meeting held at 11am on Wednesday 16 October 2007

Board Room, Westholme, Woodend Hospital Site

Present:

Chairperson: Ms Thérèse Jackson, Consultant OT in Stroke

Ms Elaine Austin, Dietitian, Woodend Hospital

Mr Doug Conochie, Public Involvement Representative

Mrs Lynsey Duncan, Stroke Training Co-ordinator

Ms Geesmik Geldof, Speech and Language Therapist, FTST

Ms Jenny Hill, Occupational Therapist, FTST

Ms Elaine Morrison, Ward Sister, Stroke Rehabilitation Unit

Ms Margaret Somerville, Chest Heart Stroke Scotland

Ms Heather Westmacott, Senior Social Worker, Woodend Hospital

In attendance: Mrs Christine Gray – Secretary CHD/Stroke Office

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1. /

Welcome and Apologies

Welcome: Heather Westmacott
Apologies: Alan Emslie, Jane Knox, Ruth Lancaster, Sandy Reid
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Minutes of meeting held on 11 July 2007

Agreed.
3.
(a)
(b) / Matters Arising
Tissue Viability – Nicola Farquhar, who had agreed to speak on this subject in August 07 had been unable to deliver on the day. The matter was “on pause” at present as the courses would change to come in line with the Stroke Core Competencies.
Membership List and Remit of Group –To note that Thérèse had spoken to a few people to ascertain whether they still wished to remain as members.
Shelagh Matthews had withdrawn from the group. Members of the Flexible Therapy Stroke Team (FTST) still felt it was relevant to attend.
It was agreed that the matter of the group remit should be re-visited annually in order to have clear objectives. To be placed as an agenda item at the next meeting. / CG
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(c) / Carer Information – Elaine Morrison had completed updating all the information and she was to present this to the Nursing & AHP forum on 16th January next. The group also wished this to be an agenda item at the next Education subgroup meeting. / EM/CG
4. / CHSS Training Courses
RGU links – Lynsey reported that Jane Knox, (Nurse Lecturer, Robert Gordon University) had agreed to attend the Introductory Course in November and December this year and hopefully would attend the Intermediate course next year. This would enable CHSS to build links with RGU. All agreed that it was important that Jane commenced by attending the Introductory Course in order to build up a whole picture of what the CHSS courses offered.
Introductory Course in Aberdeenshire – to note Lynsey had booked the Recreation Hall at Woodend as a back up.
STARs Project – Web based learning package – the STARS project group facilitators had reviewed the Stroke Core Competencies and now the University of Edinburgh were working on the web graphics – once this had been done, the package would be referred back to the facilitators to update and comment further. Further progress would be reported in due course.
Advanced Course – To note that “Postural and Tone Management” would be included in the May 08 course.
All Introductory and Intermediate courses were running smoothly – with still a high waiting list. Courses at Moray were slower to fill – Sandy had suggested that if there were difficulties then possibly to open up the opportunity to Highland colleagues. There were some changes at Dr Grays at present – with no defined “stroke unit”. Stroke patients were split between two wards, receiving the same care as previously – but the beds are based on two wards. This may be contributing to lower attendance figures from Dr Grays on the stroke courses.
Training Programme for 2008 – since the last meeting there had been changes to dates and space had been identified for holding an additional Introductory Course in Aberdeen which should help with the waiting list. The finalised 2008 programme had now been submitted for publishing in the CHSS leaflet – to be available soon.
Orkney – plans to hold training in Orkney had been abandoned as Orkney could not identify dates or funding and Lynsey could not reserve space indefinitely in planning next year’s programme.
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Shetland – Funding had been identified by Shetland to enable Lynsey to hold an Intermediate Course next year. Lynsey would explore further the feasibility of training during the summer months and whether Shetland could provide presenters willing to deliver content at an Intermediate level. If a satisfactory response was received, then the group were happy for training to go ahead. The matter of FTST written presentations submitted by the FTST team to Shetland Introductory Course was discussed. FTST members were concerned that the right message was being presented, plus responses by presenters in Shetland at the Q&A session. Lynsey gave some reassurance that she had been present when the course was running and had been happy at the course delivery etc.
Advanced Course – 21 November 07 – there would be a communication workshop (16 participants). Presented by Geesmiek.
Stroke Core Competencies – report completed July 07 and was for consultation. Lynsey had a meeting in November regarding implement ting changes to the training sessions to come in line with the core competencies. Thereafter, courses could be considered for accreditation. / LD
5. / The Rehabilitation Framework – Implications for Stroke Services
Thérèse gave a presentation around this framework in relation to stroke services. The Scottish Government had produced, February 2007 “A Delivery Framework for Adult Rehabilitation in Scotland” and this gave targeted direction of where rehabilitation was going over the next few years. This Delivery Framework policy direction needed to be examined along with other Scottish policy documents including Stroke Strategy for Scotland in order to achieve the purpose and vision, “to give strategic direction and support to all health and social care services and practitioners who deliver rehabilitation services to individuals and communities.”
Recommendations for action:
·  Rehabilitation services more accessible to users – including direct access
·  Delivered locally with strong community focus
·  Systematic approach – promoting independence, self management and productive activity
·  Comprehensive and evidence based, reflect individual needs
·  Practitioners and providers in health and social care better informed of current and evolving roles within rehab. teams
·  Health and social care professionals – to review staff resource deployment through service re-design – skill mix
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Comments following the presentation included:-
·  A lot of focus had been placed on the acute side of stroke – when a patient was hospital based – even in the hospital rehabilitation unit – but it was essential to focus on services for the stroke patient once they were discharged from hospital and back into the community. The role of the CHSS Stroke Nurses was discussed as an example of good practice already in place, and how they linked the patient with information/services pertinent to the individual and to the area where they lived. To note that the Stroke Nurse could visit the patient up to a year following hospital discharge – some needed less time but it was individualised.
·  Possibly to bring the Item of rehabilitation to the Stroke Public Involvement subgroup.
·  Stroke ex-patients so many years discharged and how they then access further support. The matter of self-referral was discussed.
·  Use of mainstream facilities to support longer term rehabilitation needs e.g. working with carers and involving them in taking clients to local facilities e.g. swimming pools. Identify a “therapy” that a person enjoys.
·  Goal setting process now being implemented in the two stroke units in Woodend Hospital, should help identify individual needs and set a right direction for individual rehabilitation within the community.
·  Possibly the MCN Nursing and AHP Forum could feed into the Education subgroup regarding rehabilitation needs.
In Summary – to look at the direction of our Stroke Rehabilitation Service and decide how to implement in terms of education.
6.
(a) / AOCB
Social Work and Carer Issues – Heather was welcomed to the meeting to observe and see whether it was appropriate to link with colleagues. At the end of the meeting Heather felt that the group needed Social Work input from the community base as her role was Social Work within the hospital setting. However, Heather was happy to attend meetings and create a link as necessary and would see if she could identify someone from the SW community side that would be willing to become involved with the group. Heather would let Thérèse know. To note there were currently lots of changes taking place within the Social Work team. / HW
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(b)
(c) / Nursing & AHP Forum – to note Heather was invited and would attend the Forum to be held on 16th January next.
Information Packs
Thérèse highlighted the following for members’ attention:
1.  My Stroke Book – produced by Greater Glasgow. – Not perceived to be very useful by some members present.
2.  Sanofi-Aventis and Bristol Myers Squibb “Transfer of Care” Information – interest was expressed in the Stroke Passport.
To note CHSS had a lot of short fact sheets already which seemed to be what people wanted. / TJ
7. / Date of Next Meeting
Wednesday 30 January 2008 at 1.30pm in the Board Room at Westholme, Woodend site. Venue had subsequently been booked.

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