MEETING OF THE NBTC EXECUTIVE WORKING GROUP Draft Minutes of the Meeting of the NBTC Executive Working Group Monday, 18 th January 2016, 1.00pm 4.30pm Holiday Inn London Regents Park, Carburton Street, London W1W 5EE Present: Jonathan Wallis (JW) NBTC Chair / Consultant Haematologist Kate Pendry (KP) NBTC Secretary / Clinical Director Patient Blood Management NHSBT Teresa Allen (TA) NHSBT Assistant Director Customer Service Stephen Bassey (SB) Transfusion Laboratory Manager / NBTC NCG representative Paula Bolton-Maggs (PB-M) SHOT Medical Director Louise Sherliker (LS) Operations Manager: PBM Practitioner Team and deputising for RG Laura Green (LG) Consultant Haematologist (in attendance for items 07/16 &15/16) Stephen Thomas (ST) Assistant Director: Manufacturing Development NHSBT (in attendance for item 15/16) Huw Williams (HW) Director of Diagnostic and Therapeutic Services Mark Woodget (MW) Deputy Director Estates & Facilities (in attendance for item 11/16) Jane Murphy () NW RTC Administrator (minutes) Apologies: Rebecca Gerrard (RG) National Lead: Patient Blood Management Team Youssef Sorour (YS) Chair of RTC Chairs Group Lorna Williamson (LW) NHSBT Medical and Research Director 01/06 Welcome and Apologies Minutes Jonathan welcomed and thanked everyone for attending. The above people sent their apologies prior to the meeting. 02/16 Executive Working Group meeting held on 22 June 2015 The minutes of the meeting held on 22 nd June 2015 were agreed as a correct record subject to a minor amendment.
03/16 Matters Arising 03/15 UK Transfusion Laboratory Collaborative and uptake of the 2 sample rule PB-M provided an update and a summary of the key findings of the survey:- Laboratory reorganisations have been/are substantial, 100/178 (56%) laboratories affected. Information about staff leaving demonstrates that the largest number have been made redundant together with a number of early retirements. These may be related to mergers. There are staff shortages with dependence on locum and agency staff. Vacancies have been present in some laboratories for significant periods of time. The highest number of vacancies are for Band 6 biomedical scientist (BMS) posts with many vacant for 2 or more years. It has become more difficult to train and mentor staff, and resources for training are reducing. Future staffing: 56 laboratories have one or more members of staff over the age of 60 years and about 140 have staff aged 50-69 years. As these members of staff retire much specialist knowledge will be lost. Comments about changes in training with the advent of Modernising Scientific Careers (MSC) suggest that knowledge and competency at the time of qualification have changed so that newly appointed staff need extra training and supervision which may be difficult to provide. Highlighted how RTC Education Days are used by a high proportion of laboratory staff. JW asked whether there was information on regional variation? Discussion about how to publish the report. Action: JW to speak to Rashmi Rook regarding publication (JW) Action: SB to look at content required to publish in IBMS Gazette possible shortened version (SB) Suggestion that result of whole survey should be fedback via a BBTS session at the ASM. Action: Discussion Point at BBTS (KP) Overview of full report to be included at NBTC Meeting in March. Action: Agenda item at NBTC meeting, 14 th March 2016 () Websites Paper provided. Following items were highlighted:- New Website Development Manager: Christine Roberts has been in post since July 2015. Christine s contact details are christine.roberts@nhsbt.nhs.uk Transfusion Practice Toolkit on JPAC: 2 sections UKCSAG and Consent. UKCSAG pages have been reviewed and updated in the last 3 months. Work continues to populate additional sections of this toolkit. Hoped that these will go live in the next couple of months. NBTC & RTC Pages on JPAC: Seeking suggestions on how to improve these pages without additional funding. Patient Information Pages on the Blood.co.uk Website: TA discussed the move of the Patient Information pages to the NHSBT.NHS.UK website in January 2016. TA indicated that there would be some discovery work undertaken in the summer to identify what hospitals want from the website. NBTC EWG 18 th January 2016 2
TORs/6. Outcome Measures JW to discuss with Graham Donald, patient representative, how reporting on patient experiences of transfusion to be captured as an outcome measure. Action: Discuss how to capture patient experience of transfusion as an outcome measure (JW) 04/15 NBTC, SHOT AND NCABT - Steering Group Membership BBTS have advertised for replacements for a Biomedical Scientist and Transfusion Practitioner. Hopefully, will have names in time for March meeting. Patient Involvement Working Group Further discussion required outside meeting regarding involving patients in PBM Strategy. Action: JW to communicate with Charlie Baker, Chair of PIWG and Graham Donald, Patient Representative (JW) 12/15 RTC Chair of Chairs recruitment Dr Youssef Sorour, RTC Chair of Yorkshire & Humber region has been appointed as role of the RTC Chair of Chairs. 04/16 Review ToR of NBTC Discussed current terms of reference. Amendments required to section 4 membership and section 5 working arrangements. Action: ToR to be updated as discussed () Group discussed specifying that RTC Chair s should be medically trained and have a deputy who could then be non-medical. Currently states RTC Chair should be a user of blood. Action: Wording to be updated to specify RTC Chair s should come from a medical background (KP/) Action: Updated ToR to be included on the agenda at the RTC Chair s Meeting, 14 th March 2016 () 05/16 Serious Hazards of Transfusion (SHOT) PB-M gave an update which was included as a paper. Highlights included:- MHRA principal haemovigilance specialist (Mike Dawe) left in November 2015 and currently has not been replaced. The MHRA are considering moving the haemovigilance team into the Inspectorate Division with a different role for Mike s potential successor. Tony Davies retired at the end of December 2015 and Jayne Addison is his successor. In the Steering Group, Claire Reynolds has handed the transfusiontransmitted infection responsibility to Rachael Morrison. SHOT have employed an apprentice, Katie Leadbetter, to assist in the office in place of the Band 4 post that has been vacant for some time. Annual SHOT Symposium 2016: being held on 7 th July 2016 in The Lowry, Salford. Deadline for abstract submission is 29 th April 2016. The focus is again on Human Factors. 06/16 NBTC Workplan 2015/16 NBTC EWG 18 th January 2016 3
Paper provided for information. On course to meet objectives set for 2015/16. 07/16 NBTC Working Groups Update TLM Working Group Workplan on the 2 sample rule being looked at by Rashmi Rook. Education Working Group Group convene via telecom. Paper provided for information. Patient Involvement Working Group Paper provided for information. Review of ToR needed to possibly include more patient representatives on this group. Action: ToR to be reviewed by RG and Charlie Baker, Chair of PIWG (RG) Transfusion Request Working Group Paper provided for information. Work in progress to agree specification for transfusion request, minimum dataset for transfusion / patient blood management and update of national indication codes. Blood Component Working Group LG provided update. FFP: Extending the shelf life of thawed FFP from 24 hours to 120 hours. An addendum to the current FFP guideline issued by the BCSH will be issued soon. FFP specification will be changed in the red book in line with the BCSH guideline addendum. To go live with component label changes on 1 st March 2016. Communication plan to hospitals in place. Liquid Plasma: Work on the haemostatic properties of this component is ongoing by the Component Development Laboratory at NHSBT. Need to analyse if there is a need following extended shelf life of thawed FFP. Hope to report these results to JPAC at the next meeting in March 2016. Platelets - Bacterial Screening vs. Pathogen Inactivation: Currently evaluating the responses to tender that have been submitted for both bacterial screening and PI. (see item 15/16 below for more recent update). LG to meet with Royal London Trauma Team as they have approached her regarding issue of whole blood. In very early stages as evidence needed. A small project will look at using 50 RBC in SAGM v 50 fresh whole blood leucodepleted. 08/16 NICE Transfusion Clinical Guideline Discuss implementation at NBTC Meeting in March. Action: Agenda item for NBTC Meeting, 14 th March 2016 () 09/16 Patient Blood Management Paper provided for information - this was a progress report of the PBM workplan summarising achievements to December 2015 10/16 NHSBT KPIs Circulated update on age of apheresis platelet issues, by site between June to NBTC EWG 18 th January 2016 4
November 2016. Highlighted some useful questions for stock optimisation. NHSBT Hospital Facing KPIs for Red Cell Reference, Manufacturing & Logistics paper briefly discussed. Paper to be sent to NBTC Transfusion Laboratory Managers Group for feedback and discussion at NBTC in March. Action: Paper to be issued to NBTC TLM Group for feedback (KP) Action: Agenda item at NBTC Meeting, 14 th March 2016 () 11/16 Leeds / Sheffield Reorganisation Presentation given by Mark Woodget. This highlighted; background, rationale, options, key considerations & timings and next steps. Further update will be available following next set of meetings on 10 th March 2016. Action: Updated presentation to be forwarded by MW in time to be included as an agenda item and paper at the RTC Chair s Meeting, 14 th March 2016 (MW/) 12/16 NBTC Recommendations for Training and Assessment in Blood Transfusion (replacement for NPSA SPN 14) Papers reviewed. Highlighted area on Appendix 1 paper to be included in 1.1. Action: Amendment required to Appendix 1 document as discussed (KP) Recommendations and appendix to be sent to HTT s via RTC Chair s for comment. Action: Covering letter to accompany documents when sent to RTC Chair s for onward circulation to HTT s (JW) For approval at NBTC Meeting in March. Action: Documents for approval at NBTC Meeting, 14 th March 2016 agenda item () 13/16 National Commissioning Group Paper provided with recent update for information. 14/16 Emergency Planning for Red Cells and Platelets Reviewed documents. Red phase hospitals to advise if they have platelets available. Amber phase to change in line with BCSH guidelines. Agreed documents to be signed off subject to minor changes. Action: Tracked changes to be sent to group before signing off (TA) Action: Final version to be included as a paper on the agenda at NBTC meeting, 14 th March 2016 () No plan to produce similar document for frozen products. 15/16 Blood Components Overview Stephen Thomas gave presentation which included the following update:- Bacterial Risk Reduction Decision made to keep Bacterial Screening for at least two more years with possible 1 year extension. Internal and external communications to be arranged. Pathogen Inactivation not quite ready to implement as presented following NBTC EWG 18 th January 2016 5
identification of several operational challenges: Buffy coat compliance (presses and LD filters) Apheresis compliance Treatment timescales IT connectivity Thawed Plasma JPAC has approved extension of post-thaw shelf-life of FFP to 120 hours for use in accordance with clinical guidelines. BCSH has been asked to prepare an addendum to current FFP guidelines Note the current draft says extended thawed FFP is for use only in major haemorrhage, it is important users do not think this universal. JPAC has drafted a Red Book change notification, which will be consistent with BCSH addendum. There will be a communication plan to raise awareness of the change itself and formally communicate intention. Also, to communicate the change and its limitations (ie for trauma only, and existing stocks will continue to have "24 hours" on the labels etc). To engage with hospitals regarding any pre-launch changes (eg in LIMS systems etc) HEV: Testing to begin 15 Feb, full stock expected 29 Feb. Post meeting note: date for availability of screened components changed to 14 th March 2016. OBOS will be changed to include a tick box for selection of HEV screened components. Due to the upcoming data centre move, the OBOS change must be installed by 31 January 2016. Hospitals will be asked to not request HEV negative components until 29 February 2016. Post meeting note: date for availability of screened components changed to 14 th March 2016. If hospitals do select HEV screened components before 29 February they will be contacted by Hospital Services. Before 15 February, hospitals will be asked to amend their order as no HEV screened components will be available. Between 15 and 29 February, HS will fulfil the order if the component is available locally, but if it is not available then the hospital will be contacted and asked if the HEV request is essential. If it is essential then efforts will be made to source the component from other SHUs; if not essential, then the hospital will be asked to amend the order. Postmeeting note: this action has been updated following further discussion components will be ready to order from 14 th March 2016 with no interim solution. Action: Invite ST to NBTC Meeting in March () Discussed how implementation is going to be difficult and demand variable. SB highlighted his concern that there won t be a barcode. Especially as he is a Winpath user and they may not be EDN ready. Reviewed HEV Factsheet for Patients. Need to make the labelling of HEV consistent on the factsheet. JW felt that we should include something about the risks of HEV in the Will I need a blood transfusion? patient information leaflet. Action: KP/LS to feedback above details back to PIWG (KP/LS) NBTC EWG 18 th January 2016 6
16/16 AOB RTC Chair Representative at EWG Meetings Replacement for Gavin Cho required. Request volunteers and present this at the NBTC Meeting in March. Action: Invitation for volunteers to be sent out (JW/KP) Action: Agenda item at NBTC Meeting, 14 th March () 17/16 Date of next NBTC EWG Meeting Monday 20 th June 2016, 1pm 4:30pm Holiday inn London Bloomsbury, Corum Street, London WC1N 1HT NBTC EWG 18 th January 2016 7
NBTC Executive working group SUMMARY OF AGREED ACTIONS Meeting held on 22 June 2015 Minute Ref Agreed Action Responsibility Completion /Review 32/15 Serious Hazards of Transfusion (SHOT) SB offered to raise a letter of support from the NCG (National Commissioning Group) too. SB NBTC Executive Working Group SUMMARY OF AGREED ACTIONS Meeting held on 18 th January 2016 Minute Ref Agreed Action Responsibility Completion /Review 03/15 UK Transfusion Laboratory Collaborative and uptake of the 2 sample rule JW to speak to Rashmi Rook regarding publication SB to look at content required to publish in IBMS Gazette possible shortened version Discussion point at BBTS Agenda item at NBTC meeting, 14 th March 2016 JW SB KP 03/15 ToR/6. Outcome Measures Discuss how to capture patient experience of transfusion as an outcome measure JW 04/15 Patient Involvement Working Group Further discussion required regarding patient involvement in PBM Strategy. JW to communicate with Charlie Baker, Chair of PIWG and Graham Donald, Patient Representative JW 04/16 Review of ToR of NBTC ToR to be updated as discussed Wording to be updated to specify RTC Chair s should come from a medical background Updated ToR to be included on the agenda at the RTC Chair s Meeting, 14 th March 2016 KP / KP / 07/16 Patient Involvement Working Group ToR to be reviewed by RG and Charlie Baker, Chair of PIWG RG 08/16 NICE Transfusion Clinical Guideline Agenda item for NBTC Meeting, 14 th March 2016 NBTC EWG 18 th January 2016 8
10/16 NHSBT KPIs Paper to be issued to NBTC TLM Group for feedback KP Completed Agenda item for NBTC Meeting, 14 th March 2016 11/16 Leeds / Sheffield Reorganisation Updated presentation to be forwarded by MW in time to be included as an agenda item and paper at the RTC Chair s Meeting, 14 th March 2016 MW / 12/16 NBTC Recommendations for Training and Assessment in Blood Transfusion (replacement for NPSA SPN 14) Amendment required to Appendix 1 document as discussed Covering letter to accompany documents when sent to RTC Chair s for onward circulation to HTT s (JW) Documents for approval at NBTC Meeting, 14 th March 2016 agenda item KP JW 14/16 Emergency Planning for Red Cells and Platelets Tracked changes to be sent to group before signing off Final version to be include as a paper on the agenda at the NBTC Meeting, 14 th March 2016 TA 15/16 Blood Components Overview Invite ST to NBTC Meeting, 14 th March 2016 Risks of HEV to be included in the Will I need a blood transfusion? patient information leaflet. KP/LS to feedback to group KP / LS 16/16 AOB Invitation to be sent out for volunteers for an RTC Chair representative at EWG Meetings Agenda item at NBTC Meeting, 14 th March 2016 JW / KP NBTC EWG 18 th January 2016 9