West Yorkshire Major Trauma Network Meeting

Thursday 10th November 2016- 14:00 – 16:00

Leeds General Infirmary

Chair:

Jon Jones (JJ)WYMTN Network Lead & EDLeeds General Infirmary

Clinical Lead

Attendees:

Mark Davies (MD)MT Lead & EM ConsultantCalderdale Hospital

Networks Manager

Ralph Armsby (RA)TARN Co-ordinatorHarrogate District Hospital

Becky BlytheLead Major Trauma SpecialistNurseLeeds General Infirmary

Kathryn Ellison (KE)Physiotherapist/TraumaBradford Royal Infirmary

Alex Danecki (AD)Airedale Trauma LeadAiredale General Hospital

Rachel Barratt (RB)TARN Co-ordinatorAiredale General Hospital

Michael Smith (MiS)Consultant EDHarrogate District Hospital

Helen HuntLeadership FellowYorkshire Ambulance Service

Andrew BottomleyGeneral Manager Orthopaedic Huddersfield Royal Infirmary

John Hancock (JH)Service Delivery LeadYorkshire & Humber Commissioning Support

Tina Wall (TW)Trauma Network ManagerLeeds General Infirmary

Apologies:

Matthew Smith (MS)WYMTN Rehab Clinical LeadLeeds General Infirmary

Kirsty Lowery-Richardson (KLR)Lead ParamedicYorkshire Ambulance Service

Doranne Beresford (DB)Divisional General ManagerBradford Royal Infirmary

Andrew SingletonSystems Resilience ManagerNorth Kirklees & Wakefield CCG

Keith KoncinskiDelivery ManagerNorth Yorkshire & Humber Clinical Networks Team

Ahmed AkhtarAssociate Specialist & MT LeadBradford Royal Infirmary

Lesley Hawthorne (LH)Consultant AnaesthetistBradford Royal Infirmary

Richard Gorman (RG)EM ConsultantPinderfields General Hospital

Andrea Berry (AB)WY Operational Delivery Leeds General Infirmary

Diane ArmstrongWard Manager, L22Leeds General Infirmary

Andy PountneyLead for Enhanced CarePinderfields General Hospital

Erceline Radic (ER)Patient Service Manager Urgent CareAiredale General Hospital

Nik Kanakaris (NK) MTC Clinical Lead Leeds General Infirmary

Fiona White (FW)Matron Leeds General Infirmary

Andy Baker (Aba)Anaesthetist Bradford Royal Infirmary

David Lavalette (DL)Trauma Lead & Consultant Harrogate District Hospital

Orthopaedic & Trauma

Kevin Peters (KP)Service SpecialistNHS England

Tamsin Gregory (TG)Anaesthetic ConsultantAiredale General Hospital

Linda Driver (LD)Developments & TransformationNHS Wakefield CCG

Stephanie Davis (SD)MatronHarrogate District Hospital

Mel Clover (MG)ED Nursing Team LeaderAiredale General Hospital

Mark Millins (MM)Lead ParamedicYorkshire Ambulance Service

Mark Powis (MP) Consultant Paeds Surgeon &Leeds General Infirmary

Clinical Lead Paediatric Trauma

Sarah Robertshaw (SR)EM ConsultantPinderfields General Hospital

WEST YORKSHIRE MAJOR TRAUMA NETWORK MEETING
1 / Introduction and apologies
Introductions were made across the room and apologies noted.
2 / Minutes of the last meeting
Minutes accepted as a true reflection of the meeting.
3 / Matters arising
Matters Arising from previous meeting:
NICE Guidance and WYMTN Guidelines - JJ to follow up compliance for MTC for NICE Guidance, Nik Kanakaris undertaking this. AD asked if JJ could resend spread sheet, each Trust will still need to have do a compliance assurance.
Action:JJ to resend NICE compliance sheet to AD
Repatriation Process/Policy - RB confirmed that still working and improving apart from Mid Yorkshire NHS Trust, on-going issues
Guidelines
  • Resuscitative Thoracotomy - MiS has drafted a guideline, JJ has made some comments and will share when the guideline is finished. Need to maybe include short list of scenarios and processes to be applied to each one.
Action: JJ to send comments to MiS
  • Penetrating Cardiac - Mat Newport, Trauma Fellow, will be finishing the draft and sending it to the cardiac team.
  • Paediatric guidelines - Group meeting to standardise the paediatric care across Yorkshire & Humber. JJ mentioned that the new chair of the Yorkshire & Humber Regional Reference Group have expressed an interested in standardising adult guidelines across Yorkshire and Humber. Feedback has been provided to say that this is not necessary
  • Blood Transfusion - JJ to share with the group, these have been finalised in Leeds and adopted the 1:1 ratio.
Action:JJ to complete update and share Network guidance
Incidents - YAS JJ confirmed that he is waiting for KLR to feedback on incidents.
Peer Review - Reports being finalised and will be issued to the Trusts. JJ thanked the teams for the effort that they all put into the process.
Simulation Training - No update, waiting to hear back from KLR, Helen is the leadership fellow and feedback that they are going simulation around elderly. South Yorkshire Network is doing simulation training with TUs. JJ said it would be good to undertake this.
Action:JJ to liaise with HH about rolling this out across the Network
Yorkshire and the Humber Major Trauma Networks’ Conference - Conference went well, report will be shared with the speakers in due course.
TARN Working Group
Date for January to meet up to discuss - medical and tarn data inclusion. Standardise the data input and ensure that all TUs are reporting the same to help improve TARN data.
Audits
CT was agreed and parameters to what will be audit will be discussed via email. What population should be looked reviewed. AD confirmed that Airedale had already undertaken this and is happy to share audit papers.
Discussion around when time to CT and what is included, requires time is it when the CT is request or when Trauma Team is called.
Action:AD to share paperwork to see if it is fit for purpose
Group to define the parameters of the audit, JJ to develop with the group
Nursing Group
First meeting in January, to start moving the agenda across. AD asked if Airedale had been contacted, senior staff and a band 5 from each TU would be ideal
TILS
AD raised concern about the TILS course, doesn’t feel that it is adequate enough and standardised or fit for purpose. Feels it is too high and too. No learning objectives. Need to attend a training course to see what it is like. AD feels it does not have a corporate feel and provides assurance. Not sure TILS meets the objectives, it was based on peer review and support. Dates for next training sessions, see if there is any in North Yorkshire
Action: TW to check with Maureen.
4. / Standing Agenda Items
  1. Rehabilitation
JH stated that NHS England have undertaken a paper around neuro rehabilitation provision in the area. Paper has been done looking at Level 1 and 2A provision, recommendation that NHS E looks to commission Level 1 & 2A. Year 2 would be down to local CCGs and how their rehab fits in, CCGs are writing their 2 year plans, which should tie in with the 5 year plan.
RB raised rehabilitation prescriptions, payment is made on 4 questions and these are on the online system. This does not cover the rehabilitation coordinator post. RA asked about the additional questions and it was agreed that these were not necessary to complete.
KE asked about rehabilitation coordinators meeting being set up, looking at standardising the role and ensure the rehabilitation is being picked up, with Matt Smith
Action:TW to set up a meeting
  1. Guidelines/Policies
Already discussed under matters arising
  1. Incident Log
MiS raised a query about needing to develop a way to share the outcomes of the reviews and shared with the network.
JJ to feedback to the Trust after the incidence in closed.
  1. Risk Register
Available now on the website:
  1. Audits
CT was agreed and parameters to what will be audit will be discussed via email. What population should be looked reviewed. AD confirmed that Airedale had already undertaken this and is happy to share audit papers.
Discussion around when time to CT and what is included, requires time is it when the CT is request or when Trauma Team is called.
Action:AD to share paperwork to see if it is fit for purpose
Group to define the parameters of the audit, JJ to develop with the group
  1. Peer Review
Already picked up by matters arising. JH mentioned that CCGs will be asked to pick up any information from review of services, peer review for major trauma and trauma units might come under this. Confirmed that it wasnot an internal review, it was external as there were outside members visiting the hospitals, CCGs and nursing staff.
  1. TARN Data/Dashboards
Looking at producing dashboards for the TUs to share at the network meeting to reflect what is going on across the Network. Looking at unmatched cases, TARN completeness and data quality. Provide an overview each TU and share with the group for comments and what else would be beneficial for comparison. Comparison page on TARN but limited data. This is to support the TUs, increasing standards and maintaining standards.
Action:TW to produce and share with the group
5. / Any Other Business
a)Emergo
JJ updated the group, the day was helpful, came away feeling less nervous than going into the exercise. Useful stuff around scene identification. Full debrief in January. JJ said it was a brilliant turn out from the Network. AD said it was good for a network response, but not for individual trust, felt it was lacking the day to day business which would happen. JJ raised the fact that Bradford was underused and not sure why. HH said that Leeds cleared enough patients which are why Bradford was low and Huddersfield took about 25 P3 patients.
JJ highlighted that there was a slight issue on the patients being sent from the scene not showing up the Trust, this was an admin error with the process.
JJ also raised the overall management of the command and control but wondered if this was down to no NHS England control.
b)Patient Experience
RA asked about a Network approach. TW said we tried to rally patients across the Network, restart it again. AD said that RB was going to contact 20 patients per year. PROMS will be rolled out to TUs as well which will be a way of gaining patient feedback.
c)Orthopaedics
AA raised an issue with paediatrics in orthopaedic and do these patients come straight to the MTC. JJ said to speak with Mark Powis.
6. / Dates of Future Meetings
12 January 2017 - Huddersfield Royal Infirmary
09 March 2017 - Airedale General Hospital
11 May 2017 - Bradford Royal Infirmary
13 July 2017 - Pinderfields Hospital
14 September 2017 - Harrogate Hospital
09 November 2017 - Leeds General Infirmary

West Yorkshire Major Trauma Network - Minutes - 10.11.20161