Regional Operational Meeting for Palliative & End of Life Care Thursday 4 th February 14:00-16.00 Wakefield Hospice Aberford Road, Wakefield, WF1 4TS Chair Kath Sartain Attendees: Kath Sartain Lead Nurse for EOLC York Teaching Hospital Julie Challenger Macmillan EOL Clinical coordinator Nth Lincs and Goole Trust Debbie Atkinson Community End of Life Lead Nth Lincs and Goole Trust Keith Kocinski Lorraine McDonald Assistant Delivery Manager Macmillan Development Manager NHS Scarborough and Ryedale CCG York, Humberside, North Lincs & Goole, Macmillan Cancer Support Anne Garry Consultant in Palliative Medicine York Teaching Hospital June Toovey Education & Audit Facilitator Health & Education Y&H Judith Bird EOL Lead Y&H SCN Dawn Thomas Suzanne Kite Lindsay Turton Helen Livingstone Sara Andrews Lead Nurse Specialist Palliative Care Consultant in Palliative Medicine Macmillan Nurse Consultant Consultant in Palliative Care Macmillan CNS SPC Team Leader Sheffield Teaching Hospitals Leeds Teaching Hospital Humber NHS FT Macmillian CNS team Airedale NHS FT/ Manorlands Hospice Barnsley Hospital NHS FT Janet Owen EOL Clinical Lead Barnsley SWYFT Janet Millard Educator in SPC & EOL care, Wakefield Hospice Mid Yorkshire Education Forum
Apologies: Lucy Adcock, Yousef Adcock, Jason Boland, Elaine Boland, Heather Jinks, Carina Saxby, Annette Clarke, Ellie Smith, Cath Miller, Marie Hancock, Dr Rachel Vedder, Louise Merriman, Linda Carmichael and Ruth Broadhurst. Item No. Item Discussion / Action Lead Deadline 1 Welcome & Apologies 2 Minutes from any previous meeting held 17 th December 2015 reviewed. Slight spelling changes made. Janet Millard from Wakefield Hospice should be added to the attendees. The minutes were agreed as an accurate record. 3 Matters Arising None not covered by agenda. 4 Work Programme 143 4.1 Health Education Yorkshire and Humber - Learning outcomes JT outlined the history and the development of the Learning outcomes. They have been piloted in 3 sites. The position now is that final tweaks are being done and then will have to have the new HEE branding applied. This is causing a delay in the process. HEYH funding was offered to support the learning outcomes from April 2016 and each trust awarded varying amounts. There was further discussion within the group on its implementation, identifying how people utilise learning outcomes and how this information can then be shared. Some organisations were turned down for funding as it was felt they were a mental health trust even though the Trust provided community care. HEE is undergoing a major process of re organisation nationally but there is a plan to develop an EOL work plan. Its key aims will be to develop learning outcomes, which Skills for health are developing. Y&H have indicated that we are keen to have our LO used/incorporated into this development rather than restarting the work. Symptom Management Guidelines have recently been revised and the final draft is currently being
reviewed by the Medical Advisors at HEE they will then be branded with the new HEE. They will then be available in electronic format and hard copy. ALL to give an estimate of how many they might need for their organisations to June Toovey please june.toovey@btinternet.com ALL HEE will provide funding for first print run. Can be put onto SCN website when complete. The DNACPR resource has been divided into chapters and is awaiting HEE branding. 4.2 4.2 Health Education Yorkshire and Humber - Educational training All the recent events have evaluated very well, especially the clinical ones e.g. heart failure and Renal have been oversubscribed. Events coming up. 10/2/16 - Managing challenging symptoms including delirium, breathlessness & psychiatry is still planned but is on the same day as the Junior Doctors strike. 15/3/16 - Annual conference now has over 100 people booked on. The morning will be focused on service improvement by the Improvement Academy and the afternoon will be examples of service improvement in practice. Tuesday 15 th March 2016 End of Life Care Regional Conference http://www.andrewsimscentre.nhs.uk/events/578/endof-life-care-conference-2016-/ *You can also call the Andrew Sims Centre s administrator, Katie Foster on 0113 85 55638 if you have any queries 4.3 Future Events Suggestions from the group for future events include; Dementia (although already done) Transitional care could be cancer and non-cancer and critical care. Compassionate Communities Alan Gallaher
DOLS update Anyone interested in contributing ideas to the programme of events please contact June Toovey june.toovey@btinternet.com for further details. ALL to note The amount of funding from HEY&H will not be known before May. 4.4 Contact list revision/update The group contact list had been refreshed and issued to the group. Any updates/comments should be forwarded to gail.peacock@nhs.net please. ALL to note Gail Peacock 4.5 ToR confirmation. An updated version of the final ToR was circulated to the group and one comment was received. It was suggested that the diagram was removed from the back of the document. KS will make the revisions and then it will go to the regional EOL group for sign off. Kath Sartain 5 National/Regional update An update was provided by Suzanne Kite. 144 5.1 National Update The Resuscitation Council UK issued a statement November 2015 advising that the wording of the guidance relating to cardiopulmonary resuscitation is under review and that guidance will be updated in line with revised recommendations for wider DNACPR form covering other treatment. Consultation closes on 24.2.16 but survey is quite long winded. Further details are awaited but it s understood that the plan is to produce a revised form/guidance in 2016. These changes are not mandated although there is a recommendation from NHSE not to have locality stand-alone own forms. https://www.resus.org.uk/dnacpr/decisions-relating-to-cprnew-statement/ 5.2 NICE Guidelines
NICE has also started the process of revising its Supportive and Palliative Care 2004 Guidance document. It will remain adult focussed but will no longer be specific to cancer and will apply to all life limiting conditions. It was felt that there was a lack of consensus on some of the definitions e.g. supportive care a subset of palliative care and that palliative care not limited to EOL. A key factor is that NICE is only applicable to NHS organisations and not charitable organisations. Also need different service models recognition. The review consultation period is closed. Comments were sent in from Y&H SCN. NICE has advertised for membership of the guidance development group https://www.nice.org.uk/guidance/indevelopment/gid- CGWAVE0799/consultation/html-content 5.3 The Heart Failure guidelines have been finalised with 2015 revision. To be taken to the next CEG for sign off. 5.4 Funding for the future of the EOL network nationally is unclear. 5.5 Regional The SCN is still under the organisational review process. There has been recent information that there will be extensive funding cuts. It is unclear how much and what impact this will have on the SCN structure although the direction of travel will be in line with NHS direction of travel and the number of networks maybe reduced. 5.6 Data Collection SK updated the group on Data collection. The OACC (Kings) underpin the SPC review. The Outcome Assessment and Complexity Collaborative (OACC) initiative is seeking to implement outcome measures into routine palliative care. Six outcome measures are used in the OACC project these include; Phase of illness, the Karnofsky Performance Status (AKPS), Integrated Palliative care Outcome Scale (IPOS), Views on Care (VoC) measure, the Barthel index (for inpatient use only) and the Zarit carer interview.
The pilot work is being drawn together and the currency developed is going to use some of the same elements. The NHSE currencies is going to include tariffs and case mix complexity. Use phase one to demonstrate quality of care and needs to be aggregated across the board to make it comparable. The information standard will be mandated next year (although this maybe deferred.) The group were keen that SK shared some of the learning from the pilot. It was discussed that this may be done by Webex. to investigate setting this up. 6. 145 AOB None noted. 7. Future agenda items/meeting schedule. 146 7.1 Proposed agenda items to include; 7.2 Next meeting date Thursday 12 th May 2 to 4 pm Wakefield Hospice Aberford Road, Wakefield, WF1 4TS *Suggested agenda items should be submitted atleast 2 weeks prior to the meeting date please to Kathryn.Sartain@york.nhs.uk. Thank you 7.3 Future meeting dates for the Regional Operational Meeting for Palliative & End of Life Care (FOR DIARIES PLEASE) Thursday 11th August Thursday 10th November *All meetings will take place at Wakefield Hospice, 2pm to 4pm 7.4 Y&H Regional EoLC Group Meeting schedule 2016 (FOR INFO ONLY) Wednesday 9th March Wednesday 8th June Wednesday 14th September Wednesday 7th December
No. Actions from the 04.02.16 Action Owner Due Date Action Status 1. Symptom Management Guidelines. Estimate required regarding number of hard copies required to june.toovey@btinternet.com ALL or on-going 2. Contact list revision/update. Any updates/comments to be forwarded to Gail Peacock. ALL/GP 3. Updated version of the revised ToR to be circulated to the regional EOL group for sign off. KS/GP 4. Heart Failure guidelines 2015 revision. To be taken to the next CEG for sign off. 5. OACC project pilot. to investigate feasibility of setting up a Webex to enable sharing from the pilot.