Approved Minutes of Regional Endoscopy Services Meeting Wed 19th December 07 NICaN

NICaN Regional Endoscopy Services Meeting

Wednesday 19th December 2007

The Plum Room, HolywellHospital, Antrim

Record of Attendees

Dr Margaret Boyle / SMO DHSSPS
Dr Grant Caddy / Clinical Lead for Endoscopy, South Eastern Trust
Dr Gerard Daly (CHAIR) / Lead Clinician, NICaN
Mr David Galloway / Deputy Director, Secondary care, DHSSPS
Dr Michael Gibbons / Clinical Lead for Endoscopy, Southern Trust
Ms Liz Henderson / Lead Nurse, NICaN
Ms Catherine Hinton / Director of Elective and Acute Services, Northern Trust
Mr Kourosh Khosraviani / Regional Clinical Lead for Endoscopy, NICaN
Mrs Sarah Liddle / Colorectal Support Officer, NICaN
Mr Roy Maxwell / Chair of NICaN Regional Colorectal Cancer Group
Ms Cathy McCook / Service Manager, OPMS, Belfast Trust
Ms Janis McCulla / Patient and Public Involvement Coordinator, NICaN
Dr Colin Rodgers / Regional Training Lead for Endoscopy, NICaN
Dr Chris Steele / Clinical Lead for Endoscopy, Western Trust

Apologies

Ms Cara McCay / Acting Director, NICaN
Mr Andrew Elliot / Director of Health Development, DHSSPS

MES_01Welcome and Introductions/Project Team Membership

Mr Khosraviani welcomed those in attendance to the first meeting of the Modernising Endoscopy Services Project Team and introductions were made. Those present agreed that the proposed list of Project Team members be accepted,with the inclusion of representation from commissioners, on whose populations Bowel Cancer Screening will have an impact. Mr Galloway will follow this up.

Ms McCook stated that the Clinical Lead for Endoscopy for Belfast Trustwill take her place on the Project Team when appointed.

Representation from proposed members not in attendance will be followed up to confirm their status.

MES_02Project Update

Mr Khosraviani provided an update in relation to the overall progress of the project.

  • Endoscopy Services Baseline assessment completed, awaiting final input of results and outstanding data from two Trusts.
  • Project Initiation Document completed for comment at this meeting
  • Patient and Public Involvement outline plan completed
  • Briefing paper prepared for Regional Workshop 3rd April 2008
  • Endoscopy Training Paper prepared for discussion at this meeting
  • GRS Business Case under development
  • Detailed Work Plan building on PID to be developed by Feb. 2008
  • List of key contacts across Northern Irelandbeing developed to aid communication

MES_03Preliminary Data from Baseline Assessment of Endoscopy Services

Preliminary feedback is summarised in the attached slides (numbers 3-16). There was discussion on the following points:

Equipment

There was discussion about the ‘equipment’ feedback (slide 10) and it was agreed to validate this information as a first step to ensure Trusts have equipment replacement programmes in place. Dr Boyle and Mr Galloway will follow this up at Departmental level and link with Mr Khosraviani.

[There has been an amendment to slide no.10 following data validation]

Data Validation

The process of data validation and report compiling will be undertaken during January and February 2008.

Unified Endoscopy Reporting System

Following discussion, it was noted that it would be useful, given the lack of clear data on demand, if this system performed the function of reporting system, linked with GRS /other systems such as PAS, and could also be used as a booking system, allowing Trusts and the DHSSPS access to demand data. It was suggested that the planned user consultation for GRS could also incorporate an assessment of the requirements for this system. Mr Khosraviani agreed to contact SDU regarding the Reporting System to ensure that this issue is kept on the agenda and that the SDU are kept informed of discussions to date.

MES_04Project Initiation Document

Mr Khosraviani outlined the Modernising Endoscopy Services Project Initiation Document contents, which had been sent to the Project Team to read in preparation for this meeting, and asked for any feedback, issues or amendments. Dr Boyle stated in reference to page 16 that the DHSSPS Bowel Cancer Screening Group has not yet been established;however there is an intention to do so.

There were no other issues with the Project Initiation Document, which was accepted.

Funding/Equipment Replacement

Discussion followed around sources of funding to support the project. Dr Boyle stated that the DHSSPS had a small amount of money to pay for GRS, staff costs and Training.

Mr Khosraviani said that Trusts have indicated that significant capital resource is required to support equipment replacement.In light of the fact that these developments would support the achievement by Trusts of the cancer access standards, a request was made as to whether the Service Delivery Unit would be providing funding. No one from SDU was at the meeting so it was agreed that Trust Clinical Leads would go back to their Trusts and look at how much would be required for equipment replacement and how much investment would be required. Mr Khosraviani will liaise with Trust Clinical Leads as soon as possible and approach SDU with a ballpark figure for 2008/09.

MES_05Patient and Public Involvement

Mr Khosraviani welcomed Ms Janis McCulla, Regional Patient and Public Involvement Coordinator for NICaN, and expressed the desire to ensure that Patient and Public Involvement was high on the agenda of the work of this group, and that a mechanism was required to ensure that this focus is central to the work of this group.

Ms McCulla stated that she was happy to be involved and to support the Project Team in bringing forward this work, suggesting that two areas that may benefit from this type of support were training and public awareness. An outline plan for patient and public involvement was agreed as a basis for the way forward for this work. It was noted that any information for patients needs to be presented in an accessible form.

MES_06Regional Modernising Endoscopy Services Workshop 3rd April 2008

Mr Khosraviani asked the Team to comment on the workshop briefing for 3rd April 2008. The document was agreed.

MES_07GRS (Endoscopy Unit Global Rating Scale)

Mr Khosraviani indicated that Trusts have requested that GRS be tailored to suit Northern Ireland. He explained the process and timescales.This process was approved.

[The attached power point presentation (slide no 18) outlines the proposed process for consultation with Trusts to allow implementation by Trusts in July 2008.]

Discussion followed on the GRS requirement which requires units to score an ‘A’ in timeliness (2 weeks for urgent cases and 6 weeks for routine cases for access to diagnostic endoscopy tests). Trusts expressed their support for the introduction of GRS and the consultation process but noted that financial support to carry out the audits required would be helpful.

MES_08Training

Dr Rodgers tabled a paper on Training which will support the modernisation of endoscopy services and gave a presentation on plans for training.

[Slides from Dr Rodgers’ presentation are in the attached Power Point presentation slide numbers 19-32]

Dr Rodgers stated that there is a requirement for a new MR Scanner/Imager to support the development of the regional endoscopy training programme.

The question of whether Upper GI Surgical Registrars should be represented on this group was raised for consideration by Project Team members. No resolution was reached.

Dr Rodgers stated that he and Mr Khosraviani will be attending training to become JAG Assessors.

Colonoscopy Practice Audit

An audit of all colonoscopies done in Northern Ireland for a four month period will commence on 1st February 2008; its purpose is to provide a baseline against which training can be planned and undertaken to support the introduction of bowel cancer screening. All Trusts have received information about this.

Nurse Endoscopists

Discussion on the subject of support for Nurse Endoscopistsfollowed; there was concern expressed that their nurse managers are responsible for ensuring their nurse endoscopists practice to a high standard, however the nurse managers may not be sufficiently experienced in endoscopy to enable them to do this as effectively as they may wish. Ms Henderson, Nurse Director with NICaN, suggested that Dr Rodgersand herself go out and meet the nurse managers to identify how this could be addressed through appraisal, alongside existing clinical appraisal arrangements. Dr Rodgers stated that he would be happy to do this.

Dr Rodgers described the regional Nurse Endoscopist forum; he agreed to find details about the next meeting of the forum and pass these on to Ms Henderson and Ms McCulla.

Bowel Cancer Screening

Discussion about the numbers and age ranges for bowel cancer screening followed; while this is not within the remit of this particular group, Dr Boyle stated that until a budget has been allocated for bowel cancer screening, these matters cannot be decided.

Celtic Workshop

Dr Rodgers highlighted that the date for the Celtic Workshop this year was 28th February in Wales. Attendees (clinicians and nurses) are sought from each Trust and it is advisable to fly and book accommodation for the night before to allow attendance at the meal and opportunity for information exchange/networking.

MES_09Dates for future meetings

The next meetings will be held:

  • Wednesday 5th March 20082.30 – 4.30 pm.
  • Wednesday 28th May 2.30pm – 4.30pm

(Details of the venue will be circulated closer to the time.)

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