Minutes: Confirmed. Service Delivery and Organisation for Acute Medical Emergencies. Guideline Development Group Meeting 18 & 19.

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Minutes: Confirmed Guideline Development Group Meeting 18 & 19 Service Delivery and Organisation for Acute Medical Emergencies Page 1 of 5

Date and time: 6 September 2016, 1000-1600 Minutes: Unconfirmed Guideline Development Group Meeting 18 & 19 Service Delivery and Organisation for Acute Medical Emergencies Place: Present: Boardroom, National Guideline Centre, 180 Great Portland Street, London W1W5QZ Julian Bion, Chair and Professor of Intensive Care Medicine, Birmingham University, and Consultant in Intensive Care Medicine at Queen Elizabeth Hospital, Birmingham (Chair) Nerys Conway, Trainee in Acute Internal Medicine, Bristol Royal Infirmary, Bristol Christopher Dykes, Out of hours GP, Bristol Jeremy Henning, Consultant in anaesthesia and critical care, British Army, James Cook University Hospital Middlesbrough and Defence Lecturer in Critical care, Royal College of Defence Medicine/Royal College of Anaesthetists Marcus Hughes, Consultant psychiatrist, Department of Liaison psychiatry, St George s hospital, London Sara Morgan, Emergency Department Matron and acting Head of Nursing, St. George s Hospital, Tooting, London Timothy Edwards, Consultant paramedic, London Ambulance Service NHS Trust, and Emeritus Flight Paramedic, London Air Ambulance Royal London Hospital Mike Jones, Consultant in Acute Medicine, County Durham and Darlington, and Senior Lecturer, University of Durham Sue Palmer, Clinical Lead Hospital at Home Team, Oxford Health Debra Quantrill, Patient Member, Twickenham Richard Day, Secondary Care Doctor, Southampton City Clinical Commissioning Group Jennifer Hill, Guideline Lead, NGC Dave Wonderling, Head of Health Economics, NGC Clare Jones, Senior Research Fellow, NGC Maria Cruickshank, Research Fellow, NGC Amy Kelsey, Senior Project Manager, NGC Sedina Lewis, Research Fellow, NGC Vicki Pollit, Senior Health Economist, NGC Apologies: Jason Kendall, Consultant in Emergency Medicine, Emergency Department, North Bristol NHS Trust Cathy Finnis, Patient Member, Kent Anna Edwards, Patient Member, Kent Amanda Farrer, Residential Care Home Owner and Manager of The Knells Country House, Houghton Michael Gill, Medical Director, Health 1000: The Wellness Practice, Page 2 of 5

King George Hospital, Ilford Kate Straughton, Physicians Associate, Acute medicine, Royal Shrewsbury Hospital, Shrewsbury & Telford Hospitals NHS Trust Opinder Sahota, Honorary Professor in Orthogeriatric Medicine, University of Nottingham, and Consultant Physician, Health Care of Older People, QMC, Nottingham Philip Dyer, Deputy Chair and Consultant in Diabetes and Endocrinology, Diabetes Centre Heart of England NHS Foundation Trust Daniel Lasserson, Senior Trust General Practitioner, Department of Geratology, Oxford University Hospitals NHS Trust, Abingdon Community Hospital, and Urgent Care GP, Oxford Health NHS Mihir Varia, Locum community pharmacist and Senior pharmaceutical adviser, NHS East and North Hertfordshire CCG, Hertfordshire Clifford Middleton, Guidelines Commissioning Manager, NICE NICE Staff: Jane Lynn, Business Analyst Notes 1. Welcome, apologies and declarations of interest The Chair welcomed the group to the eightteenth meeting of this Guideline committee. JL was welcomed to the meeting. Apologies were received from PD, JK, AE, MG, OS, KS, MV, DL and CM. The Chair declared that in relation to the previous declarations recorded in the DOI register, for this meeting, the following should apply: The DOI register was made available to the GDG Deputy chair. The Deputy chair reviewed the DOI register and deemed that none of the original DOIs were in conflict with the agenda topics and clinical questions under discussion at the meeting. No action was required. The Chair then requested updates to the existing declarations of interests from GDG members. No declaration was received, so no action was required. 2. Update from subgroup D The GDG was presented with an update on the progress from the subgroup D reruns. 3. Health economic update The GDG was presented with a health economic update. 4. Any other business None. Page 3 of 5

Date and time: 7 September 2016, 1000-1600 Place: Boardroom, National Guideline Centre, 180 Great Portland Street, London W1W5QZ Present: Apologies: Philip Dyer, Deputy Chair and Consultant in Diabetes and Endocrinology, Diabetes Centre Heart of England NHS Foundation Trust Mike Jones, Consultant in Acute Medicine, County Durham and Darlington, and Senior Lecturer, University of Durham (until 14.15) Daniel Lasserson, Senior Trust General Practitioner, Department of Geratology, Oxford University Hospitals NHS Trust, Abingdon Community Hospital, and Urgent Care GP, Oxford Health NHS Mihir Varia, Locum community pharmacist and Senior pharmaceutical adviser, NHS East and North Hertfordshire CCG, Hertfordshire Debra Quantrill, Patient Member, Twickenham Richard Day, Secondary Care Doctor, Southampton City Clinical Commissioning Group Jennifer Hill, Guideline Lead, NGC Dave Wonderling, Head of Health Economics, NGC Clare Jones, Senior Research Fellow, NGC Peter Rouse, Health Economist, NGC Alexander Haines, Senior Health Economist, NGC Giulia Zuodar, Document editor NGC (notes) Maria Cruickshank, Research Fellow, NGC Sharangini Rajesh, Research Fellow, NGC Julian Bion, Chair and Professor of Intensive Care Medicine, Birmingham University, and Consultant in Intensive Care Medicine at Queen Elizabeth Hospital, Birmingham (Chair) Nerys Conway, Trainee in Acute Internal Medicine, Bristol Royal Infirmary, Bristol Christopher Dykes, Out of hours GP, Bristol Jeremy Henning, Consultant in anaesthesia and critical care, British Army, James Cook University Hospital Middlesbrough and Defence Lecturer in Critical care, Royal College of Defence Medicine/Royal College of Anaesthetists Marcus Hughes, Consultant psychiatrist, Department of Liaison psychiatry, St George s hospital, London Jason Kendall, Consultant in Emergency Medicine, Emergency Department, North Bristol NHS Trust Timothy Edwards, Consultant paramedic, London Ambulance Service NHS Trust, and Emeritus Flight Paramedic, London Air Ambulance Royal London Hospital Cathy Finnis, Patient Member, Kent Anna Edwards, Patient Member, Kent Sue Palmer, Clinical Lead Hospital at Home Team, Oxford Health Amanda Farrer, Residential Care Home Owner and Manager of The Knells Country House, Houghton Michael Gill, Medical Director, Health 1000: The Wellness Practice, King George Hospital, Ilford Page 4 of 5

Sara Morgan, Emergency Department Matron and acting Head of Nursing, St. George s Hospital, Tooting, London Kate Straughton, Physicians Associate, Acute medicine, Royal Shrewsbury Hospital, Shrewsbury & Telford Hospitals NHS Trust Opinder Sahota, Honorary Professor in Orthogeriatric Medicine, University of Nottingham, and Consultant Physician, Health Care of Older People, QMC, Nottingham Clifford Middleton, Guidelines Commissioning Manager, NICE NICE Staff: Jane Lynn, Business Analyst Notes 5. Welcome, apologies and declarations of interest The Deputy Chair welcomed the group to the nineteenth meeting of this Guideline committee. JL was welcomed to the meeting. Apologies were received from JB, CM, CD, MH, JK, AF,MG, JHE, TE, SP, OS, KS, SM. The Deputy Chair declared that in relation to the previous declarations recorded in the DOI register, for this meeting, the following should apply: The DOI register was made available to the GDG Deputy chair. The Deputy chair reviewed the DOI register and deemed that none of the original DOIs were in conflict with the agenda topics and clinical questions under discussion at the meeting. No action was required. The Deputy Chair then requested updates to the existing declarations of interests from GDG members. No declaration was received, so no action was required. 6. Update from subgroup B The GDG was presented with an update on the progress from the subgroup B reruns. 7. Health economic update The GDG was presented with a health economic update. 8. Any other business None. Date, time and venue of the next meeting GDG20&21: 10&11 October 2016, 10am 4 pm, Boardroom, National Guideline Centre, 180 Great Portland Street, London W1W 5QZ. Page 5 of 5