Nursing ERG - DRAFT Minutes Date: Tuesday 25 th March, 15:00-17:00 Venue: Meeting room 2, 3 rd Floor 170 Tottenham Court Road, W1T 7HA Chair: Judith Douglas ATTENDEES Name Role Trust/Organisation Judith Douglas Chair of ERG BHRUT Kay Eaton UCLH representative UCLH Lynda Farmer H&N Board representative UCLH Jacquie Peck Colorectal/UCLH Representative UCLH Sharon Cavanagh Lead for LWBC and AHP London Cancer Melanie Ridge Earlier Diagnosis Programme Manager London Cancer Raten Davies Breast CNS Royal Free Flora Dangwa Haematology Board representative Royal Free Philippa Dooher Breast Board representative The London Clinic Karen Phillips Lead Cancer Nurse Whittington Fiona McKenzie Patient Experience and Involvement Project London Cancer Manager Martina Kelly OG Board Representative Homerton Nichola Kane Lead Cancer Nurse (Solid Oncology) Barts Health Nellie Munga Breast Screening Nurse Barts Health Stuart Caplan Patient representative APOLOGIES Name Role Trust/Organisation Jill Herbert PAH representative PAH Alison Hill Lead Cancer Nurse UCLH Margaret Brown H &N Board Representative NMUH Karen Summerville Gynaecology UCLH Elizabeth Lloyd-Dehler Patient representative Gill Robertson PAH representative PAH Michael Pine BCF Representative BCF Fiona Paterson Julie Bayliss GOSH Representative GOSH Cliodhna O Sullivan Urology Board Representative Royal Free Catherine Docherty Royal Free representative Royal Free Julie Woodford RNOH representative RNOH Kim Grove Brain & Spine representative BHRUT Pauline McCulloch Colorectal Board Representative Homerton Lena Community Nursing Representative Barts Health Coombs O Brien Denise O Malley Royal Free representative Royal Free 1
ACTION LOG Action Owner Date agreed Status Circulate the A&E audit results slides and FM 25/03/2014 Open patient case study slides. Look into and circulate research on outcomes FM 25/03/2014 Open and experience of HNA tool use. Meetings reset for 2014 - it was agreed that JD & FM 25/03/2014 Open the meeting times would alternate between: Tuesday AM, Tuesday PM, Thursday PM and Friday AM. An online discussion forum would be set up on FM 25/03/2014 Open Yammer to enable informal discussion between meetings. An online discussion forum post around JD 25/03/2014 Open research possibilities will be started. Re-examine the membership of the group. JD 25/03/2014 Open All other issues raised by the survey would be JD & FM 25/03/2014 Ongoing either standing agenda items or special topics for presentation at Nursing ERG meetings. Develop CNS role workstream. JD, NK, 25/03/2014 Ongoing KE KE will share further information about the KE 25/03/2014 Open UCLH cancer CNS work at a future meeting. 2014 Level 2 training dates will be recirculated. FM 25/03/2014 Open Circulate a brief summary of work on the CNS FM 25/03/2014 Open audit to disseminate by Lead Cancer Nurses. Circulate copies to the group of documents FM 25/03/2014 Open outlining courses available for nurses. SC will explore possibilities for research strand SC & MB 25/03/2014 Open of annual plan around HNA and evaluating implementation. Mark Barrington (MB) / SC along to clinic to SC, MB, 25/03/2014 Open show the lack of space for HNA implementation. NK FM will circulate information prescription FM 25/03/2014 Open update to the wider group LF will send FM the Head and Neck template LF & FM 25/03/2014 Open for transferring patients, to be circulated. All Nursing ERG members interested in All 25/03/2014 Open screening in BME communities to contact Nellie Munga Nellie Munga to be added to the Nursing ERG contact list FM 25/03/2014 Open 2
1. Welcome and apologies JD welcomed members of the group and apologies were heard. 2. Minutes from the previous meeting & matters arising The minutes from the previous meeting (July 2013) were agreed and all matters arising were agreed to already be on the agenda. 3. A & E Audit Presentation of results MR presented the A&E audit results to the group. It was agreed the FM would circulate the slides and the patient case study slides. The initial recommendations from the work are: To work with informatics in trusts to improve data quality, ensuring accurate, robust and timely data, which will measure in near real-time how many cancer patients are diagnosed via A&E. To discuss how the ICS can embed this metric, as part of routine clinical processes. To discuss optimum pathways for patients with colleagues in primary and secondary care and develop a recommended pathway for the patient who presents in A&E. To further identify reasons why there is a delay in diagnosis once the patient has presented to A&E and to ensure fail safe mechanisms are put in place. To work with primary care to extend the data collection and to analyse the data jointly in the pathway boards and by trust to find ways of reducing the numbers of patients who end up presenting as an emergency. To take learning from patient interviews and do further work to understand which patients are most likely to ignore symptoms. 4. HNA implementation and other LWBC SC presented the work so far on HNA implementation and in the Living With and Beyond Cancer workstream. The Pan-London HNA tool has been developed with the Psychosocial ERG and work is ongoing on familiarisation training sessions. It is proposed that half-day sessions be run in each Trust with attendance from CNSs, run by the appropriate clinical psychologists from the Psychosocial ERG and SC will attend one half-day session per Trust. Trusts will organise the date and time for the training. It is hoped that Lead Cancer Nurses will attend for at least part of the session and each training session will train 20 CNSs and AHPs at a time. SC asked for feedback about how best to run these at each Trust. It is envisaged that the first trainings will take place over April / May. Regarding HNA tool implementation, SC outlined that 9 out of the 11 London Cancer Trusts have confirmed that they have introduced the tool across at least one tumour site. Barriers to implementation, including resource constraints, have been identified. NK raised the concerns around technical issues and resource constraints for Barts Health. SC stated that the HNA and training could be rolled out as needed at Trusts, according to local constraints and concerns. NK raised the issue of some research on HNA done by London Cancer 3
Alliance (potentially?) looking at difference in outcomes and experience for patient where tool used vs where the tool has not been used. FM will look into this research and circulate. KP raised whether Macmillan training (as part of the e-hna pilots) would also cover same things as the HNA familiarisation training proposed. Macmillan training covers technical needs but the London Cancer offer will provide greater familiarisation training. SC reiterated the need to have local conversations about how best to roll out training. Minimum 6 weeks notice will be given for timing. NK fed back that 20 attendees might be too many (in terms of down-tools time) and SC agreed that it could be flexible depending on sites. DC highlighted that Macmillan are still looking for e-hna pilot sites and urged other Trusts to apply. 5. Report on responses to ERG survey JD summarised the report on responses to the ERG survey and highlighted the external changes within the wider landscape and London Cancer patch, particularly around reorganisation within local organisations. Effort had gone into developing work around the number of CNSs needed per patient per tumour type but unfortunately funding was not found to develop this work further. The report outlined 6 recommendations: 1. Seek agreement on a change of meeting time to alternating times including Tuesday AM. 2. Set up an online discussion forum to enable informal discussion in between meetings. 3. Re-examine the membership of the group. 4. Develop workstreams with clear objectives within the 2014/15 plan relating to the top 3 areas of concern, and create or maintain sub-groups to take this work forward. 5. Include the other system-level issues raised either as standing agenda items or special topics for presentation at Nursing ERG meetings. 6. Review the regularity of meetings once a 2014/15 workplan has been agreed. 1. It was agreed that the meeting times would alternate between: Tuesday AM, Tuesday PM, Thursday PM and Friday AM. 2. An online discussion forum would be set up on Yammer to enable informal discussion between meetings. 3. JD would look at the membership of the group and look particularly at members who had neither turned up nor sent apologies in the last 12 months. 4. The group agreed to focus on one workstream examining the role of the CNS. The workload of a CNS has not been reviewed recently and it was felt that perhaps this was the time to explore this including the CNS role and job description. NK suggested changing the focus to amount saved (via bed days for example) by further CNS growth. 5. All other issues raised by the survey would be either standing agenda items or special topics for presentation at Nursing ERG meetings. 6. The group were agreed that quarterly meetings were sufficient and are still happy to come to Tottenham Court Road for meetings. 4
6. CNS audit feedback and actions Following the discussion above on the report on the survery responses, JD presented the summary report on the CNS audit. While this brought up already identified issues, it is a useful audit of perspective. FM will circulate a brief summary of work on the CNS audit to disseminate by Lead Cancer Nurses. It was felt that standardising what CNSs do across Trusts could be helpful. The group could look at CNS job profiles. This work would distinguish between what various similar roles do. UCLH has done a lot of work to develop a cancer CNS community of practice to learn from each other and help solve some of the challenging issues. The Macmillan Support Officers, working with CNSs, have made a tremendous difference as well. KE will share further information about this work at a future meeting. KE s internal audit of the role of CNSs has led to an increase in CNSs. The majority of CNSs have done ACST and level 2 training. Level 2 training dates will be recirculated by FM. NK raised that Barts would like more ACST as they have a number of new CNSs. 7. Update on working groups Education LF and PD outlined the education opportunities for nurses within our area. City do run courses but accessing their portfolio was challenging. They outlined that most difficulties are around funding and discussed the need for a supportive statement to encourage Trusts to focus on learning and development. DC outlined the option for funding from Macmillan for Macmillan Professionals. FM to circulate copies to the group of document outlining courses available for nurses. CNS role As CM left, this group has not got off the ground. This will be pursued in the 2014/15 workplan. 8. Nursing ERG Annual Plan 2014/15 Having discussed the need to focus on the CNS role, the group discussed research and patient experience work within the annual workplan. Research could be explored through Masters or research nurses needs. An online discussion forum post around research possibilities will be started, focusing on the following specifics: CNS workforce and learning and development the number of patients per CNSs research around HNA and evaluating implementation. SC will explore this. NK raised getting Mark Barrington (MB) / SC along to clinic to show the lack of space for HNA implementation. SC agreed to this. 5
9. Information prescription FM circulated an update from Tatyana Guveli (Macmillan Development Manager). FM will circulate update to the wider group. The Breast Pathway Board are keeping a focus on this and London Cancer will keep updated on work in this area. 10. Update on Staff College training Unfortunately there has been a lack of interest in attending this due to time commitment. It was agreed that work on this would be shelved. 11. London Cancer Pathway Board updates The Head and Neck Pathway Board have agreed a pro-forma to send patients between Trusts and are next looking at amalgamating the local patient experience surveys. Patient information at each stage of the pathway will also be agreed next. LF will send FM template for pro-forma to be circulated. 12. Any other business Nellie Munga (Barts Community Breast Screening nurse) is working to improve screening in BME communities and would like to be in touch with anyone interested in this work or with patients in this area. Raten Davies has quite a few but they often leave the country mid-treatment. FM and Raten will be in touch with Nellie. Nellie Munga to be added to the Nursing ERG membership list in place of Lena Coombs O Brien. 6