MEETING OF THE REGIONAL TRANSFUSION COMMITTEE CHAIRS Monday, 28 th September 2015 10.00am 12.30pm Royal College of Obstetricians and Gynaecologists 27 Sussex Place, Regent's Park, London, NW1 4RG Draft Minutes Present: Dr Mike Desmond MD Chair and North West RTC Dr Kate Pendry KP Clinical Director for PBM NHSBT, Secretary of NBTC Ms Teresa Allen TA NHSBT Assistant Director: Customer Service Dr Sarah Wexler SW South West RTC (deputising for S Allford) Dr James Bamber JB East of England RTC Dr Gavin Cho GC London RTC Dr Peter Larcombe PL South East Coast RTC Dr Nigel Sargant NS South Central RTC Dr Allistair Dodds AD North East RTC Dr Jon Cort JC East Midlands RTC Dr Chris Newson CN West Midlands RTC Dr Youssef Sorour YS Yorkshire and the Humber RTC Dr Jonathan Wallis JW NBTC Chair Prof Mike Murphy MM in attendance Ms Rebecca Gerrard RG NHSBT National Lead: PBM Team Mr Brian Hockley BH Data Analyst and Audit Manager Dr Paula Bolton-Maggs PB-M SHOT Kairen Coffey KC Education & Audit Lead for PBM Team (in attendance) Nicola Greaney NG Customer Service Support Coordinator Apologies: Dr Sarah Allford SA South West RTC Ms Celina Bernstrom CB EA to the NBTC RTC 01/15 Welcome and Introductions MD introduced KC who will be an observer for the day. Apologies were given by Sarah Allford. RTC 02/15 Minutes of the RTC Chairs Meeting 16 th March 2015 The minutes of the meeting held on 16 th March were approved as a correct record. 28 th September 2015
RTC 03/15 Matters Arising Not discussed. RTC 04/15 Review and Discussion of the RTC Reports North East RTC AD explained that the NE is adopting a region wide policy for management in bleeding of NOACS Newcastle is moving to a stock holding centre which may have implications for transfusion training. East of England RTC Pathology Modernisation continues to be a major concern with 12 of the 18 NHS Trusts in the region part of one of 3 Pathology Networks. JB mentioned that his RTC Chair membership has now reached the end of his term. A successor will need to be appointed. They have so far been unable to recruit more clinicians to the RTT which may impact on selecting a new RTC Chair to attend the NBTC Meetings. London RTC There has been a lot of activity happening within the action groups in the London Region. The Platelet action group have recently completed two surveys, Double Dose and Where Do Platelets Go. The results will be released soon. The PBM Group will be commencing with the Pre-op Anaemia Clinic project in the next reporting period. GC explained that NHSLA transfusion training wasn t a requirement anymore so this has been pushed off future agendas at regional meetings. GC asked the group whether any of them has had problems with this. No one reported any problems. GC has been the RTC Chair for London for 2 years and would like to step down and find another successor to attend future meetings. A discussion took place amongst the group whether the new RTC Chair will need to be a doctor. JW explained that they will need to be an active user of blood as mentioned in the NBTC Terms of Reference and medically trained. North West RTC Key issues in the NW region include funding for the PBM Initiatives and communication of specific requirements of transfusion. There is no easy solution for this due to lack of operability between IT systems. SP-ICE might offer the possibility of a national database, but only for those patients tested at RCI and that hospitals have signed up to the data sharing agreement. There would need to be further thought as to how specific requirements could be held on the SP-ICE database whose responsibility would it be to ensure that the information is 28 th September 2015 2
accurate and kept up to date. South Central RTC The PBM Group are currently drafting a survey on the top ten tips for implementing IV Iron. This will become a regional guide. South East Coast RTC PL would like to thank the committee for acknowledging the efforts that has gone into Harvey s Gang. Harvey s Gang recently won the team section of the Kate Granger Compassionate Care Awards. PL will be stepping down as SEC RTC Chair in September as his 4 year membership will expire then. Expressions of interest for the post will be invited shortly. South West RTC Sarah Wexler gave an overview of the SW report. SW will be auditing the use of Platelets in the SW. Sarah Wexler explained that transfusion practice in primary care is10 years behind secondary care so the SW is also auditing red cell use in primary care. They have an ex GP engaging with the audit. West Midlands RTC CN explained that one trust hadn t signed up to the NCA of Lower GI Bleeding; the Consultant Haematologist explained that he felt a lack of support in the trust both clinically and managerially. A letter of support was sent to the Trust by CN as chair of the RTC Would like to have meetings accredited by a Royal College for CPD; CN noted that the RCoA had started charging for to assess and allocate CPD accreditation for meetings JW suggested that this should be discussed with the Royal College reps in the NBTC meeting as to whether this is common practice or is this just a regional issue. Yorkshire & Humber RTC A survey will be rolled out in September 2015 about the management of patients who have TTP with a view to developing a regional service Availability of albumin Do other regions find this a problem? There has been a national shortage and the Department of Health are looking at developing guidelines on Albumin to enable more equitable procurement. YS explained that TPs, who are transfusion based, are covering duties outside of their role so they can cover as a Nurse. This results in TPs losing 20% of their time. East Midlands RTC 28 th September 2015 3
JC gave thanks and praise to Odette Colgrave, who is the RTC Administrator for the EM region and Y&H RTC. There s an opportunity in the EM region to use ICE, which is an order communication system, to generate transfusion request forms in the future. This means they will already be pre-printed out. A discussion took place on how to make sure we check the right patient ID. RTC 05/15 South East Coast The Informed Consent Action (Group) Pad PL gave a verbal update on progress with this project. The ICAG pads have been introduced to the SEC region and proved most successful in East Kent Trust and Surrey & Sussex Trust. There will be an article in the September edition of Blood and Transplant Matters. There was a discussion about changing the stickers for the use of Paediatrics. The stickers are within the pad for the clinician to peel off and stick on the notes. This has turned out to be a successful project but needs wider uptake. RTC 06/15 Feedback from UKTLC/NBTC Survey PB-M gave a PPP on the feedback from the recent UKTLC/NBTC Survey. RTC 07/16 RTC Audit Report BH gave an update on regional audit activity JW mentioned that Transfusion Medicine Journal is willing to publish results from an audit. We would need to submit the audit with a strong recommendation from RTCs. RTC 08/15 Website Update KP gave an update on website management on the behalf of Christine Roberts, NHSBT Website Manager. NHSBT recently appointed Christine Roberts as Website Manager to support the NBTC & RTC Pages on the JPAC website along with the Hospital and Science website. A discussion took place about the content on the website and for the NBTC / RTCs to review their sections on the JPAC website. The visibility of the website needs improving as the JPAC figures show a low volume of traffic. It was mentioned that the content on the RTC pages were out of date however RG explained that there are two people responsible for each region so they should ensure that the contents of the pages are contemporary. RTC 09/15 Interactive Session: Clinical Benchmarking A new NBTC transfusion request working group has been established to support the Clinical Benchmarking project. The NICE guidelines to be published in November this year and KP would like the group to 28 th September 2015 4
input their ideas into the project. - To produce a standardised specification for transfusion request. Need to develop this specification. Have a drop down list for the reason for a transfusion then the second part would be the justification. This is currently being trialled in Oxford by MM. Several centres use Sunquest ICE for order comms and joint working would allow widespread adoption of the specification in these centres. Sunquest are keen to work with the group to develop a best practice alert to drive appropriate blood use along the lines of the Oxford system - The indication codes would need to be revised as they were last reviewed in April 2013. The transfusion request working group will update the codes and these will be sent for review by NBTC members and RTCs... RG mentioned that there has been a comment that any new recommendations indication codes should be added to the end as most hospitals are currently using the current ones in audits and would find it difficult starting from scratch. The thresholds in the indication codes would be based on the NICE guidelines but would be amenable to local variation if necessary. MD said that Clinical benchmarking had been presented at the PBM Conference in 2012 and wondered why there had been little progress since then. KP explained that this has been a very complex project, including working with HSCIC for 2 years so far but that now that we have provisional approval from HSCIC that it should be possible to move forward, although the next stages could well take a year or two more to reach the point of a feasibility study. Funding has been requested from NHSBT for a project manager. KP asked the group to review: the national patient blood management dataset and the key performance indicators and provide feedback. Action: KP would like all to spend time looking at papers E E3 and feedback to KP by 15 th October. Action: If anyone is interested in joining the Working Group for benchmarking then please let KP know. RTC 10/15 RTC Chairs Item This is MD s last meeting as the chair for the RTC Chairs meeting and also as the NW RTC Chair. The replacement for MD for NW RTC Chair is Dr Craig Carroll. The replacement for the chair of the RTC Chairs meeting would be Dr Youssef Sourer. RTC 11/15 Reorganisation of the North Stuart Penny gave a presentation on the modernisation of manufacturing in the North of England. Below are a few key points from the presentation: - NHSBT will move to three manufacturing sites. Manufacturing 28 th September 2015 5
from Sheffield and Newcastle will move to Manchester - Working 24/7, NHSBT will get the best use of donations and the ability to make components 24/7 - There has been a few issues raised by hospitals to date, e.g. Amount of routine stock to be held at SHUs, contingency for poor weather (how to get blood across the Pennines) and the provision of specialist components. SP commented that the bulk of stock will move overnight in temperature controlled vehicles. NHSBT will ensure that stock holding at all SHUs is reassessed as part of this initiative. - Next steps would be to continue discussions around HTCs, HTTs and user groups. Individual discussions will take place at Hospitals where required then we will develop and agree plans of provision. - A separate project will review the provision of other services EoP (East of Pennines) NHSBT will initiate formal consultation with Hospitals to understand hospital needs and identify solutions which work for patients, hospitals and NHSBT. At the end of the financial year, NHSBT would like to have assessed options and be in a position for a final proposal for EoP TA raised a query about the East of Pennines project regarding feedback from Hospitals for solutions around diagnostics. MD asked if solutions were produced for these sites, would this have an effect on other regions. TA said that we are currently just looking for solutions for hospitals in the EoP region. YS asked will a second delivery for blood products be honoured in the new proposal. SP said this would be discussed in the consultations within each Hospital. RTC 12/15 Any Other Business None was raised. RTC 13/15 Date of Next Meetings NBTC/RTC Chairs Spring meeting Monday, 14 th March 2016 at The Hotel Russell, 1-8 Russell Square, London, WC1B 5NR NBTC/RTC Chairs Autumn meeting Monday, 19 th September 2016 at Royal College of Obstetricians and Gynaecologists, (Rooms on Regents Park) 27 Sussex Place, Regents Park, London, NW1 4RG 28 th September 2015 6
Regional Transfusion Committee Chairs Summary of Agreed Actions: Meeting held on 28 September 2015 Minute Ref Agreed Action Responsibility Completion /Review RTC 09/15 Interactive Session: Clinical Benchmarking KP would like RTC Chairs to review papers E E3 and feedback to KP by 15 th October. All 15 th October If anyone is interested in joining the Working Group that supports the clinical benchmarking project then please let KP know. All 15 th October 28 th September 2015 7