Action Lead(s) Deadline

Transcription

1 Cancer Rehab Actions of the meeting held on Monday 06 June 2011, 12:00 Lecture Room, Cookridge Suite, Level 7, Bexley Wing, St James's University Hospital Present: Ms N Byrne Ms J Ashton Mrs D Bradshaw Mrs R Stevens Ms K Thompson Mrs C White Mrs G Smith Mrs B Machin Ms S McKiniry (Chair) Mrs J Toovey Calderdale and Huddersfield NHS Foundation Trust Leeds Teaching Hospitals NHS Trust St. Leonard's Hospice Wakefield Hospice York Teaching Hospital NHS Foundation Trust Yorkshire Cancer Network Apologies Mrs E Chambers, Mrs M Houghton, Mrs J Schofield, Dr J Todd 1. Welcome and Apologies 1 Victoria Newell from Grunenthal Ltd kindly provided lunch and gave a short presentation on a new pain management product available. 2. Action Log from the last meeting 2 The action log from the last meeting was agreed as an accurate record. 4. Rehab Exec Group and Wider Group 3 Sherry Mckiniry outlined the role of the Wider Rehab Group and the Rehab Exec Group. To circulate the membership lists of the wider Group and the Exec Group. Page 1 of 5

2 4. Rehab Exec Group and Wider Group 4 The Exec Group will meet 4 times a year: to steer the strategic direction of cancer rehabilitation inline with national guidance and ensure adherence to the Network Rehab Work Programme; two-way communication between the wider Rehab Group and the host organisation and other professional groups. Representation from all 4 AHP professions and Lymphoedema who will be responsible for: consulting rehabilitation colleagues in their locality (including relevant management) on debateable agenda items prior to the meeting to agree and feed into the group the locality and different rehab professionals views, recommendations and agreement; feeding back key messages from the meeting and disseminating information for consultation as appropriate to clinical and managerial colleagues; providing rehab expertise from own professional group. Ensure relevant issues pertinent to the professional group are considered as part of the work of the group. active support to the Chair & Vice Chair to progress the work programme. All members of the Group are expected to play a part to deliver the agreed work programme of the group. This may involve taking on a leadership role for certain aspects of the programme e.g.: user involvement, patient information, service improvement, research etc, or for specific tasks. To circulate meeting dates for the Exec Group. 5 The wider Rehab Group will hold 2 workshops a year, it is expected that AHPs and other professionals involved in cancer rehab will attend workshops as relevant. The purpose of the workshops will be to: update and share information regarding cancer rehabilitation; provide a forum in which to discuss, plan and implement key strategies based on the work programme through a shared commitment to agreed common aims, by working together to clarify issues, formulate strategies and develop actions plans; achieve an outcome based on a focus topic. Accomplish work set by the Executive Group in order to deliver the measures outlined in the Peer Review measures. To circulate workshop dates for the Wider Group. Page 2 of 5

3 5. Feedback from Rehab Event 6 The Group were informed that feedback from the Rehab Event was positive, comments included: AHPs / CNSs learnt something that would be beneficial in their work; AHPs appreciated a dedicated events rather than rehab being included in site specific event programmes; Delegates appreciated the prestige of the speakers and the appropriateness of the p presentations in relation to cancer rehab; AHPs gained a better understanding of the workforce/commissioning agenda; Networking was beneficial. Areas for improvement: More time for networking; More workshop time; Healthier food. 6. Future Rehab Events 7 Discussion took place around a second rehab event to take place in 2012, it was mentioned that strategic/commissioner led outcomes should be included. Delegates at the event requested future events but topics were not suggested. 7. National Cancer Rehab Update 8 NCAT have developed a national Universal rehab pathway; concerns were raised that this lacks any referral triggers which will make knowing when to access the Universal pathway difficult., N Byrne & J Toovey Ongoing The Group agreed to continue with the local generic rehab pathway until further clarity from NCAT is received. To make additions to the local generic pathway prior to circulating. 9 It may be necessary to identify, within the universal rehab pathway, the specialist skills of those AHPs who work across a variety of medical conditions (non cancer specialists) in order not to dilute or undervalue the complexity of AHPs reasoning skills. Page 3 of 5

4 8. MSCC Rehab Pathway 10 The local MSCC rehab pathway has been developed by AHPS in Leeds along side the clinical pathway, however concerns have been raised about the lack of community related interventions. To send the Hull MSCC rehab pathway to the Leeds team for information. 9. Outcome Measures 11 Discussion took place around alternative outcome measures including the Functional Impairment Measure (FIM) and the Functional Assessment Measure (FAM) which appears applicable to Occupational Therapy and Physio Therapy but less useful for Dietetics and Speech & Language Therapy. 9.1 TOMS 12 Kathy Thompson presented the Therapy Outcome Measures (TOMs) tool and identified some limitations of using the tool. Mainly associated with cause and effect from interventions the tool measures team results rather than identifying particular interventions by profession. It may be unsuitable for Dietetic use due to the limited items being measured. 9.2 Bartel, PROMS & PREMS 13 Sherry Mckiniry presented the Patient Reported Outcome Measures (PROMS), Patient Experience Outcome Measures (PREMS) and Bartel outcome measures. Bartel is a short measure used to identify some functional problems, the tool is used to determine a baseline level of functioning and can be used to monitor improvement in activities of daily living over time. However the tool is limited in the type of problems it can identify due to the limitation of the questions included. It does appear to widely used by a mix of health professionals and may provide a starting point. PROMS and PREMS are patient focussed tools and are promoted by the DOH although there still remains little evidence to support the use of the tools with cancer patients. Page 4 of 5

5 10. Outcomes/ Golden nuggets from the Rehab Pathway interventions 14 Sherry Mckiniry asked the Group to consider the outcomes expected from the pathway interventions. The Group agreed that outcomes fall into two categories: Therapy related outcomes and Strategic/Commissioner related outcomes. It was agreed that both category outcomes would be pertinent to all rehab pathways and most would remain the same for each set of interventions. Rather than taking each rehab pathway and identifying the interventions in isolation one rehab pathway should be sufficient for identifying all outcomes. 6 Strategic outcomes were identified: reducing admissions/readmissions (bed days saved); rapid discharge (shorter hospital stays); reduced GP visits, need for OOH services/a&e or crisis interventions; extended time to secondary presentation through exercise, nutrition, well being; better patient management of self & symptoms/ lessen carer burden/ breakdown of home situation; return to work. Therapy related outcomes; the Group agreed that the referral triggers would serve as the desired outcomes e.g.: patient referred with mobility problems, the outcome will be to improve mobility. To populate the outcomes template. 11. Any Other Business 15 Ongoing The Group agreed that urology requires no specialist AHP intervention and that all urology patients requiring rehab should be referred to the local universal/generic rehab pathway. Further work is required on the other rehab pathways to establish if any other AHP interventions can be removed and placed in the universal pathway. To continue work on the rehab pathways. Date of Next Meeting(s) Wednesday 30th November :30am Lecture Room, Cookridge Suite, Level 7, Bexley Wing, St James's University Hospital Page 5 of 5