Out-of-Hospital Cardiac Arrest reference group minutes: September 2019

Items and actions

Welcome and Introductions

1. The Chair welcomed attendees to the meeting. On behalf of the group he thanked the former Director of BHF Scotland for his contribution to Scotland’s OHCA Strategy and wished him every success in his new post as Chief Executive Officer at Resuscitation Council (UK).

2. Introductions were made round the table.

Apologies

3. These were received from 7 individuals. 

Minutes

4. The Minutes of the last meeting, on 1 May, were agreed as an accurate record.

Actions from Previous Meeting

5. The Chair noted the actions from the previous meeting:

• Action 1: Invite a representative from BASICS to join the group – Secretariat. A representative already in the reference group works with BASICS and can update the group as needed.
• Action 2: Amend minute to reflect discussion – Secretariat. One amendment.
• Action 3: Circulate presentation on planning post 2020 - Secretariat. This had been circulated to the group.
• Action 4: Take forward a new draft plan/strategy for the Reference Group’s and SG consideration – OHCA Delivery Group. This was discussed at agenda at item 3.
• Action 5: Finalise a date for an initial meeting on CPR in deprived areas/hard to reach groups to take place in St Andrew’s House. A discussion took place on 31 May with agreement that attendees would liaise on issues going forward, particularly in light of planning for the strategy post 2020 which aims to focus CPR training in areas where the currently strategy hasn’t reached e.g. disadvantaged communities.
• Action 6: To explore funding opportunities with the Health Foundation. A discussion had been planned with the Foundation. This needed to be rescheduled and SALFS were aiming to progress this.
• Action 7: Update from Health Boards on planned actions for September Reference Group meeting – Secretariat. Ongoing. Boards have continued to update on arrangements for CPR learning.
• Action 8: Consider where gaps are in young people learning CPR – SALFS and Secretariat – Ongoing. SALFS representative confirmed that in terms of schools and young people, they are seeking to recruit a project worker within the next 6 weeks to specifically focus on this aspect of the project

Planning Post 2020

6. Attention was drawn to the draft tabled paper ‘Saving Lives Together: High Level Action Plan’. The group talked through the main points emphasising the opportunity to refocus the current strategy’s lens, expand the partnership approach and begin new avenues of direction. The draft represented a summary of conversations that had started to develop and would lead to an agreed way forward. 

7. The positive impact that the existing Strategy had made was set out and the group talked about next steps with elements mapped to the chain-of-survival. These could include further work for SALFS around culture, young people, inequalities and communities, anticipatory care, a digital plan, co-responding, public access defibrillators (PADs), in-hospital critical care, after care underpinned by data and R&D. It was proposed that a writing group to progress a further draft would be formed.

8. It was noted that the Strategy had been challenging and effective in driving positive change within the SAS and supported throughout the organisation. Good progress had been made and the value of having a national strategy to focus work was seen as a strength. 

9. The Scottish Government highlighted the need for work to reflect the aims of the current National Performance Framework, Programme for Government and wider heart disease policy. It was agreed that further input from partner organisations would be sought to take forward work.

10. SAS commented on the importance of representation from local government and the potential for the refreshed proposals to contribute to a reduction in drug related deaths. The Chair noted the need to have COSLA on the group and for an off-stage discussion with drug leads to scope the potential of approaches to OHCA to address this.

11. SALFS partners reported that they were looking at how to further adopt strategic and sustainable approaches to inform the way ahead. SALFS representatives noted that anything the partners could feed into inequalities work around heart disease and women and other topics would be very welcome.

Action point 1 – OHCA Delivery Group – Proposals and discussions on next steps for strategy at the next meeting of the group in March 2020.

CPR Learning and Culture Change

SALFS

12. SALFS representatives provided a brief update reporting that numbers for those CPR skilled stood at 510,000. Plans to make a formal announcement on reaching the 500,000 figure were going ahead to coincide with European Restart a Heart Day on 16 October and SALFS were working with partners on messaging. Work would be taken forward with Young Scot on peer to peer learning, and a meeting on inequalities had taken place recently. Engagement with Marks & Spencers and the SFRS’s Community Action teams to deliver CPR learning were being progressed and was scheduled to be ready by mid-October.

Progress Data Linkage

13. Headline figures for the next OHCA Data Linkage report should be available for mid-October. It was noted that in terms of processing the data, before moving to the reporting phase, a delay had been introduced to the data cleaning and analysis stage and steps were being taken to provide a resolution. It was hoped that this component of data processing could be brought under the auspices of the SAS going forward.

PADS

National Defibrillator Network (NDN)

14. BHF talked through the paper previously circulated to the group on the NDN ‘Circuit’ and reported on good progress. The project had gone live on 14 August and engagement with existing SAS resources was taking place with a significant number of defibs registered. No major issues were reported and positive momentum on the project established with the SAS. Plans for a formal public launch were being developed for new year 2020. 

PADS modelling

15. The background to the PAD modelling project work was explained. It had been envisioned that the project would inform a view on where PADs could be optimally located and provide a risk map based on the modelling. The findings of the modelling showed suggested locations based on historical prevalence of cardiac arrests and highlighted that the data existed to cover the whole of Scotland, a resource not previously available. Suggestions for next steps were put forward and included formal reporting, linking to the Atlas of Variation and developing a web-based visualisation for interactive public use with appropriate guidance, based on historical instances of OHCAs. It was noted this would provide people with a choice about actions to take, particularly in high-risk areas and if the web resource indicated a PAD already positioned in a sub-optimal location. It was noted that placing PADs in locations such as ATMs and coffee houses also had merit if properly advertised and both approaches could be dovetailed together. A discussion had been progressed with a European manufacturer who had provided a quote. The group was informed of the coordinated approach St Andrews First Aid had been leading on in Inverclyde with the Jayden’s Rainbow charity regarding PADs and first aid training and would be keen to link to this resource going forward. The Chair suggested linking to the Atlas of Variation leads at ISD to scope the potential for a shared learning. 

Action Point 2 – Coordinate progress with the PAD modelling project with Atlas of Variation leads at ISD.

Updates

16. An update was provided on progress made by the Scottish Fire and Rescue Service (SFRS). Service transformation negotiations with the Fire Brigade Union (FBU) remain ongoing and SFRS project work was ready to go ahead once resolved. A paramedic has been recruited to take this work forward. The new deal being negotiated with the FBU was focussed on new ways of working and a vote on the next steps was to go ahead.

17. Police Scotland update. The co-responding work rolled out to Highland Division was ongoing. Defibs had been used on a number of occasions in the Highlands with successful outcomes and noted that the SAS also received support from firearms teams who carried defibs as part of their inventory. Costed practical training in first aid, including PADs for police officers was being planned. There is an initiative rolling out smartphones to every police officer in Scotland and the opportunity to link to digital resources such as the GoodSAM app was highlighted. Police Scotland welcomed interest from stakeholders.

18. It was reported that regarding cardiac arrest management, recruitment had taken place at the SAS to take forward end-of-life care project work and this would feed into OHCA resuscitation planning.

19. CHSS highlighted recent research on OHCA survivors and return to work reported on Resuscitation: Official  Journal of the European Resuscitation Council website: https://www.ncbi.nlm.nih.gov/pubmed/31539607

20. The Scottish Government confirmed that 32 first aiders had been identified to progress CPR learning amongst staff. Steps were being taken to publicise the opportunity, aimed to coincide with European Restart a Heart Day in October.

21. St Andrews First Aid reported that they had invested a significant amount in managing a first aid in primary schools campaign with work progressing with COSLA and the Scottish Government. A joint conversation with the SAS was to be taken forward regarding the First Responders Network.

Date of Next Meeting

22. No other business was raised. The Chair thanked attendees and confirmed that Secretariat would confirm the details for the next reference group meeting.