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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 JR 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 JR 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 JR 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 JR/EK 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 JR/EK