Name of Group / Meeting: Diabetes Foot care Meeting Date: 17 February 2017 Time: Venue: Present: Apologies: 2:00am 4:00am Meeting Room 1, Second Floor, Chester-le-Street Hospital DH3 3AT Kirstie Taylor, AHSN NENC (KT) Julie Parsons, Northumbria HCT (JP) Helen Warburton, North Tees and Hartlepool FT (HW) Elaine Ricci, City Hospitals Sunderland (ER) Lynn Calland, Gateshead Foundation Trust (LC) Rahul Nayar, City Hospitals Sunderland - Chair (RN) Kate Mackay, Northern England Clinical Networks () Karen Dunn, Northern England Clinical Networks (KD) Claire Froggett Lucy Wales Emma Scott Naveen Aggarwal Jonathan Duffy Linda Hicks Gillian Mulvey Nicola Coates Rob Colclough Seema Ijaz Simon Ashwell Page 1 of 8
Brief Summary of Meeting: RN welcomed the Group and introductions were made. Previous minutes were agreed as a correct record. There were no declarations of interest. Matters Arising: Website Work was continuing on the Networks website as a whole. RM said there was a need to understand what was important and relevant to foot care information, as going forward, only one year s material would be available to view for each network. Interest had been received from other sites wanting access to the website in order to share good practice. Direct Referrals between Hospitals Update This was progressing well, although, region- wide there were still issues with people agreeing to use NHS Net email addresses. This issue was currently held in abeyance. Charcot Pathway Update This is now complete and listed on the website. Both Nottingham and London are interested in this work. Foot care Pathway and National Foot care Audit Update Both the Foot care and Inpatient national audits would be published the following month (March 8 th ); a rough dataset was anticipated. 100% participation was noted. These would be published at the DUK Conference in early March and It was agreed units and the network should consider drafting a suitable response in anticipation of the results. With regards to in-patient foot screening (neuro-vascular assessment) along with referral to Foot MDT s for acute admissions will be key components for the audit and factors the network needs to address. Durham Hospital had previously incorporated as part of their admission clerking booklet a section on inpatient diabetic foot screening, if successful this could be a useful tool to help other units around the region. Page 2 of 8
Information and presentation on Tissue sampling piloted at Newcastle had been uploaded and shared. RN would like to look at screening, treatment of ulcers and who is involved in the MDfTs. Data is available and agreed to undertake a data crunching exercise to establish a starting point. Previous Action points Completed. With regards to number 7, RN agreed to contact DUK as agreed, but informed the group she was seeing newly appointed staff on 22 February with ES. Workplan It was envisaged the foot care work plan would dove tail into the diabetes work plan. Reference was made to a link previous circulated by on foot checks. Wide variations across the Region were noted. Although the information could be used to help with planning capacity and demand issues, there is concern about the number of foot checks being undertaken which appear to be decreasing Reference was made to PHE data outlining decrease in foot checks despite increasing numbers of people with diabetes. Link below refers. https://fingertips.phe.org.uk/diabetes#page/0/gid/1938133002/pat/46/par/e39000027/ati/19/are/e38000041 Reference was made to a useful link on NHS Digital which gave access to information on an individual CCG basis /RN to forward link to Group RN referred to the previous years foot care Audit and said huge self-referral rates had been identified, this would be reflected in data expected 7 March. Work on Vascular Centres was still in abeyance, however, work previously identified would continue. Page 3 of 8
Workplan to be shared with minutes. Transformation Plans National STP Funding was to be distributed across 44 STPs. The Northern Region had 3 STPs and a request had been made to bid in collaboration with CCG STPs. A number of applications had been submitted for foot care. The process for bidding had been driven nationally the previous year and lack of sufficient notice had resulted in bids not being submitted. It was hoped this would be avoided in the next round and bids would be submitted within timescale. Funding would only be available for the first year as there would be no recurring funding. Regional gap analysis on MDfT to start alignment with NCEPOD recommendations RN advised that following internal discussions the idea of resurrecting peer reviews had been agreed. As this initiative would not be funded, the Group were asked if they would consider visiting neighbouring organisations within the Region to share good practice and identify possible gaps; this was agreed. RN said in order to embark on a transparent process, good gap analysis was imperative. As appropriate individuals would need to be approached for agreement to this course of action, an email would be forwarded for onward circulation. would share Peer Review Template with the Group. Current gaps in services were discussed and it was agreed in order to recognise what was happening Regionally, going forward, at each Network meeting a member of the group together with a colleague from their own team would give a brief presentation on their good practice. A Volunteer was sought for the next meeting and would be in touch. ER to send a copy of a suggested format to the Group. Page 4 of 8
Foot care Activity Profiles The Group were asked to consider the Foot care Activity Profiles. No formal mechanism to discuss data had been identified. RN would take this issue forward at a Regional level. Podiatry and AF Following previous discussions regarding pilot work undertaken in Durham and Darlington, queries had been raised in relation to numbers identified (5,000). Linda Hicks had now confirmed, IT had added everyone together and data should have showed for every 500 patients seen 1 new AF case was picked up. would amend the report and reissue to the Group, she also agreed to meet with all areas in due course. The Group noted Professor Oliver James, Medical Director, AHSN had suggested there maybe some monies to develop an App to deal with IT issues. RN said Podiatry and AF was something that could be added to the Agenda for the Clinical Networks Quality Improvement Day to be held on 26th April 2017. Comms KT outlined the role of Comms. It was noted they had been contracted to undertake a general network role and an SLA was currently in development. Work had been undertaken with Jenny Hicken on the new website and a meeting had been held to discuss the possible creation of a calendar of activities to map out what was going on; once the SLA was agreed the calendar would be shared. A report was expected 7/8 March which would be added to the website. KT advised Comms could help with templates and it was agreed she would work with to raise the profile of sub networks and determine who they could contact on a monthly basis to keep updated. KT advised she would be happy to attend the next meeting and would share the aforementioned calendar once the SLA had been agreed. Reference was made to Clinical Trials Week. The group were asked if they had any examples of best Page 5 of 8
practice or good patient stories they could share. On 22 March a Quality Fellows event would be held, following which, training would be put in place. ` An event would be held early April to consider bids and how they would be implemented, KT to feedback at next meeting. Any other Business 3.1 Annette Routledge had been appointed as Clinical Lead in-patient diabetes on behalf of the Network. 3.2 Potentially, another patient representative would be joining the Group. 3.3 It was agreed another Symposium would be held, RN had forwarded an email to Podiatry Managers for their support, this would be resent. Discussion followed on attendance, and specific distribution lists to target appropriate individuals. The event would take place on 10 October at The Durham Centre, Belmont. would consider previous evaluation forms to draft an Agenda. The Group agreed there was a need to include Wound Management Assessment on Diabetics. would liaise with Alison Featherstone to determine if any resources would be available to support the event. 3.4 A Diabetes Quality Improvement Event was to be held on 26th April 2017 at the Durham Centre, Belmont. RN advised it would be good to include foot care on the Agenda and asked the Group to consider possible items for discussion e.g. pathways or any good practice. Group to feedback to RN. Next Meeting The next meeting will be held on 5 May at the Education Centre, Sunderland (please note this meeting has been moved from 19 May) Payment for parking will be required. Page 6 of 8
ACTION POINTS: Agenda Item 2.1 2.2 2.3 2.4 Subject Actions Target date Person responsible Matter Arising Charcot Pathway Update DUK agreed to undertake a data crunching exercise to establish a starting point. to feedback outcome of meeting to be held 22 February to RN. Work Plan /RN to forward NHS Digital link to Group /RN Transformation Plans Regional gap analysis on MDfT to start alignment with NCEPOD recommendations Foot care Activity profiles would share Peer Review Template with the Group. ER to send copy of suggested presentation format to the Group. As appropriate individuals would need to be approached for agreement to carry out Peer Reviews, an email would be forwarded for onward circulation. Individuals were to inform who would present their good practice at the next foot care meeting to be held on 5 May. Group to consider activity profiles. RN would take this issue forward at a Regional level. ER All All RN Page 7 of 8
Agenda Item 2.5 2.6 Subject Actions Target date Person responsible Podiatry and AF Any Other Business Symposium would amend the Podiatry and AF report and reissue it to the Group. would meet with all areas in due course. RN to resend email to Podiatry Managers for their support. would consider previous evaluation forms to draft an Agenda. would liaise with Alison Featherstone to determine if any resources would be available to support the event. Group to consider possible items for the Agenda e.g. pathways or any good practice and feedback to RN. RN All Page 8 of 8