NORTH OF SCOTLAND PLANNING GROUP

NORTH OF SCOTLAND PLANNING GROUP Minutes of Sustaining Oncology Services in the North of Scotland (North of Scotland Oncology Services Review SLWG) Time: 3.30-5.25pm Date: Tuesday 30 September 2014 Main Venue: Foresterhill House Committee Room, ARI site + V/C: Pathology Lab, Raigmore Neurology Seminar Room, Ninewells Chair: Jim Cannon, Director Regional Planning, NoSPG Present: Grace Ball, Regional Programme Manager (Cancer), NoSPG; Diane Brawn, Radiotherapy Manager, NHS Highland; Steve Colligan, Section Head of Radiotherapy Physics, NHS Highland; Keith Farrer, Programme Manager, NoSPG; Lesley Forsyth, Regional Programme Manager (Cancer), NoSPG; Jim Foulis, Clinical Service Manager, NHS Tayside; Carol MacGregor, Consultant Oncologist, NHS Highland; Derick MacRae; Cancer Services Manager, NHS Highland; Neil McLachlan, NOSCAN MCN Manager; Una Milne, Head of Therapeutic Radiography, NHS Tayside; Gillian Needham, Postgraduate Medical Dean, NES; Ruth Nisbet, PA, NOSCAN; Mark Parsons, Macmillan Regional Cancer Pharmacist, NHS Tayside; Nicola Redgwell, Radiotherapy Manager, NHS Grampian; Les Samuel, Consultant Oncologist, NHS Grampian; Audrey Warden, General Manager, NHS Tayside; Apologies: Jane Barrett, Clinical Lead for Programme; Frances Elliot, Deputy Medical Officer, Scottish Government; Pip Farman, NoSPHN Representative; Annie Ingram, Director of Workforce, NHS Grampian; Peter King, Consultant Surgeon, NHS Grampian + NOSCAN Lead Clinician; William Moore, Consultant in Public Health Medicine, NHS Grampian; Marianne Nicolson, Consultant Medical Oncologist, NHS Grampian; Les Samuel, Consultant Clinical Oncologist, NHS Grampian; Sami Shimi, Consultant Surgeon + Lead Cancer Clinician, NHS Tayside; Cara Taylor, Macmillan Cancer Nurse Consultant, NHS Tayside; Jane Tighe, Cancer Centre Lead, NHS Grampian; Item 39-14 Welcome / Introductions JC welcomed everyone to the meeting followed by round table and V/C screen introductions. There was a slight delay in NHST joining in by V/C. 40-14 Accuracy of previous meeting notes (Wednesday 30 July 2014) These were accepted as being an accurate record of the meeting. 41-14 Matters arising Item 21-14i Regional capacity shortfall escalation process GN advised there would an annual Careers Fair event in future and this would allow an opportunity for territorial Board to have stands. She said the Deanery covered all Scotland now and it was increasingly important to have a presence at such events. Item 24-14 Communications The September newsletter giving up to date information on the SOSNOS, programme would go in the next few days. Item 25-14 Cancer Modernisation funding NHSH had been unsuccessful in their bid for an electronic MDT. KF would Page 1 of 6 Action

be in touch with DMacR to go over CCP. Item 35-14d Communication Plan & will revisit the original PID following the clinical leads meetings and the consensus event when a clearer direction will be known. 42-14 Discussion a Regional patient transfer tracking system Grace presented an outline proposal based on feedback from Unit Operational Managers on the need to have a system in place to track regional transfer of patients. The question has arisen whether any existing software/systems/ tools used by any of the boards could be adopted for this purpose. KF / JC suggested agreeing a business need in the first instance then look for a solution before making recommendations. JF suggested trying a national process but KF said this had already been suggested in WoSCAN but a number of Boards did not want to move nationally at present. NMcL said a 2 nd Beatson satellite centre would open soon and the west would then need a tracking system. KF supported the use of CCP as a reliable tool. reported that CCP is not used in Tayside and is not compatible with their current IT systems. DMacR said it was a while since NHSH looked at CCP and at the moment they were using a spreadsheet for tracking. said the recording had to be more robust than this. 4.00pm Carol MacGregor joined the meeting AW agreed the need for a patient transfer monitoring system but urged cation around terminology because of the potential for confusion with Cancer Tracking which is a requirement for waiting times tracking and cancer audit data. AW asked if cancer tracking and cancer audit systems are aligned across the Boards. KF said different boards have different configurations some combine cancer tracking and MDT others were separate functions. AW will liaise with the cancer audit and business access teams in NHST and will set up a meeting for AW, JF and to discuss this. AW/JF/ b KF agreed CCP was not perfect but was constantly evolving and could be used for both tracking and/or MDT. He gave the example of thyroid using it as an MDT tool only. Lothian had given local hosting to NHS G for the duration of neuro MDTs and it had worked well. Orkney, Grampian and Shetland use CCP for tracking. KF advised CCP can import data from SCI store but it does not work with radiotherapy ARIA and chemocare so data has to be entered manually. KF suggested Tony Rafferty do a demo, either by V/C or face to face; welcomed this suggestion and asked if DMacR, JF and Sue Brown could be invited. Harmonisation of patient travel subsistence costs advised that there here are differences across the North of Scotland on patients entitlement to support for travel and subsistence. NHSH is presently updating its policy which should be available at the end of this year and asked if the other boards might consider adopting this as a joint approach for the region. JF advised there was an established protocol in Page 2 of 6

NHSTfor all patients and questioned if it could be applied differently just to Oncology patients. If there were changes for cancer patients, there would need to be a change for others. DMacR said NHSG & NHSH were interpreting the national guidance differently so suggested holding back until NHSH had completed their policy. Comparison paper of the six NoS boards to be added as agenda item for December SOSNOS). Oncology Patient Transfer Standard Operating Procedures (2014) had prepared a SOP detailing the process of patient transfer coordination for patient receiving treatment outside their home board. This had been widely circulated and commented upon and now requested SOSNOS ratification. GN questioned if clinicians had been involved in mapping the patient journey, and had any lay people or patients been involved in constructing the SOP. undertook to revisit the process with patient groups. DMacR said there was a gap nationally and this needed to be shared with the west of Scotland. JF agreed with these comments and asked for a tight turnaround time review of the SOP and that it be tested for patients. to complete a graphic with clear threads showing the communication responsibilities within the SOP. c KF said it was unclear if the referrer or receiver was coordinating the travel/ accommodation. said that during conversations with ECC and BWoSCC they had been explicit that referring boards should be responsible for arranging transport and accommodation. advised ECC was also keen to add contact names in each board to the transfer SOP; NHSH have a named coordinator (Emma Ross) but there is no identified coordinator for NHSG or NHST. KF suggested coordination could be done electronically in CCP. JC suggested assessing CCP to see if this SOP could fit into CCP. AW suggested it may also be possible that checkpoints could be built into their tracking tool. to speak to Gary Jenkins (BWoSCC) and Clare Gorman (ECC) to discuss how they manage transport and accommodation coordination for patients from other boards e.g South Ayrshire, Borders, D&G Feedback from Clinical Leads 10 Sept meeting It was acknowledged there was little agreement resulting from this meeting and further discussion was needed on NHST aligning with NOSCAN or SCAN and Grampian and Highland having a tighter alliance. AW advised that following the NPF, Lesley McLay, Chief Exec, NHST and their Medical Director were seeking an urgent meeting with clinical and local management to discuss this, and move the agenda forward. JC said LMcL would follow Richard Carey as Chair of NOSCAN and added NHST was needed in an obligatory way, to sustain services in the north. Page 3 of 6 NHST

d Future service models tabled 3 models at this meeting and explained each one in turn. e GN thought this was very helpful to see these models and suggested adding contemporary leadership publications such as the King s Fund to demonstrate collective working, not collaborative. GN also suggested 3 slides from Mike West s work on quality health care. She emphasised the importance of clinical leadership. welcomed these comments and said the point of the consensus event was based on how to overcome barriers, strengths/weaknesses and what are the alternatives. had looked at different options and was open to any other suggestions. GN suggested these models be presented at the Consensus Event but not to refine them beforehand. KF said he had been working with NoSPG for 2 years and a regular working issue is with clinicians and not with management teams. He questioned if there was some organisation which worked with clinicians to encourage them to think differently. GN suggested working on pared learning which encouraged conversations across disciplines, conversations around building relationships and involves colleagues shadowing different posts. AW advised NHS T had started to use this and JF had been involved in the early stages. JF said this has been done at team and unit level and is ideal to explore collaboratively and go through the process at local and regional level. JC asked how the group would reach eventual agreement but replied that the agenda for the Consensus Event would cover all aspects and once & had prepared a paper to present to NoSPG, the 6 Chief Executives would make the decision on which model to follow Consensus event programme was keen to attract a range of disciplines to this event and outline the potential and the challenges to moving to regional collaboration. JC suggested GN s point on leadership and GN volunteered to discuss this beforehand with &, but offered her apologies for the actual event. The basis of the event would be to encourage grass roots champions for regional working. Feedback indicates that some Oncology professional groups feel detached from decision making and that so far discussion may have been predominantly medic centric, so this event would provide an opportunity for all to be involved. Cancer Leads and members of the Oversight Group would be invited. had hoped for input from Malcolm Loudon and Peter King but this would no longer be possible. CMacG added there were problems with radiology and pathology in regional MDTs. said not all MDTs would be regional and there would still be autonomous working although KF said regional MDTs replacing local MDTs would give clarity around models. JC questioned whether there should be a series of consensus events; KF agreed there may be a need for these. JC said Dr Frances Elliot, Deputy Chief Medical Officer, Scottish Government has asked for clear outcomes. GN asked who would champion the idea in the future as it would be useful to have someone in each centre who colleagues would listen to; CMacG agreed with this suggestion. JC said further conversation would take place outside of this meeting. / GN// Page 4 of 6

would be looking for colleagues to help with facilitation lists. 43-14 Reporting a b c d e f 44-14 a Escalation Policy ratification has redrafted this and circulated nationally to SCAN, WoSCAN and the Island Boards. thanked JF, SB and DMacR for their contribution. will table this final paper for ratification by RCAF on 28 November. JC thanked & for their work on this. PACs data transfers reported that Dr Geraldine McClure (NHSG) has kindly provided guidance to the programme team on ways by which the use remote radiotherapy treatment planning could be improved to support regional working. A key feature of her guidance and that of the Heads of Medical Physics is that PAC s should be investigated as measn to safely transfer RT treatment data as well as images., Dr Salam Souliman and Steve Mason (both NHST) subsequently met with the NSS National PCS team and Carestream to discuss this proposal. Alan Flemming (NSS) and Norman Pinkney (Carestream) currently explore this with their teams. Table for SOSNOS discussion in December. Paper light update Les Samuel had asked if there was a possibility of harmonising paperwork across the 5 centres. The move from the Radiotherapy Planning Board to the National Planning Forum had halted progress. A national meeting had been set up, but advice from today s table was there was no quick fix. Workforce update to note reported: Highland have two new long terms locums and are currently stable Tayside have some radiography vacancies. Tayside are due to interview for a proleptic consultant Grampian has 3 consultant vacancies at present; 1 has been filled by a locum, 0.6 is being covered by a registrar and 2 consultants are doing extra sessions. Grampian and Highland both have Medical Physics vacancies It is acknowledged that there is likely to be succession planning problems for Nursing and Radiography within over the next 5 years. CMacG reported that Kay Kelly would now cover NeuroOncology for NHSH and that Les Samuel was still carrying out Upper GI and Lower GI radiotherapy in Highland. CMacG reported that the new locum would now cover Sarcoma and Lymphoma for NHSH. JF asked if RC had been advised of this and CMacG confirmed that he has been made aware. Activity plan update to note updated actions from the last meeting. Risk Log update to note There was no change to the risk log. voiced concern over risks to the programme if & s input continues to be sought for involvement in board specific work / wider national work. Both parties stated they were keen to be involved in national work relating to this programme, but noted risk to the anticipated outcomes of the SOSNOS programme if they take on work not directly related to this programme. JC suggested additional work should be taken to the Oversight group for further discussion. AOCB ehealth JC reported he had sent an SBAR to regional ehealth leads re connectivity Page 5 of 6

b issues. This follows LS s work in Highland where he still faces difficulty accessing NHSH clinical systems through NHSG firewalls. Access to GCS System JC had also spoken to ehealth Leads about information stored on the NHST GCS system; they had no issue on giving clinicians access to this. CMacG asked pressure be kept on ehealth issues as these had been ongoing for some time. JC asked Kerry Russell to go back to ehealth in October/November to ensure progress is keeping to time. KR c 2015 meeting dates January to June 2015 SOSNOS meeting dates and venues are attached. 45-14 Dates and times of next SOSNoS meetings As outlined below Wednesday 29 October Tuesday 25 November 3.00-5.00pm 3.30-5.30pm Foresterhill House Committee Room, ARI site Foresterhill House Committee Room, ARI site Seminar Room Macmillan Suite Raigmore Seminar Room Macmillan Suite Raigmore Renal Seminar Room, Ninewells 512 880644 Ward 32 Education Room, Ninewells Tuesday 16 December 3.00-5.00pm Foresterhill House Committee Room, ARI site Seminar Room Macmillan Suite Raigmore Ward 32 Education Room, Ninewells Page 6 of 6