Attendance: Consultant Neuropsychiatrist, NHS Lothian (Lead Clinician/ Chair) SABIN Programme Support Officer, NHS NNMS

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1 National Services Division Minutes Gyle Square 1 South Gyle Crescent Edinburgh EH12 9EB Telephone Fax Subject: SABIN Steering Group Meeting V0.0 File ref: K:\07 Health Support Ser\Specialist & Screening\NMCNs & NMDNs\Networks\SABIN\Steering Group\Minutes Author: Lucy Johnston Date: Monday 6 th June pm-3.30pm, BR1 Gyle Square, Edinburgh Attendance: Alan Carson Mary Adams Liz Blackman Aileen Ferguson Gaille Gray Shiona Hogg Lucy Johnston Lance Sloan Consultant Neuropsychiatrist, NHS Lothian (Lead Clinician/ Chair) New SABIN Programme Support Officer, NHS NNMS Senior Programme Manager, NHS NSS SABIN Programme Manager, NHS NSS Headway Allied Health Professional Manager Rehabilitation, NHS Forth Valley SABIN Programme Support Officer, NHS NNMS Consultant in Rehabilitation Medicine, NHS Fife Videoconferencing/ Teleconference: Avril Beattie Clinical Co-ordinator, NHS Tayside Doug Ross Patient Representative, Stirlingshire / Forth Valley Apologies: Alex Baxter Barbara Chandler Alisdair Fitzgerald Douglas Gentleman Alison Hawitt Lorna Langrell Ashish MacAden Tom McMillan Claire O Brien Bhupinder Panesar Angela Sprott Consultant in Paediatric Neurodisability Consultant in Neurorehabilitation, NHS Highland Consultant in Neurorehabilitation Medicine Clinical Director/ Consultant in Brain Injury Rehabilitation, NHS Tayside Speech & Language Therapist, Robert Ferguson Unit Associate Specialist, Robert Ferguson Unit Specialty Doctor (SAS), NHS Highland. Deputising for B Chandler Professor of Clinical Neuropsychology Specialist Head Injury Nurse Consultant in Rehabilitation Medicine ABI Service Co-ordinator, West Dunbartonshire Council 1. Welcome, introductions and apologies The Chair welcomed everyone to the meeting and to Ms Beattie on videoconference and Mr Ross by teleconference. Apologies were noted as above. 2. Minutes and Action Log The minutes of the last meeting on 22 nd February 2016 were agreed by the group. All actions within the log were noted below: 1

2 17: Steering group membership - Ongoing 29: Data collection - a SLWG to be convened with Dr Carson, Mr McMillan, STAG and ISD to discuss what data was required and if it could be collected on a national basis. 33: Communication Plan to be circulated for sign off. If no changes are received, it will be assumed the group is content with the document 34: Paediatric ABI teams Event this idea has been shelved until the foreseeable future. 35: Education Strategy has been drafted and will be completed and sent out for comment to the group. 2.1 SABIN Review Mrs Blackman noted that SABIN will undergo a network review in 2016, with the final report to be submitted to the National Patient Public Professional Reference Group (NPPPRG) and also the National Specialist Services Committee (NSSC). The review assesses the extent to which each national managed clinical network is achieving the core principles of Managed Clinical Networks. It will examine whether the network is meeting the needs of its stakeholders, assess if it is achieving its original designation objectives and identify the value the network adds to healthcare in NHS Scotland. The report to NSSC about the network s performance will also make recommendations on its future status. Mrs Blackman provided an overview of the process of a network review, re-assuring the group that this would be done with the network, not to the network, that this formed part of the standard governance of networks; there was nothing unusual about the review. It was explained that the review would be carried out with the involvement of the network and stakeholders along with external experts. The review will provide an opportunity to take a critical look at the network and compare how it has met/will meet its aims and objectives, taking into account the eight core principles, as set out in the Core Principles of MCN development document (CEL ): Principle 1 - Principle 2 - Principle 3 - Principle 4 - Principle 5 - Principle 6 - Principle 7 - Principle 8 - Clear management arrangements and leadership of the MCN A defined MCN structure setting out the points at which the service is to be delivered and the connections between them The use of a MCN annual work plan The use of a documented evidence base by the MCN The multi disciplinary and multi professional constitution of the MCN, which includes patients A patient-centric approach Optimising the MCN education and training potential and continuing professional development Generating better value for money An Expert Review Group will be convened to review the network and will look at the evidence from SABIN to see if it had met its original designation and also the impact of the Clinical Strategy and Health and Social Care Integration, and how the network fits in with those. Ms Ferguson will draft a Project Initiation Document for this review and would welcome any suggestions for names of colleagues/other staff who could be invited to be a member of the Expert Review group. Ms Blackman would also support this process. 3. Service Improvement Pilot ACTION: Ms Johnston will send the Review presentation to the group. An update was requested regarding the pilot for the SABIN Service Improvement model for early management of brain injury and referral to appropriate services. 2

3 Dr Carson gave an historical overview and update with reference to the major trauma centres and the model that had been proposed by SABIN. The Scottish Government had agreed to fund a pilot looking at a business case, and if successful, would be a major driver for change in Lothian and Tayside, with Forth Valley and Fife also potentially being part of the pilot. Approval for the commencement of a Pilot was granted in December The three strategic areas considered for development to improve TBI care in Scotland were revised pathways, improved rehabilitation services and systematic data collection. Dr Carson noted that one issue was to ascertain how many trauma centres there would be and that the original plan had been that development of the centres would be cost neutral. The question remained as to how many trauma centres were required in Scotland. Technically, from the modelling, two or one centres could fit with the experience and skills and although there would be advantages to maintaining four centres. A media release was noted; First Minister Nicola Sturgeon has confirmed there will be a major trauma centre in Aberdeen. Clinicians' concerns had been raised at a meeting of NHS Grampian's board last month after the Scottish government announced the decision to have four such centres was under review. Ms Sturgeon said: "There is no dubiety, there will be a major trauma centre in Aberdeen." She said there would be also be centres in Dundee, Glasgow and Edinburgh. In response, Labour said the "apparent U-turn" had come at the last minute. The Conservatives said voters may ask why it had taken until the final days of the election for the "unequivocal commitment". nd the iberal emocrats said no-one in the north east would believe what was being said until the trauma centre was actuall in place ". Referrals from the roadside using the ambulance algorithms meant that any patient less than Glasgow Coma Scale (GCS) 13 should go to a National Trauma Centre (NTC) in the first instance. Some GCS 13 patients would go to a local trauma centre and others to the Victoria or Western General. The problem so far has been working out where patients are going and what the service will look like using the model. Information was still required about the ambulance configuration and what would be the primary and secondary transfer rules. After this information was obtained there would be a more detailed pilot and this would inform the NTCs and what would actually be carried out there, what resources would be available and what procedures they would have. It was important to have equitable standards of care across Scotland for anyone with a brain injury. It was highlighted that there are problems in each of the health boards (e.g. protected beds in Forth Valley). There were concerns about the pathway, that it is too generic and not specific to clinical needs. It was noted that the ambulance data will come from the ambulance service when they have finalised their pathway. 4. ABI E-Learning Resource Ms Johnston advised that the SABIN E-Learning Resource was on schedule and all the content would be uploaded to the site by the end of June, with a view to completing final editing throughout July. Content would also be evaluated during July with a group of expert reviewers who would appraise the content and design of the site. The upgrade to the professional version of the site had gone well and had enhanced the features and usability of the site. Shutterstock graphics had been requested and was in the process of being added to the financial system, so as to obtain a licence for a month to buy the images for the site. 3

4 5. Paediatric Workstream and Best Practice Statements Ms Ferguson had visited all centres except Inverness. An approach had been made to The Child Brain Injury Trust (CBIT) to hold some parent/carer focus groups to ensure their views and experiences were taken into account. Some additional feedback was also obtained from acute colleagues in the neuro team in Aberdeen and some input from community rehabilitation would be added before publishing. Once all comments are collated then it will be sent to a paediatric clinician for final approval. Ms Ferguson had discussed dissemination with the various teams, and whether they want to go forward with setting quality indicators to audit against. Glasgow and Tayside particularly, were keen to be involved. 6. Events 6.1 Education Event 1 st September, Alan Carson A paper was circulated with a summary of all 62 attendees and their job roles. There had been a good sign up so far for this events and preparations were on schedule. Details would be re-sent to the Steering Group, who were urged to mention the conference to Emergency colleagues. ACTION: Aileen Ferguson 6.2 Head Injury Info Day It was noted that the day took place at the Grand Central Hotel in Glasgow on 11 th May, and SABIN had had a stand. Ipad feedback had been gathered to inform the information requirements of service users and third sector organisations. 7. SABIN Website & Comms Materials Ms Ferguson will be working on the website within June and July. Those Steering Group members with whom she had not yet met to discuss their views on what was required, would be receiving a request for an appointment in the coming weeks. A new, free, platform (Wordpress) had been identified, and a test site had been started. Information was being added and a disclaimer had been put on the older Globalweb site. 8. Governance Annual Report and Action Plan This is a document required b all networks as set out in the Chief executive s letter and was circulated for information and comments from the Steering Group. Ms Ferguson noted that the action plan was important as it reflects the actions planned for 16-17, and as such would be measured against these in the review. 9. AOB 9.1 Information from CHEST Heart and Stroke was circulated to Steering Group - they were looking for volunteers: Members of a Steering Group to provide strategic direction and support for the project Module authors, who will be responsible for developing content prior to it being transformed into an interactive learning resource Module reviewers, to act as critical readers for the content Any volunteers to contact caitrian.guthrie@chss.org.uk 4

5 10. Date of Next Meeting: Gyle Square 22 August 2016 at 1pm, Boardroom 2 7 November 2016 at 1pm, Room February 2017 at 1pm, Boardroom 1 5