Lothian RESPIRATORY MCN CORE GROUP Wednesday, 17 th September 2.00pm to 3.30pm The Chancellor s Building Seminar room 6, RIE

Transcription

1 Lothian RESPIRATORY MCN CORE GROUP Wednesday, 17 th September 2.00pm to 3.30pm The Chancellor s Building Seminar room 6, RIE 1. Introduction and apologies for absence Present: Dr Ninian Hewitt - GP and Lead Clinician, Respiratory MCN (Chair) Professor William MacNee - Respiratory Consultant, RIE Donald Noble Consultant, St Johns Simon Dunn - Clinical Nurse Manager Maureen Reid - Primary Care Pharmacist, Edinburgh LHP Matt Perrot Specialist Physiotherapist Gillian Cunningham - Service Manager, CTR Cat Young - MCN Coordinator for Respiratory Care, NHS Lothian (Minute) Apologies: Alyson Malone - Strategic Programme Manager, NHS Lothian Katie Johnston - Primary Care Pharmacist, Edinburgh LHP Gillian Cunningham - Service Manager, CTR Shena Brown - Respiratory Care Facilitator, WL CHCP Prof Harry Campbell - Professor of Genetic Epidemiology and Public Health, UoE Kim Bracher - RNS St John s Hosp Angela Lindsay - AHP Manager, Edinburgh CHP Laura Groom - Clinical Specialist Physiotherapist Community Jenny Scott Pharmacist, RIE Ninian welcomed Simon to the group. Simon has recently taken over from Grace as Clinical nurse manager for respiratory care. Ninian noted the great contribution Grace had made to the group and wished her well in her new post. 2. Minutes of the previous meeting July Minutes were accepted as an accurate record of discussions. 3. Matters arising from previous meetings 3.1 Bronchiectasis website /SMP The Bronchiectasis website is now up and running at: The video for Clearing your Chest will be added as soon as it has sign off from Dr Hill. The group are still hoping to have some kind of launch later in Autumn/Winter This item will now be removed from the agenda.

2 3.2 LearnPro The LearnPro modules are now complete and are being shared with other boards. Please follow the directions below to access the modules: To access the module go to - In Categories click on the CPD icon Scroll down to Add Courses Click on the Course Title which will be Lothian: Spirometry Select Add This item will now be removed from the agenda. 3.3 Efficiency Productivity work stream - Invest to Save project The group discussed the most recent data from the Invest to Save project (April June). The scorecard showed the figures had gone down however Ninian advised that Amanda had indicated these figure may not be correct and is awaiting an update. Matt noted that the figures did not reflect what the feeling was in actual practice. Ninian will provide an update to the group when he can. The main issue identified was around the psychology element with very few people being seen currently. The project group discussed the possibility of introducing a quicker assessment type. Ninian will speak to Grianne about this. Issues are still being experienced with the LUCS and Scottish Ambulance elements also. The project group are looking to see how they can make some savings so the project can be extended to March. Bill emphasised the need for accurate figures to be able to understand the central CRT workload and to be able to review activities. Ninian will speak to Amanda about getting an accurate update of figures. Circulate scorecard electronically(cat) Get accurate figures from Amanda and circulate update to the group (Ninian) 4. Asthma workstream 4.1 Local Asthma data Ninian spoke to the paper he has produced which looks at Asthma in the under 8 year olds and the 8 16 years old range. He noted the QOF asthma register includes all patients over the age of 8 but no information on the younger children. The official numbers in QOF data are an underestimate of the total numbers affected by asthma. With help from the Bluebay system Ninian managed to get a response from 72 practices who supplied their numbers for the under 8 year olds and the 8 16 years old range. Please find paper attached. The paper will be circulated to Sick Kids and anyone else who may be interested.

3 4.2 Response to Asthma UK Ninian advised in response to Asthma UK s formal notification to the chief executive on the poor delivery of annual checks in Lothian and throughout Scotland generally, he has produced a paper outlining the possible reasons. Please find attached to the minute. He noted that that currently there is an issue around exception coding and QOF. Whilst exploring the data on annual checks he could not identify any patterns in terms of area, derivation status, practice. Ninian will submit a paper to the National Advisory Group to initiate discussions around the QOF in an attempt to get the issue with exception coding fixed. Asthma UK are happy for this to take place and will be in attendance. Cat will circulate a copy of both full reports to all core members; respiratory nurses; consultants, and CHP leads. Circulate copies of full reports (Cat) 5. Nitric Oxide The group discussed the best practice for Nitric Oxide within primary and secondary care. The group discussed the possibility of using Nitric Oxide as a method to support step down in primary care however felt there may be some practical issues surrounding it. They discussed possibly trialling it in a couple of practices and reviewing its impact. It may also be added into sci-gateway pathway. Donald noted an issue around future funding of the niox viro machines which were previously paid for by physiology. Ninian agreed to explore the possibility of alternative funding. The group agreed they should explore nitric oxide as diagnostic tool in secondary care, will look into where they can get funds for future machines for secondary care. Explore nitric oxide as diagnostic tool in secondary care (Ninian/Donald) Explore funding opportunities (Ninian/Donald) 6. Oxygen Services Ninian is waiting for a number of responses still and will update at the next meeting. 7. COPD enhanced service for Community Pharmacy in Lothian Maureen advised that the COPD enhanced service will begin shortly within community pharmacy. Some issues have been raised around it operationally and the practicalities of the service.

4 8. Idiopathic pulmonary fibrosis (IPF) Ninian noted the inaccuracies and the difficulties in diagnosing IPF. He informed the group he and Nik are writing a paper to provide some help around it. This will be circulated to all GP s. Issues were raised about the Xray element and that the Hypoxia level needs to fit with the guidelines. Ninian will review the paper along with Nik and will circulate to the group. Review comments made by group on IPF paper and recirculate for sign off (Ninian/Nik) 9. Educational Events The first of the PLT events took place in Mid Lothian on the 10 th September; it was well received with a good turnout of around 60 delegates, a mix between GP and practice nurses. The next event will take place on 24 th September at the Paul Taylor Lecture Theatre at St John s. If you would like to attend any of the events please let Cat know. A programme is attached for your interest. 10. Sleep services The MCN are supporting the sleep service to look at the volume of referrals coming in and to provide some help in improving the quality. As a large amount of these referrals are coming in from other regions Ninian is hoping to introduce a stricter protocol for referral. He has produced a paper which he has shared with Kim Dickson and Tom MacKay and is awaiting comments. Within the paper he has described areas which could be targeted prior to referral to sleep service such as patients smoking; alcohol, and obesity. In terms of health behaviour the group felt patients levels of motivation were part of a much larger issue which may need to be addressed. Ninian noted they are also awaiting feedback from the Grampian pilot which sees oxygen and sleep being considered simultaneously. Ninian will keep the group up-to-date with any activity. 11. Patient engagement Cat informed the group she is currently carrying out a mapping exercise to identify routes to patient engagement as currently the MCN have very little. Initially she will carry out a mapping exercise, followed by a patient engagement survey to assess the best approach to engagement. She is hoping she can build up a virtual network of contacts who will be able to feed in to the group as well as the group being able to approach for any support. She will keep the group informed of all activities. 12. Smoking In collaboration with the Diabetes MCN, and Heart Disease Strategy Programme Board, the MCN are looking at how they can support the smoking cessation service to reach their current targets to gain 1764 successful quits at 12 weeks from 40% most deprived areas. Initially the group are planning a mail out inviting smokers from the two top SIMD to attend the smoking cessation service. If the up-take for this is good this may be expended to include outpatient clinics and stent clinics.

5 13. Date of Next meeting Date: Wednesday 15 th October 2014 Time: 14:00 15:30 Location: Seminar Room 6, Chancellor Building, RIE Summary of Actions Item Action Who When Complete 3.3 Efficiency Circulate scorecard Cat When Productivity work stream - electronically Updated Invest to Save Get accurate figures Ninian project from Amanda and circulate update to the group 4. Asthma workstream Circulate copies of full reports Cat When finanlised 5. Nitric Oxide Explore nitric oxide as diagnostic tool in secondary care Explore funding opportunities Ninian/ Donald Ninian 8. Idiopathic pulmonary fibrosis (IPF) Review comments made by group on IPF paper and recirculate for sign off (Ninian/Nik) Ninian/Nik