National Advisory Board for Rehabilitation: January 2021

Attendees and apologies

Present:

• Carolyn McDonald  (Chair) (CM), SG – Chief Nursing Officer’s Directorate
• Bette Locke (BL), SG - Chief Nursing Officer’s Directorate and Clinical Priorities Policy 
• Susan Wallace (SW)y, SG – Clinical Priorities Policy
• Bryony Murray (BM), SG – Clinical Priorities Policy
• Jemma McGuffie (JM), SG – Clinical Priorities Policy
• Jacques Kerr (JK), SG - Senior Medical Officer, Directorate for Health Performance and Delivery
• Jan Beattie (JB), SG – Chief Nursing Officer and Primary Care Directorate
• Angela Gall (AG), British Society of Rehabilitation Medicine 
• Belinda Robertson (BR), Healthcare Improvement Scotland
• Caroline Deane (CD), Workforce lead, Scottish Care
• Dr Nadine Cossette (NC), liaison psychiatrist, Royal Infirmary
• Lisa Powell (LP), Convention of Scottish Local Authorities (COSLA) 
• Phil Mackie (PM), Public Health Scotland      
• Sara Redmond (SR), Health and Social Care Alliance
• Emma Stirling (ES), Allied Health Professions Directors (Scotland) Group 
• Marianne Hayward (MH), Health and Social Care, South Lanarkshire
• Ruth Glassborow (RG), Healthcare Improvement Scotland (attended as guest)            

Apologies

• Dr Alastair Cook (AC), SG – Mental Health Policy    
• Nicola Dickie (ND), COSLA 
• Alex McMahon (AM), Scottish Executive Nurse Directors 
• Malcolm Daniel (MD, Consultant in Anaesthesia and Intensive Care, Glasgow Royal Infirmary
• Dr Tara Quasim (TQ), Senior Lecturer in Anaesthesia and Critical
• Laurie Eyles (LE, SG – Health Improvement Policy

Items and actions

Welcome, introductions and apologies - Carolyn McDonald

CM welcomed all members and members provided introductions and a background on their role within the Board.

Apologies were noted as above.    

Minutes of previous meeting - Carolyn McDonald

The Board confirmed that the minutes reflected an accurate record of the last meeting in December 2020. Ongoing actions will be covered as part of this agenda.

Matters arising - Bette Locke and Susan Wallace

• Your COVID Recovery - Clinical Priorities Unit to circulate paper. 
• terms of reference, comments to Clinical Priorities box/ Secretariat - in particular are there any other key policy areas or external representatives required to be on the group; and are the Terms of Reference reflective of the Board’s objectives?
• quality improvement - comments on driver diagram and updated aim to Clinical Priorities team/ Secretariat and Bette Locke.
• to have one to one follow-up conversations with members – Bette Locke – ongoing 
• to send thoughts on quick wins to Bette Locke, copying in Clinical Priorities mailbox – ongoing 

BL advised that the driver diagram has an updated proposed aim, which was discussed and members were asked for feedback. Members were informed that BL is continuing to have follow-up one to one meetings with members of the Board.   

BR provided an update from the Care Homes CPAG group. BR advised that there is a need for a simplified rehabilitation guide that can be used in and around care homes. JB highlighted that the real impact for many people is the impact of lockdown. 

CD informed the Board that Scottish Care are currently holding their three-day Care Home Gathering exercise. Early feedback from this event is the change in residents overall because of lockdown and self-isolation as often people are confined to rooms. The increased physical and mental frailty of people in care homes as a result has been significant. SR noted the relevance across the wider population particularly for people with long term conditions. SR suggested that there is work needed on communication around disruption to rehabilitation and more broadly around what is currently available. SR suggested that NHS 24 could be a helpful connection to NHS Inform. A link with them would be useful for this group. 

ES informed members that there are a variety of online resources being promoted by Allied Health Professionals across Scotland so information is likely out there already, it just needs to be pulled together. ES highlighted that a national rehabilitation guide for people with all of the relevant links would be helpful. 

BR informed members of the work HIS are doing around the Primary Care portfolio. BR advised that HIS has been working with SG colleagues around the Care Navigation toolkit, which was published in December 2020. BR highlighted that HIS have strong links with NHS24. BR suggested that through the Care Navigation work there is something we can do to help to promote a rehabilitation type resource. 

Actions: 

• it was advised that links should be made with NHS 24
• SR suggested that there is work needed on communication around disruption to rehabilitation and more broadly around what is currently available
• BR noted that the iHub Care Navigation programme may be beneficial to the Rehabilitation Programme
• BL to follow up with BR around Care Navigation work
• members asked to submit any comments they have regarding the Terms of Reference to Bette Locke (deadline passed)
• Bette Locke asked to send revised version of the driver diagram with updated proposed aim
• Your COVID Recovery paper to send to members
• it was suggested that useful rehabilitation related information and links be gathered and presented through the medium of an online tool

Quality improvement models - Ruth Glassborow Director of Improvement, Healthcare Improvement Scotland

RG was invited to present an overview of QI models and how they might relate to implementation of the rehabilitation framework. 

RG delivered her presentation on Quality Improvement Models. The key themes included:

• for change to happen we need will, ideas about what to change and the ability to action the change in place across all key players 
• the Quality improvement journey for access 
• some considerations around designing large scale complex change programmes 
• a slide on the assessment of the most suitable spread mechanism/s

Comments from membership

SW suggested the need to think about what support is needed now such as communications and toolkits that may help support the services now. We can also consider other approaches for long-term change. 

JK advised that there is scope for triaging where there are challenges and determining a hierarchy of what needs the attention right now.  
The group discussed the need to utilise the will that is currently in the system to deliver the quick wins. The group also thanked RG for delivering her presentation and introducing them to new quality improvement concepts. 

Actions:

• follow up conversation prior to next NABR meeting in February to be arranged including BL, CM, RG and JK around bringing back some recommendations to the Board around what we do next
• JK suggested that as a follow up we have a session around triage and what do we need to focus on right now

AOCB - all

None

Date of next meeting - Carolyn McDonald

Wednesday 24 February 2021, 11:00-12:30

AOB 

CM advised the Board that there has been a successful application from Robert Gordon University on a COVID research proposal, evaluating emerging models of community rehabilitation for people experiencing the effects of Long COVID to inform a response around service delivery across Scotland.

Actions

• call to membership for suggested revisions to the proposed minutes of the advisory board meeting on the 10 December 2020 - All - deadline passed
• Secretariat to publish finalised minutes of the advisory board meeting on the 10 December - Secretariat - ongoing
• Secretariat to send finalised Your COVID Recovery paper, updated driver diagram with aim (not sent) and link to Going in the Right Direction Toolkit to NABR members    - Secretariat - partially completed
• Secretariat to organise next 6 monthly NABR meetings - Secretariat - completed
• Secretariat to circulate Ruth Glassborow and Belinda Robertson’s slides on Quality Improvement Models to membership - Secretariat - to be sent with agenda for next meeting, minutes and other supporting documents unless requested by members beforehand
• rehabilitation policy team to discuss with Jan Beattie and team the development of a rehabilitation guide for care homes - Rehabilitation policy team - not arranged yet
• Bette Locke to follow up with Belinda Robertson around Care Navigation work - Bette Locke - completed (virtual meeting was arranged on 26 January)
• follow-up conversation prior to next NABR meeting in February to be arranged including Bette Locke, Carolyn McDonald, Ruth Glassborow and Jacques Kerr around bringing back some recommendations to the Board around what we do next - Rehabilitation team and some other members - not arranged
• rehabilitation team to consider suggestions raised at this meeting by wider membership - Rehabilitation team - ongoing