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Minutes
Meeting title: Deciding right Implementation Group
Date: 4th March 2013
Time: 2.30pm
Location: Cathedral Room, Waterfront 4
Present:
Claud Regnard, St Oswalds Hospice
Louise Watson, South Tyneside NHS FT
Emma Gordon, NEAS
Sheila Dawson, St Theresa’s Hospice
Maggie Deytrikh, N Tees and Hartlepool
Elizabeth Kendrick, End of Life Care Lead
Vicki Dodds, SHA
Bill Cunningham, Northumberland West CCG
Apologies:
Alison Featherstone
Andrew Stainer
Jane Bentley
Lynda Dearden
Pat Bolton, CD&D PCT
Jayne Robson, SHA
Lynn Gibson, NTW
Chris Watson, NTW
Mike Bunn, Gateshead NHS FT
Mark Girvan, Sunderland PCT
Dorothy Mathews
Dawn Turner
Florence Gunn
Item
Minutes (key decisions and action points)
1
Welcome and Introductons
Sheila Dawson and Maggie Deytrikh were welcomed to the group and a
round of brief introductons took place.
2
Minutes of the Last Meeting
The minutes of the last neeting were reviewed and agreed as an accurate
record.
3
Matters Arising
Yellow envelope/sticker system
Feedback from presentation at the Cancer Network Service Users Group
was provided to the group. The system was very positively received with
Person to
action
From 3 October 2011 NHS North East, NHS North West and NHS Yorkshire and the Humber - the three
strategic health authorities in the North of England - will be placed under a single management framework
and work together as NHS North of England.
only one suggestion about the stickers being made smaller. The group was
happy to keep the envelope blank but suggested two sticker formats that
could stick on either glass or the back of a home entrance door.
Recent discussions with SHA managers means that funding is now agreed
to allow an initial start up supply for Trusts and GP practices.
Action 1: Progress orders and produce reorder details for ongoing
supply after the end of NHS North East
Action 2: Prepare communication plan
Promoting MCA
Initial discussions with ‘Twisting Ducks’ looked to suggest that production
of a video was out of budget however the group were updated with more
recent funding option enquiries. These included the possibility of a Trust
funded video that could be shared across the region and other lines of
enquiry from The Lawnmowers production company. There was also some
debate about potential funding via postgrad institutes. The conversation
continued to include the benefits of translating current training into video
format and the group agreed that funding options continue to be
researched
LCP Review
The group agreed that Deciding right would respond to the review.
Responses from North of Tyne and the Association of Palliative Medicine
were to be shared with the group.
4
Deciding right Mobile App
The project was presented to the group the key point being as follows:
 Plan to progress during March
 Funding from Bright Ideas award had been matched with SHA
funding to allow project budget
 Iphone and Ipad initially with consideration for android still underway
 Intended to be a decision support tool therefore forms and CLIP
worksheets etc will not be included in the app
 Process for maintaining updates under discussion
 Free of charge initially but there is potential to become income
generating in the future
5
DNACPR Regional Form
The revised DNACPR form was presented to the group with feedback from
consultation with the Service User Group. The 12 month review date was
expected to be positively received by GP colleagues and other
ammendments were discussed.
The form was agreed subject to further changes which included the
following;
 Addition of wording to say that a patient can request review at any
time
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EK
CR/MD



Reword section 1 to include place of decision origin
Reword section 6 to state date of review and reviewer details
Add phrase to state origin of form (DH requirement given that North
East has been removed from the NHS lozenge logo)
Action 3: Revise the form and redistribute to clinicians included in the
CR
consultation
Action 4: Send the revised form to SHA Communications Team to
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ratify format and logo positioning etc
There was agreement that during the transition stage in implementing the
new forms that the review period could be amended on forms that were
preprinted to say 3 months. This would be communicated via NEAS
processes to ensure crews acknowledged such changes as valid
Action 5: NEAS Cascade process
6
NEAS Update
The update was presented highlighting that an average of 5 to 7 ‘flagging’
forms were currently received at NEAS. An audit of use of the forms and
sections that clinicians were leaving blank was underway to allow review of
the document before the end of March.
Deciding right had been included in the training package being delivered to
Community First Responders.
NEAS reported a couple of incidents involving PTS, usually reported via
GP practices and this was to be addresses by specific training.
The update assured the group that on the whole there was a high degree
of generally positive feedback from crews about emergency attendances
where forms where in place and produced as per procedures and the
consensus that implementation was improving.
7
Patient Information Web Resource for Deciding right
A discussion around the need for a patient section to the website was
brought to the group. It was agreed that this could be progressed further
but was part of the initiative that could be put on hold until transition was
over and new structures where embedded
8
EHCP Printing
The group considered local processes for printing EHCP forms given
feedback that some GP practice do not have access to a colour printer.
The group opinion was that colour EHCP forms were less of an issue than
DNACPR forms for obvious reasons around speed of location and ease of
locating should it be among other papers. It was therefore agreed that
black and white EHCP were acceptable and/or if there was a need it was
acceptable to NUTH to offer supply in the same way they supplied the
DNACPR forms
EG
9
Beyond March 31st
This item was deferred to the next meeting given that as yet there had
been no formal clarification about what would happen with Deciding right.
This led the discussion to the logistics of a formal public launch.
The scale of the launch was discussed briefly and options were still under
consideration
Action 6: Add to next meeting agenda
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10
Any other business
YAS Clinical Alert
The clinical alert from Yorkshire Ambulance Service that was shared by
South Tees Trust was reported to the group which set out the process for
acknowledging Deciding right DNACPR form over the Yorkshire /North
East border.
NEAS reported reciprocal arrangements for Yorkshire and Humber forms
coming into the North East
Irene Young/Service User Rep
The group were updated about Irene Young’s email stepping down from
her role as sevice user representative with Deciding right and her
acknowledgments were shared. It was agreed that a letter of appreciation
would be formally sent from this group.
The group agreed that a request go to the next Cancer Network Service
User Group for them to consider the process for a replacemeent patient
representative for future meetings
Action 7: letter to go out
Action 8: Contact Service User Representative Group formally
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LMC Letter
A letter dated 1st March from Gateshead and South Tyneside LMC was
shared with the group. It highlighted three issues around the following: the
need for DNACPR forms to be colour, the 3 month DNACPR review and
the need for GP review in 24hours for palliative care patients discharge
from hospital.
The response was discussed and agreed
The group were informed that in Gateshead and South Tyneside DNACPR
forms are available free of charge for GP practices and supply details have
been distributed. These details should be included in the response to the
letter to allow feedback to practices.
Action 9: Letter to be sent in response
11
Date and time for the Next Meeting
The group agreed that a next meeting should be arranged for the end of
April
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