National Advisory Committee for Neurological Conditions minutes: May 2020

 

 

Attendees and apologies

• Stephanie Fraser (Chair) (SF), Bobath Scotland
• Susan Walker (Deputy Chair) (SW), NHS Greater Glasgow and Clyde
• Dr Jenny Preston (Deputy Chair) (JP), NHS Ayrshire and Arran
• Becky Duff (BD), Neurological Alliance of Scotland
• Dr Callum Duncan (CD), Consultant Neurologist/ NHS Grampian
• Tanith Muller (TM), Neurological Alliance of Scotland
• Anita Stewart (AS), SG – Clinical Priorities Policy, Team Leader
• Gerard Gahagan (GG), SG – Clinical Priorities Policy, National Framework Lead
• Jamie Cochrane (JC), SG – Modernising Patient Pathways Programme
• Gail Smith (GS), Angus Health & Social Care Partnership, Interim Chief Officer
• Jolanta Lisicka (JL), SG – Clinical Priorities Policy, Senior Policy Officer  
• Jemma McGuffie (JM), SG – Clinical Priorities Policy, Policy Officer and Secretariat

Items and actions

Items and actions

Attendees and apologies

1. Welcome, Introductions and Apologies

SF welcomed Gail Smith, Interim Chief Officer of Angus Health & Social Care Partnership, as a new member, and no apologies were noted as above.

2. Review of previous actions

JM informed the Committee that she has received a full return of completed Declaration of Interests forms from members.  It was agreed that NACNC minutes from the meeting in February were approved by all NACNC members.  Ongoing actions will be covered as part of this agenda.

3. Update on Covid-19 situation (from SG, NHS, LA and 3rd sector perspectives)

RD and CD gave an overview from operational perspective:

• In Lothian/GGC, clinics have continued via virtual or telephone consultations. Very urgent cases still seen face-to-face under relevant and appropriate precautions.  Annual leave has been cancelled, so there is more capacity plus number of referrals are reduced.
• RD highlighted the expected impact of lockdown restrictions on neurological population in terms of psychological and physical wellbeing, many of whom rely on exercise as part of self-managing their condition.
• In Grampian, Near ME has been utilised but important to reflect that individuals may opt for telephone for various reasons.  This approach has been particularly useful for 1st seizure and headache appointments and useful for obtaining patient histories.  Reflection that it has been important in advance of consultations to provide people with advice about setting up their room to facilitate physical assessments etc.
• Through clinical networks, aware that non-tertiary boards have been more affected and re-deployed to support other units.
• RD reflected that future service design will involve opportunity for more remote consulting and that is helpful in terms of enabling people to access the right professional, in the right place at the right time.
• The capacity of diagnostic services do not seem to have been as affected as originally thought and routine scans have still been performed across the country.
• The Committee felt the creation of an informal clinical network was a benefit to more easily share practice and approaches across Boards.

AS and GG provided an update from the Scottish Government, which included:

• The two main areas of work has been around responding to the initial situation and putting in place arrangements to protect people that are vulnerable to the virus.
• SG policy officials have been liaising with CMO advisers and stakeholder organisations for a variety of different conditions, to look at the clinical risks and to disseminate information to the public.
• The next phase is recovery and re-mobilisation of services, considering the safe and incremental prioritisation using data and emerging evidence.
• SG policy officials are engaging with different sectors about recovery across the whole of government, not just in health.
• Jolanta Lisicka from the Participation Team is supporting the Clinical Priorities unit with the implementation work going forward.

All other NACNC members provided an update with their experiences being varied. However, all agreed that technology services such as the video consulting service, Near Me has been hugely beneficial.  It was highlighted that some of the neurological population have still had to have community visits and have not been able to use Near Me because of their condition or not being able to access technology.  It was also highlighted that it is important that a variety of options are provided for patients to engage with services to avoid inequalities in care.

Neurological Alliance of Scotland (NAoS) has started to talk to its members about measuring people’s recovery. If there is a change in condition during or after COVID-19, does this align with anticipated prognosis or has it been accelerated because of COVID-19. In this regard, not necessarily the condition making COVID-19 worse, but COVID-19 making the condition worse or both.

Committee agreed it was helpful for SG to provide messaging in recent weeks about health services being open for urgent care and that healthcare can be provided safely.

Committee was interested to learn more about options being considered to provide exercise opportunities e.g. organised outdoor gym sessions, as part of relaxing lockdown measures.

4. Impact of Covid-19 on the Framework for Action

GG provided a detailed update against the Framework’s commitments, early actions and priorities. Understandably the pandemic has meant some areas of activity have been temporarily paused (including Atlas of Variation and Healthcare Improvement Scotland self-evaluation assessment).

GG highlighted, however, that there are many opportunities to be pursued. COVID-19 has brought many areas to the forefront e.g. remote consulting, the use of anticipatory care planning and role of carers. Leadership remains critical, as does data/ measuring tests of change.

Committee considered it would be useful to understand the emerging data about usage of virtual consultations and the respective needs of neurological population e.g. if more could be included about chair-based activities.

The Committee felt it is important for SG to provide an update externally, to summarise progress made to date and the changes to early actions/ priorities as a result of COVID-19 pandemic. SG agreed and thought useful opportunity to seek input about the amended priorities. NAoS agreed to collaborate with SG on development of communication and engagement plan, with exploration of supporting implementation.

SG officials advised that they expected to retain £500,000 framework funding for 2020-21 but would confirm when formalised.

The Committee asked SG for revised priorities to be set out under short, medium and long-term timescales.

5. Scottish Access Collaborative update

JC informed the committee that the workshop on 4 March had been a productive event, with lots of enthusiasm from attendees for development of national pathways. Actions to follow up in working groups had been put on hold due to COVID-19 but felt that this recovery period is the right time to have these discussions and debate.

JC agreed to share programme evaluation for ACRT/Vetting work via the Knowledge Hub.

6. AOCB

GG reminded the committee that there are outstanding call outs for 2 new members who represent the Chief Nursing Office and the Chief Social Work Office.

The Committee decided to hold another meeting at the end of June, in addition to the scheduled meeting in September.

7. Agree next steps and next meeting

NACNC Actions
No.	Action	For
1	To gather information as to how services are developing between the response and recovery phase.	Gerard Gahagan
2	To provide update on Neuro Alliance – Lived Experience Report.	Becky Duff
3	To provide update around engagement and reporting back for the Framework.	SG Clinical Priorities Team
4	To follow-up with contact about the Grampian Network.	Gerard Gahagan
5	To follow up with RD about shielding advice and how that develops.	Gerard Gahagan
6	To circulate revised priorities, which will be set out under short, medium and long-term timescales.	Gerard Gahagan
8	To gather and circulate information about options being considered to provide exercise opportunities e.g. organised outdoor gym sessions, as part of relaxing lockdown measures.	SG Clinical Priorities Team
9	To collaborate with SG on development of communication and engagement plan, with exploration of supporting implementation.	Becky Duff
10	To share programme evaluation for ACRT/ Vetting work via the Knowledge Hub	Jamie Cochrane
11	To provide an update externally, to summarise progress made to date and the changes to early actions/ priorities as a result of COVID-19 pandemic	SG Clinical Priorities
12	To arrange an introductory one to one meeting with Gail Smith.	Gerard Gahagan
13	To share Framework funding figure once confirmed.	SG Clinical Priorities
14	To organise next NACNC meeting for the end of June.	Jemma McGuffie