TPFS Executive Meeting, Bristol, 20/01/2015
Present – T.D, MMJ, KC, SP, AC, AW, KT, CK, IL, JR, Industry –Medtronic (formerly Covidien) (Nick Inman and Ruth Hodgkinson).
Apologies – MC, Kat G, Kath G, ML.
- The minutes from the last Executive meeting were read and recorded as correct with no corrections.
Agenda
1)Sponsorship and the role of industry in TPFS. Ruth Hodgkinson, AW, MMJ.
Ruth had worked on an industry sponsorship document for financing TPFS. It was a tiered policy that for the most part reflected an annual subscription/payment to TPFS. The levels were Platinum, Gold, Silver and (Bronze). The emphasis was on industry presence at our 3 meetings – ACP, 2 day annual meeting, and scientific meeting. Ruth said the real attraction for a company was sponsorship of a symposium at a meeting. Prices from 15k – etc. Clearly annual payment to TPFS would mean that at ACP there would be no industry payment to ACP for our day. This has not been completely discounted.
Action – AW, MMJ, RH to work and finalise the following day. Completed.
2)Finance. AW.
We have a 21k balance; TD still to submit invoice £ 3,500 for web site development.
If a recognised centre or PF group wished to run a pelvic floor course of sufficient educational content, then TPFS would finance and “badge” the initiative after due consideration.
RH stated that industry wishes TPFS to be a separate entity from other societies. She went on to say that for example, her company (Medtronic & Covidien) would wish to use different sources to fund different activities e.g. annual conference funding, immersion courses, small chapter meetings etc. Discussion took place regarding the role of Pharma in funding TPFS.
Action – MMJ to discuss with Yan Yainnakou
An outstanding issue was the ongoing funding of our website. ACP (Steve Brown) has apparently agreed to pay for this; they just want the site up and running. We need to find out what our monthly maintenance fees are from Formedia
Action – TD to discuss with Formedia [Approx £ 150.00/year}
TD confident that tomorrows meting will make a modest surplus for TPFS.
3)Training. AC, JR.
Discussion centred on the teleconference of the previous week (minutes had been circulated). JR said that our website was key to promoting training [posting a curriculum, courses on offer]. TD said that we needed to establish exactly which colorectal surgeons are actually doing pelvic floor work (104 according to recent census). Once identified these consultants could then advertise clinics, operating lists etc to which trainees or fellow consultants could attend. We all can learn from each other! A curriculum should be and is in the process of being developed along with PBAs for index procedures to kite mark trainees (and future consultants). JR has been in discussion with ISCP who are supportive of the initiative. IL suggested that TPFS might consider offering a viva post CCST. CK will be posting core reading list on TPFS website.
This initiative will all be voluntary and outside/not a requirement for CCT. AC discussed the notion of essential courses, specialist courses (e.g. ARP/Ultrasound), and personal courses e.g. immersion for operating.
TD encouraged AW to continue developing his web based EAUS training module, involve the Birmingham/Sheffield groups etc and launch it on the web site. The web site could also be used to host a physiology teaching/sign off platform (AC to discuss with Mark Scott & Steve Perring)
Action – all to read minutes, all to inform AC of courses for website.
AW and MMJ to discuss with Ruth formation of immersion courses in LVR with Ruth. TD to DW Justin Davies re approaching ACP executive for approval of what we will term “voluntary additional education); Approved and supported by Council 09/02/15.
4)Q&A, Governance. AW, MMJ, MC
Initial discussion centred on the letter sent to trusts regarding expression of interest for mesh related complications following LVR (this was enclosed).
Eight centres replied – Gateshead, RVI, Sheffield, Oxford, Poole, Southampton, St. Marks and Bristol. In addition Karen Telford (South Manchester) and Andy Williams (St Thomas’) may submit. The notion of these being “tertiary” centres generated much discussion.
Action – TD/MC and MMJ to respond to these centres. TPFS will support their expression of interest provided that they prospectively collect outcome date, ideally on the “Dendrite” system. MC to bring together his QA/Governance committee ASAP and process this initiative. TD expressed a desire that this committee be constituted out of TPFS members
CK – We need accredited pelvic floor centres and then a lesser number of centres that deal with complicated cases (e.g. mesh complications, revision surgery/neuromodulation). MMJ- these centres should not simply focus on mesh complications but also on re-do operations after failed LVR. KC – we need to develop a course for management of these cases or develop a network of centres that allow surgeons to visit and watch/discuss these cases. CK – we need to define what constitutes a pelvic floor centre first. JR – we should get away from the notion of a tiered system and the notions of tertiary referral centres and instead focus on “accredited units”. KC – pointed out that things are different in Scotland where the money does not follow the patient and centres expressing an interest could be swamped.
CK – lets start by defining a standard. It’s all about the MDM and key personnel. We can gain a lot form the census document – defines key procedures and what pathology should be dealt with by a pelvic floor centre. For example external prolapse – any colorectal surgeon, whereas LVR, or ODS – “accredited” pelvic floor centre.
AW – results of census (were enclosed). Poor returns but a reflection of trusts offering true pelvic floor work. The census had grouped practices into – no pelvic floor work/regional centre/specialist centre. It was worrying that some places were doing LVR whilst displaying no interest in pelvic floor work. The variability in the numbers of sphincter repair/SNS implantations was noted. In reality we should simplify into those that do and those that don’t.
AW – suggested the results helped especially with NHS England who may utilise the results for commissioning purposes, but CK stated that we need to simplify. The notion of an accredited pelvic floor centre (MDM, BFB, ARP, neuro-modulation, perineal and abdominal ops for prolapse), and a centre that does extra specialist management e.g., re-do surgery, pudendal nerve decompression etc was forwarded.
AW- Kite mark will come via commissioners but stressed that they may want TPFS to decide the standard setting and the resources document we are working on is key. It was agreed that the primary consideration for being defined as a pelvic floor centre was participating in an MDM.
AW- the MDM does not have to be site specific. AW asked if colorectal surgeons should do joint clinics with uro-gynae. MMJ suggested that the minimum should simply be co-participation in MDM. TD said that for recurrent gynae prolapse a CRS was considered by NHSE to be a core member.
The ACP resources document that AW had written (was enclosed) would be our most powerful tool. This would define what an MDM/MDT should be, and perhaps key pathologies and procedures.
Action – MMJ to re-circulate and Exec to forward opinions to AW.
5)Membership – KT
We have grown by 33% (93-119 members) since last Exec. KT would forward to MMJ a document discussing membership (will be enclosed).
TD – We need to have representation on TPFS Exec of affiliated members (allied health care workers/physios, specialist nurses etc) belonging to other societies e.g., PGOP, BSG. A constitution for such a committee has been added to the website. Each group/society should forward a name of a current TPFS affiliate member
Action – TD and MMJ to invite interested societies
TD/MMJ discussed this with Jane McClurg, current chair of PGOP who supports this initiative (the following day).
It was noted that following a recent poll (of TPFS members) conducted by MMJ that TPFS applications would continue to require a proposer & seconded from TPFS and a brief CV.
The Exec decided to ignore the assertion made by ACP that members from EuropeanSCP should become members of ACP if they wanted to join TPFS.
KT – To ask for expressions of interest from AHCWs and organise a ballot.
6)Database – CK
A short history of Dendrite. Karen Nugent (ACP) passed the Dendrite project onto CK. CK feels that as it stands it doesn’t give us what we need/requested; it is too slow. He has had multiple meetings with them in person to discuss service development and progression. The database did not even work in their offices in London! Dendrite still has an attraction despite this. ACP likes it. CK – if it works, it’s a lovely system and he has put a lot of work into it. AW – how much money do we owe Dendrite? TD – ACP has not paid them anything? AW – needs to speak with Peter Dawson (ACP) to see if there is a contract with Dendrite.
What options do we have? We could ask Kath Gill’s husband to design us a new database. Exec decided against Oxford system as built on old platform.
The consensus was to contact Dendrite and give them one last chance.
The following day Dendrite contacted CK. The database finally worked.
Action – CK to email Exec to inform them of log on process.
7)Programme – IL, CK
DDF – speakers all confirmed. Steve Brown is managing Dragons Den. Submissions open until 22nd Feb. Subject matter is grant applications. Rules of engagement decided. Unsure if anyone is brave enough to stick their head above the parapet.
Should we have an October TPFS meeting? IL – Oxford course now ceased due to national meeting and the fact that most people are trained.
Consensus – run with Oct 2015 2 day meeting. ? Day 1 research, a dinner, Day 2 hot topics, politics and AGM. The programme should be directed towards the whole team.
Action – Karen Telford to check to see if Manchester is suitable
Regarding ACP 2016 meeting KC will ask Bob Steele to contact MMJ.
8)Elections – TD
The constitution as written dictates that the Chair is up for election in 2015 (Oct). Consensus was to seek approval in October at AGM to push this forward by at least another 6 months. MMJ to ask TPFS members for nominations re Chair-in Waiting. AW – this should be someone from the existing Exec. TD - whilst it would be sensible for a member of the current executive to stand, constitutionally anyone from the membership can stand. If that person enjoyed the support of the membership so be it. We will run an AGM at October meeting.
9) AOB
KC proposed that TPFS Exec “badge” a pelvic floor fellow in Dundee. This was agreed.
Action – TD to respond to KC
Date of next meeting – TBC depending on October annual meeting.