North of Scotland
Managed Clinical Network for Eating Disorders
Annual Report
April 2007 – March 2008
Contact:
Linda Keenan
Network Manager
Managed Clinical Network for Eating Disorders
Bennachie Building
Royal Cornhill Hospital
Cornhill Road
ABERDEEN
AB25 2ZH
Tel: 01224 557858
Contents Page
Foreword 3
Summary of Network Achievements over the past year 4
Network Activities 5
· Eating Disorder Inpatient Unit
· Strategy Day – May 2007
· Managed Clinical Network Website
· Eating Disorder Conference
· Launch of NHS Tayside Outpatient ED Service
· Scottish Health Council – Small Grant Award
· National Eating Disorder Education & Training
· Generic Clinical System
· Outpatient Activity in North Scotland
Quality Assurance Programme 14
Financial Report 16
Membership 17
Managed Clinical Network Information Map 18
MCN Workplan 20
NEEAT’s Business Case 24
· Appendix 1
Foreword
The Eating Disorders Managed Clinical Network has continued to work hard and has made some significant advances over the past year and this report details these advances as well as highlighting what we aim to do in the forthcoming year.
Our website is now available (www.eatingdisorder.nhsgrampian.org) to keep everyone up to date with the work of the MCN as well as providing useful information for patients, carers and health professionals.
Delivering for Health noted that it was time to take stock of MCN’s role. This led to the publication of - Strengthening the role of Managed Clinical Networks HDL (2007) 21. It was published in March 2007.
This HDL reiterated the core principles underpinning MCN development and covers issues such as integration of MCN’s with other NHS bodies; leadership and management; patient and carer involvement; accreditation; and information technology. These are all areas in which we have been working on in the past year.
We would like to take this opportunity to thank all staff across the Managed Clinical Network for all their hard work in the past year which has contributed greatly to the good progress we have made.
Linda Keenan Dr Harry Millar
Network Manager Lead Clinician
Summary of Achievements in the past Year
· NHS Tayside launched a Tier 2/3 Service in November 2007. The MCN Lead Clinician and Network Manager are involved in the monthly service Development meetings with the service.
· The MCN launched its website in August 2007 and has had c1500 hits. The website provides up to date information for Patients, Carers and Health Professionals. It provides links to useful information, other useful websites as well as providing information on the work of the Managed Clinical Network. It can be found at www.eatingdisorder.nhsgrampian.org.
· A successful MCN Strategy Day was held in May 2007.
· The Quality Assurance Framework is currently being written.
· Another successful Conference for Eating Disorders Specialists was held in Aberdeen in November 2007.
· Work is progressing on the National Eating Disorders Education and Training – Scotland project.
· Eating Disorders Inpatient Unit – approval was given to progress with the unit February 2008.
· Continue to be involved in discussion with NSD and private sector providers.
· Generic Clinical System - being used on a daily basis by clinicians in NHS Grampian and roll out to the rest of the North of Scotland and to the new In Patient Unit is being led by the MCN.
· Establishment of a Questionnaires Sub-Group.
· Participation in the North of Scotland Planning Group (NoSPG) Annual Planning Event.
· A successful application was made for a small grant from the Scottish Health Council.
Network Activities
Development of Eating Disorders Inpatient Unit
In April 2007 a Service Development Proposal was produced. This proposal laid out a plan to refurbish an unused ward at Cornhill Hospital in Aberdeen and turn it into an Eating Disorders Inpatient unit. At the end of April 2007 agreement, to this proposal, was agreed in principle at the NoSPG.
Work began with the Physical Planning Department to draw up plans for the unit in July 2007 whilst more detailed work on the financial side of things was undertaken.
In November 2007, a paper was sent to the Chief Executive of NHS Grampian, Highland, Tayside, Orkney, Shetland and the Western Isles asking them to present the paper to their relevant Finance Group to seek approval for funding.
Approval was given by constituent Health Boards in February 2008. Building warrants have been sought and work is due to begin on the unit in early summer 2008 with a view to opening the unit in the early part of 2009.
This work has been a main focus of the MCN over the past year and work will be ongoing to develop care pathways to ensure that clear protocols for admission, inpatient care and discharge planning are in place.
Ongoing talks are taking place regarding a small number of day places for intermediate care, which will be mainly for Grampian patients.
Strategy Day May 2007
A very successful strategy day took place in May 2007. This was attended by a variety of disciplines and was well received by all who attended.
The day started off with short presentations from Dr H Millar, Grampian EDS, Dr Yvonne Edmonstone, Highland EDS and Dr Paula Collin, Tayside EDS. They described the current services in their areas with Dr Collin concentrating on what she envisaged for the new Tayside service.
Various topics were discussed as follows -
1 – Questionnaires
2 – Waiting List Management/Assessment Procedures
3 – Treatment Options/Other Clinical Functions
4 – Referral Guidelines/Documentation
Out of the Strategy day a sub-group was set up to look at the use of questionnaires across north Scotland. Agreement has been reached about certain core questionnaires to be used by all specialist services. Individual services were going to look at additional questionnaires they wished to use within their own services. Follow up questionnaires to measure outcome are also under discussion.
MCN Website
The MCN website was launched in August 2007. In its first 2 days of being live it received over 200 “hits”. Feedback on the content has been very encouraging.
Two examples of feedback received are shown below:-
“I was very impressed with your website and found it extremely informative”
Specialist Speech and Language Therapist
Royal Aberdeen Children's Hospital
Aberdeen
“The website looks great! Really impressive overall”
Consultant Clinical Psychologist
Royal Cornhill Hospital
Aberdeen
Work is ongoing with the website and it is constantly being updated with the latest news and events in the world of eating disorders.
The website contains information for patients, carers and healthcare professionals and provides information about available services across North Scotland.
It also contains information on the work of the MCN including past minutes and agendas, the MCN Project Plan.
It can be found at www.eatingdisorder.nhsgrampian.org
Conference for Eating Disorders Specialists – November 2007
Another very successful Eating Disorders Conference was hosted by NHS Grampian in November 2007. The Conference was entitled Severe and Enduring Eating Disorders. It was extremely well attended and received.
Another Conference is planned for 13th/14th November 2008 entitled Co-morbidity and Complexity in Eating Disorders. Preparations are well underway with a number of speakers with international reputations agreeing to attend.
NHS Tayside – New Outpatient Service
The Tayside Eating Disorders service was launched on 5th November 2007.
The Current Staffing Composition is as follows:-
· 0.6 wte Consultant Clinical Psychologist/Lead Clinician
· 3 x 0.5 wte Clinical Psychologists (one for Angus, Dundee and Perth & Kinross)
· 1.0 wte (Flexible) Trainee Clinical Psychologist
· 1.0 wte wte Administrator
· 1.0 wte Dietician
· 1.0 wte Band 6 Nurse
Post still to be recruited to are as follows:-
· 0.5 wte Consultant Psychiatrist
Dr Millar is acting in a consultative role until the appointment of a specialist psychiatrist.
The service is based at Constitution House in Dundee with established clinics at Murray Royal Hospital in Perth, Wallacetown Health Centre, Dundee and Whitehills Hospital, Forfar.
Both Dr Millar and Mrs Keenan have been involved in the development of the service and continue to attend regular Service Development meetings. They have agreed to take the lead in planning the implementation of the Generic Clinical System within Tayside.
Scottish Health Council – Small Grants Scheme
In January 2008 we made an application for a small grant from the Scottish Health Council Small Grants Scheme. This was to enable to do a number for things including:-
Hosting a 2 way information day for patients and carers in order to
· ascertain their views on Eating Disorders Services in North Scotland
· show them the plans for the new ED IP Unit
· ascertain their views on the patient journey through outpatient care
· ask for suggestions to enable us to plan effective care pathways
To produce a poster for GP Surgeries across the North of Scotland to promote the Managed Clinical Network and encourage patient/carer involvement.
Publication of Care Pathways by December 2008
In March 2008 we were informed that our application had been successful and we were allocated a grant of £1500.
A condition of the award is that we submit a progress report to our local Scottish Health Council office by October 2008 and a Final Report by February 2009. We will also enter our work onto the Scottish Health Council website www.evolvingpractice.org to allow others to share our work.
We have set a date of Saturday 7th June 2008 for this day. We will host this day in Aberdeen, but if enough interest is generated from other areas then it may be possible to host the event in other areas as well. For more information please contact or telephone 01224 557858.
National Eating Disorders Education and Training – Scotland
Initial funding of £5700 was allocated by NES to develop a 3 year business plan for Eating Disorders Education and Training in Scotland.
The original Project Proposal has been updated and was submitted to NES at the end of March 2008. An SLA has been agreed and further funding of £33,700 has been allocated by NES to take the project forward. (A copy of the Project Proposal is attached at Appendix 2)
The final curriculum will be agreed during April 2008.
Originally it had been the intention to look at 3 levels of training
1. Certificate Level – based on knowledge and skills
2. Diploma Level – which would involve submitting case studies
3. Higher Level
After discussion a principle was agreed that, for the first stage, we would concentrate on level one with further scope to widen this to the Diploma and Higher level in the future.
For further information please see Appendix 1 or contact Linda Keenan on 01224 557624 (email: )
Any system for accreditation which was developed would be compatible with other systems e.g. CBT accreditations and KSF.
A section on attitudes and experience would be kept and this would be evidence based.
Generic Clinical System
In 2004, The Scottish Executive Health Department asked for volunteers to become early adopters of the Generic Clinical System, a computerised clinical record. The Grampian Eating Disorders Service was successful in their application for this. A Project Board was set up with representatives from The Grampian EDS, Grampian IM&T Department, The Scottish Government Health Department Information Service and AxSys Technology Limited, the company who were successful in being awarded the contract to provide the GCS.
In April 2006, Jane Fletcher, Senior Dietitian and Deputy Lead Clinician for the Eating Disorders Service was appointed as Project Manager and was funded for 3 sessions a week to take the project forward. This funding was essential to ensure the success of the project. Jane and others worked very energetically between April and November 2006 on a detailed specification and AxSys were able to construct the special forms and other software to go live with the system in November 2006.
Since then EDS has been using the GCS to document all clinical activity and clinicians are enthusiastic and fully committed to using the system as its primary clinical record. Other features in the system include a diary feature and links to laboratory results and SCI Store, which are extremely useful and time saving for clinicians and secretaries. The GCS will be able to enable electronic communications with primary care through the SCI Gateway and this should be available soon.
A web-based version of the GCS is being developed and this will allow relatively easy extension of the system to other health boards in the North of Scotland. Preliminary discussions are underway with colleagues in NHS Tayside who are keen to explore the feasibility of using the system within the new NHS Tayside outpatient service. It is also anticipated that the system will be implemented within the new North of Scotland inpatient unit, to be based in Aberdeen. If the system is implemented in the other health boards this will mean ready electronic communication between the inpatient unit and local services. There will be the potential for direct entry of information about patient’s progress from distance sites and also, to access from distance sites, information about the progress of inpatients while they are in Aberdeen. Discussions are underway to harmonise as far as possible some of the standardised questionnaires being used in specialist eating disorders services across the North of Scotland and it will be possible to accommodate these questionnaires within the structure of the Generic Clinical System.
Summary of Eating Disorder Referrals in North Scotland 2007/2008
Quality Assurance Framework
Quality Improvement Scotland undertook a project to create guidance and pathways for MCN’s to develop Quality Assurance programmes. Below is an extract from QIS website. (http://www.nhshealthquality.org/nhsqis/3689.html)
Managed Clinical Network Redesign Project
A project to establish processes that enable local Managed Clinical Networks (MCNs) to develop their quality assurance programmes and obtain subsequent approval by their NHS boards; refine the existing NHS QIS processes for approving regional and national MCN quality assurance programmes and identify the role of NHS QIS in monitoring MCN performance against their quality assurance programmes.