PALLIATIVE CARE PROJECT REFERENCE GROUP MEETING
NOTES OF 2ND MEETING
Tuesday 2 June 2009
11am – 1.00pm
Attendees:-
Maggie Grundy (Chair) / NHS Education for ScotlandLiz Travers / NHS Education for Scotland
Ann Marie Rice / The University of Glasgow(representing Margaret Sneddon)
Karen Orr / Macmillan Cancer Support
David Rennie / Scottish Care Commission
Linda Johnstone / St Andrew’s Hospice
Robert Bestow / MND Scotland
Elizabeth Ireland / The Scottish Government
Stan Wright / NHSForthValley
Bryan Healy / Scottish Social Services Council
Audrey Taylor / NHS Education for Scotland
Annie McDonald / Crossreach
John Walley / Accord Hospice
Claire Tester / NHS Quality Improvement Scotland
Emma Dymond / Strathcarron Hospice
Sally Lawton / NHS Grampian
Sandra Campbell / NHSForthValley
Alison Morrison / NHS Tayside
Fiona Kelly / Dementia Service Unit, University of Stirling
Anne Cochrane / ASWD, South Lanarkshire
In Attendance:-
Dawn Bartwicki / NHS EducationApologies:-
Mark Aggleton / The Scottish GovernmentMargaret Sneddon / The University of Glasgow
Lynda Blue / British Heart Foundation
Nina Fraser / NHS Shetland
Jennifer Nicholls / Associate Advisor, Northern Deanery
David Oxenham / Marie Curie Hospice
Peter Kiehlmann / Macmillan Lead Cancer GP, NHS Grampian
Elaine Maclean / Care Commission
Dawn Moss / Educational Project Manager (Child Health) NES
Jenny Henderson / Alzheimers Scotland
Michael Brown / EdinburghNapierUniversity
Andy Carver / British Heart Foundation
Maggie Whyte / Marie Cure Cancer Care
Phil Cotton / The University of Glasgow
- WELCOME AND INTRODUCTIONS
Maggie Grundy welcomed everyone to the 2nd Project Reference Group Meeting, and round the table introductions were made by the group.
- APOLOGIES
A number of apologies had been received, and these were recorded as above.
3.MINUTES OF PREVOUS MEETING AND ACTIONS ARISING
On reviewing the previous minutes, it was highlighted that there were 3 omissions in respect of the attendees, ie Sandra Campbell, David Rennie, and Linda Johnstone, and the minutes will be amended to reflect this. There were no outstanding action points, however, in respect of item 6, Remit of Education Champions, Maggie Grundy reminded the group that the Education Champions have been nominated by the Boards’, and additional nominations from Boards will be accepted.
Action : DB to amend previous minutes
- UPDATE ON PROJECT PLAN
A project update report had been circulated to the group along with the meeting papers, in advance of the meeting. Liz Travers updated the group on progress to date, and took comments and questions from the group.
Advanced Care Planning (ACP) - Liz updated the group on 2 commissions that are available for competitive tendervia the NES tender website - This prompted group discussion around the content of the commissions and concern over the short timescales.Liz explained to the group the timescales were necessary to allow the successful bidder(s) adequate time to develop and deliver the education during 2009-10. Elizabeth Ireland gave positive endorsement and support of the importance of developing a consistent approach to the processof ACP within the project.
Communications Skills Training (CST) –This education project isworking closely with other NES workstreams to adopt a strategic approach to communication skills training.Work is underway to identify and develop a national framework for communications skills training. There is significant anecdotal evidence across all work streams of a distinct need and demand for support in this area. A suggestion was made that the PDSA cycle may offer a useful approach to communication skills training and to help to embed skills into practice.
The model for advanced communications skills training used in Englandwas discussed, however a note of caution was offered as this model appears to only offer communications skills training at an advanced level. The proposal to develop a workforce development (WFD) approach to communications skills training, ie ongoing support in practice, after the initial training, poses a significant challenge. Elizabeth Ireland advised that the patient experience programme could perhaps contribute to the WFD approach. Funds are available to support the development of the staff/patient experience, and a range of comments and feedback from the group strongly endorsed the effectiveness and validity of positive supporting evidence. A number of suggestions were made regarding areas where this training could be most effective, and included Social Care Networks, Dementia, Admin staff, and Undergraduate Training. This prompted discussion on how best to engage senior staff in this process, and effect a culture change.Communications skills training for those whose first language is not English was also raised, which highlighted a number of issues around regulation, and the role and responsibility of the employer.
DNAR –Dr Elizabeth Ireland updated the group on DNAR developments. There is a desire for a consistent policy across all care settings in Scotland, with the Lothian DNAR model being cited as the preferred option. Dr Peter Keihlmann is leading on this. Elizabethwill bemeeting with the GMC later in the year andwelcomed comments and suggestions on this subject.
Action : All
Liz updated the group on the intention to develop a DVD with a variety of potential scenarios as a training tool to support DNAR, which will be launched at the Living and Dying Well Conference on 3 December 2009.
This prompted discussion re how best to facilitatethe implementation of Living and Dying Well in the care home sector. Maggie Grundy advised that she will be meeting with Ian McMaster to consider appropriate models for this sector. Elizabeth Ireland is keen to engage with staff in care homes, and is involved with the Scottish Care Commission in this regard, and an off-line meetingwill be arranged to move this forward.
e-library - Liz updated the group on some new functionality and additional features available via e-library. Opportunities are being explored to use this resource to develop a Palliative and End of Life site for sharing, accessing and disseminating information and outputs of this initiative. In addition, the usefulness of a virtual managed education network is being explored and if developed could be a way of sharing education and training opportunities for all staff, with a similar structure to that of the Clinical Skills Managed Education Network. This prompted discussion on the best way to facilitate the implementation of Living and Dying Well within the care home sector.
- PATIENT INVOLVEMENT
This discussion focussed on the need and appropriateness of having a patient representative on the group. It was felt that the voluntary sector and user-led organisations (eg Long Term Conditions Alliance, Carers Scotland, QIS/PFPI groups)may be well placed to contribute, if required.
Action : MG/LT to invite patient representation
- EQUALITY AND DIVERSITY IMPACT ASSESSMENT
This document was reviewed and discussed. Maggie Grundy explained that completing anImpact Assessment is a requirement for all NES projects. The purpose of the document is to ensure equity, and make sure no one is disadvantaged or excluded within the boundaries of the project, and in line with the principles of the Living and Dying Well Strategy. Completion of this document will be developed over the lifetime of the project, and will be a standing Agenda item. The group were invited to comment, and a question was raised with regards to ethnic minority representation on the group, as part of the wider patient involvement strategy.
Action : LT/DBto update and seek advice as appropriate
- RISK ASSESSMENT AND MANAGEMENT PLAN
This document was reviewed and discussed. Elizabeth Ireland suggested that in line with Board level engagement with Living and Dying Well, the plan should be reviewed and the risk scores re-assessed and evaluated, with a view to being reduced. However, there were some additional comments and issueswith regards to other sections, where perhaps the risks may need to be increased.
Action : LT/MG ro review and update document
- COMMUNICATIONS STRATEGY
This document will be a standing Agenda item, and will be reviewed at each meeting. A suggestion was made that the SHOW website could be used as the depository for all the outputs from the various activities related to Living and Dying Well, and could enable the communication and dissemination of outputs, findings, and recommendations.
Action : All to review and comment
- AOCB
Sally Lawton requested a progress update on the work of the Quality Assurance and Palliative Care sub groups. These groups have not yet met, but will do so shortly.
Action : LT/MG to arrange
10. DATE OF NEXT MEETING
The proposed date for the next meeting is w/c 31/8, and the group will be invited to indicate their preferred date. Opportunities for VC are also being explored.
Dawn Bartwicki
10 June 2009
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