ESSEX CANCER NETWORK LEAD CANCER/PALLIATIVE CARE NURSE MEETING Tuesday, 13 th March 2012 9.30am-11.30am At Swift House, Middle & Annexe Present: MINUTES Carol O Leary (Chair) COL Nurse Director, ECN Karen Spurgeon KS EoL Care Facilitator GP Practice Education, ECN Michelle Bath MB Macmillan Development Manager, Macmillan Kate Patience KP Macmillan AHP & Survivorship Lead, ECN Beverly Waker BW Acting Lead Nurse, BTUHFT Sharon Quinn SQ Community Services and Development Manager, St. Luke s Hospice Joan Howlett JH Clinical Lead, Marie Curie 1. Apologies Jo Tonkin, Ray Wilson, Jane Sutherland, Debbie Sevant, Kathy Corcoran, Karen Munro, Gill Booth, Stella Fletcher, Emma Willey, Ann Smits, Deb Hickey, Matt Riddleston 2. Previous Minutes 22 nd November 2011 On Page 3 under St Luke s Hospice it should read Counselling Team not Cancer Team. Following this correction, the minutes were agreed as a true record of proceedings. 2.1 Matters Arising not on the Agenda All matters had been dealt with from previous minutes apart from COL s action to send e-mail requesting feedback as to what is currently being done to gather data from patient surveys given out by GP s. COL will action this. All other matters are covered under the agenda. 3. Standing Agenda Items 3.1 Updates for discussion Basildon - BW gave an update from Basildon. At Basildon they currently have a short-fall for a CNS for Urology and Gynae and are trying to employ. She confirmed the info-space is up and running. The Macmillan Team at Basildon have a big shortfall of nursing staff at present. Heather has left and a Band 7 replacement is due to start around April. BW also advised that Virginia from the Palliative Care Team will be filling her post. The User Group at Basildon are doing a face to face patient satisfaction survey and it is hoped good feedback will be received from Skin, Colorectal and Breast patients. Page 1 of 5
St Luke s SQ gave a brief update. They have now opened the satellite to the adult counselling centre in Billericay and they are already quite busy getting referrals from that end of the patch. The official launch of the satellite will be at the end of May. SQ also advised that with effect from the end of this month, the day hospice will be a doctor short and although the position has gone out to advert, no response has been received. They are reviewing the model at the hospice and may be looking at a nursing practitioner s role. 3.2 User Partnership Groups Michael Scanes has had a meeting with his counterparts in the Heart/Stroke Team to see if there is anything we can work together with and talk about any issues that a common between the groups as perhaps a way forward for Networks in these unclear times. KP advised that many membership changes had taken place in the Network Partnership Group and there was now a new Chair and Vice Chair in Mid Essex. Changes in membership have also taken place in the Basildon and Colchester Groups. SQ added that the first meeting of the Steering Group was taking place at the hospice, which MS had been invited to join. She has produced a draft Steering Strategy to be discussed and taken forward from there. 3.3 Macmillan Developments/Feedback MB introduced herself as the new Macmillan Development Manager for Essex and gave an update of things currently going on. In the North, KP has an exercise programme up and running, which it is hoped can be expanded. She confirmed a new Macmillan Urology CNS had been agreed and an advert was currently out for this post. MB continued that there is a big gap in Psychological Support in Mid Essex, which she is hoping to pick up with Nancy Cohen and the Trust have agreed to support this. Information provision is also a big gap in Mid. In Basildon, unknown primaries are being discussed with potentially having a CNS in place there. They are also looking with St Luke s at specialist physiotherapy and are carrying out a scoping exercise looking at what is needed in the acute community and hospices. At Southend the big project is still the information centre, which is currently at the feasibility stage. Also at Southend the potential of having a CNS for unknown primaries in the future is being discussed. Regarding benefits advice, the North East service was launched in February. The service in the South is in place and it was hoped that this could be expanded to Mid, but this is no longer happening. MB will be looking at alternative ways of getting the service there. MB invited group members to contact her and they wished to raise anything or perhaps invite her to events/meetings. Her e-mail address is mbath@macmillan.org.uk KP then gave an update on her Survivorship role and informed the group that she has been given an extra day for this work. Some progress has been made across the patch and she has been giving lots of talks about plans etc. NHS Improvements had asked for EOI to prototype three new pathways of care (breast, urology and colorectal). Southend have put in a bid and are hoping to carry on this work regardless of the outcome from the EOI. North East Essex has a steering group already set up (chaired by Linda Mahon-Daly) and has a draft business case in development. The idea is to risk stratify patients and give appropriate follow up, meaning supported self management for all routine patients. The reduction in consultant follow up should release money which needs to be reinvested into support services (CNS and AHP). A paper was taken to the ECN Network Board and they have agreed that implementation of these pathways should be supported, and KP will be taking this forward in all areas. Page 2 of 5
COL advised the group that they had failed to get 1:1 initiative, which she had informed them of a while ago regarding different level Macmillan nurses at GP surgeries and it had been hoped that Liz Towers would be included in the pilot, although this turned out not to be the case. MB told the group that we would still be able to bid again in the future. 3.4 End of Life Care East of England Education Facilitation Projects ABC Col explained this project. A was the ACST group, B group generic nurses and C being the nursing home staff. Facilitators are available now in all localities, so progress is being made. GP Practice KS advised the group that the pilot on 7 GP surgeries had now been completed and they are continuing to roll out across South West Essex with a view to maybe also doing Mid Essex. She added that responses had been varied and there is a need to be persistent with Practice Managers. Some GP s feel they do not need assistance, although many Practice Managers have been forthcoming as to where they feel problems are arising. KS will be contacting Catherine O Doherty at Basildon to discuss various issues that need resolving. KS is also currently planning a workshop with GP members around difficult situations and conversations in conjunction with Anglia Ruskin University, which is due to take place in May. This workshop will be for GP surgeries across the board. SQ added they Dying Matters have done a GP pilot project trying to get GP s involved and have produced a very nice DVD that they use and have some really good resources. COL confirmed that we have some funding to put on events for GP practice staff if anything can be identified. 3.5 ACST Training COL gave an update. Successful pilots had been held where training had been condensed into 2 days rather than 3 and so this now was the model going forward with effect from March. Initially only 9,000 was received, although Connected have now said if they gave us another 7,000 could we guarantee to spend in on courses. We also have some service improvement funds left. Courses are available throughout the year and if group members would like to know these or can think of anyone who would benefit from the training, they should contact Christine Bolton. As the group are aware, Level 2 practitioners within the Network have to have had the advanced comms on a Network based training programme. Roger Crellin, Sylvia Young and Bridget Moss have finished training packages they are going to be running in South East in April on a try it out basis. If it goes well and it is the agreed model we want to go with, it will be rolled out across the Trusts. COL has received many e-mails from CNS s in CHUFT saying they want to get on to the course. It is hoped to get it out and running by September. 3.6 NICE Supportive and Palliative Care Guidance Key Worker Document- has just been reviewed and there are no real changes. It has, therefore, been agreed and given a 3 year review date. Psychology- hopefully things are now moving in terms of level 3 support. 7 day working- hope to have some movement on this. BW confirmed that at Basildon they are making a point of looking into 7 day working. Page 3 of 5
Draft Supportive & Palliative Care Measures - COL and Catherine O Doherty have met to go through these. They are not expected to change a great deal and it is hoped to get them out in April, which would mean a Self-assessment and Internal Validation this year by 4 Acute Trusts. COL handed out a copy of the up to date Peer Review Programme for the group s information. She added that she is trying to get the Network Configuration document and directory together. She has sent the document out requesting a template be completed by each organisation to put together as a network document. 3.7 Work Programme Under this section, COL also included the Nursing Strategy updated by SQ, Stella Fletcher and Deb Hickey. There was also an Action Plan with this, which has been turned into the Work Programme so it actually mirrors the Nursing Strategy. COL asked for the group to look through Strategy and forward any comments to her. The group went through the Work Programme very comprehensively and a few amendments were made. One of the suggestions that came was to have a CNS day for new CNS s in particular annually. It was suggested that a forum be developed and sent out on a quarterly bases asking what topics they would like to discuss. It was thought an afternoon half day would be a good time. COL will e-mail out to this distribution list to advise them that we are planning this half day and ask them what hot topics they would like to be covered. SQ suggested something on Survivorship (with KP) and maybe assisted dying as Virginia in the Macmillan Team had produced a great piece of work on this, which she had won a prize for. BW said it would be good to get people to share their ideas around Survivorship. The date suggested for this event was 2 nd week in June. Action: COL The group also agreed to plan an audit with feedback from a maximum of 10 CNS s per organisation asking what topics they think would be beneficial to them and the Network in general. Community nurses would also be included and it was suggested to be done over a period of one month. COL will e-mail out asking for topics. Action: COL 4. Draft Peer Review Measures Cancer of Unknown Primary 4.1 COL advised the group that the measures are now out for Cancer of Unknown Primaries. A lot of work is being done with this alongside AOS and that group. This will now be looked into more and there is obviously a lot of work that can be done and it is felt a CNS for this group is needed. Various discussions took place on the various solutions that could be considered. 5. Any Other Business Regarding the HOPE programme, SQ reported that she had met with Carol Holloway and they have put forward an expression of interest to run the programme. It was pointed out that Mid Essex (Farleigh Hospice) have also expressed an interest. St Luke s will be doing some joint training with Fairleigh in early July. They have committed to run 2 groups 1 in November and 1 in January. 4 facilitators are being put forward at this stage and although funding stops in January, there will be more funding available after this. Babette Knox from the Cancer User Service Group in Basildon has agreed to help and will also be trained. SQ will keep this group update on the programme. Page 4 of 5
SQ also advised that she had attended the Paediatric Palliative Care End of Life meeting. At this meeting they were talking about developing a green folder for use in people s homes. SQ queried if this group had heard anything about this? No-one from this group had, and SQ will report this back to the Paediatric Palliative Care group at their next meeting. 6. Dates of next meeting All at 9.30am-11.30am, Swift House, CM2 5PF, Middle and Annexe 8 th May 2012 10 th July 2012 25 th September 2012 27 th November 2012 Page 5 of 5