1. Congenital Heart Disease Network – South Wales and South West
Network Board Meeting
15th March 2017

2. National Context Update
NHS England has formally launched consultation – closing 5th June 2017
UHW consultation event 15th Mar
UHB consultation event 15th May
Bristol City Councillors to formally support UHB and SWSW Network

3. Self-assessments / visits - paed

4. Self-assessments / visits - paed

5. Self-assessments / visits - adult

6. Self-assessments / visits - adult

7. Headline Reds and Ambers – Paed and Adult
Network approach / Staffing (actions underway):
Formalised pathways – Being written by AT and DW
MDT attendance – Letter of support written to all CDs. PECs / cardiologists to inform if unable to attend. Option to remote access
Transfer of images / remote access – UHB-UHW test. Mapping all availability
Standard patient information records – Awaiting a national steer. AT on CRG
Registered nurse and dedicated consultant time – Network will need to define options and then approach commissioners. Considering virtual CNS slots to video L1 centre
Training and education:
End of life, breaking bad news, pall care – Pall care best prac in progress. Other training should be available locally. Contact network if not to include in next annual session
Formal network training plan – To be developed
Ability to rotate to L1 centre – Possible in principle, but time a constraint
Organisation, governance and audit
Network-wide audit / governance framework (including for risk and incidents) – Mar Board
Wider meetings for audit, M&M, CPD – Mar Board
Standard database - Awaiting a national steer. AT on CRG

8. Patient Engagement Circulation Newsletter Email + In-patients
OPD clinic visits Exeter
Fetal survey
Listening event March
NHS England, May
Virtual ref group
Web site, July
Facebook, Jun 17
Pt engagement Cardiff, Autumn
Circulation Newsletter
contacts
In-patients PICCU, ward 32, NICCU, BHI
OPD clinic visits Exeter ( pic) Others in the diary
Fetal survey March
NHS England May 15th
Vitual ref group for advice
Listening event March
Web site
Pt engagement Cardiff Autumn

9. Working group updates Image sharing:
UHW IEP / PACS – installing and testing new PACS, then business case for IEP link
UHW use of Ipads
Miraki box
Mapping capabilities for digital archive, PACS and IEP
Option of trialling GE system
Palliative Care – meeting 16th Mar to progress work from last Board
Website – procurement in progress, expected live July 2017
M&M – proposal to combine morbidity and adverse incident reporting (for discussion in PM workshop)

10. Bristol Independent Review
Progressing well with good engagement from families and commissioners from England and Wales
Visit from Bristol & South Gloucestershire councillors v positive, with commitment to write letter of support for UHB and the network in NHS E consultation
6-month progress to Overview and Scrutiny Committee
Patient-friendly progress report being drafted
Some slippage on timescales due to need to demonstrate embedding of new processes
Challenges around how to implement some changes in practice – e.g. patients recording consent conversations and requirement for explicit anaesthetic consent

11. Nurse education strategy
Set Scene
Standards Local Link Nurse Nurses with an interest
44 clinics a week in 36 centres
Partnership/Shared Care to Network care, up-lifting skills
Small numbers in-patients
Visiting Cardiologists, in-house cardiologist, PECs expectation of a RGN
Challenges
Identify RN/Child, RN/Adult,
Expertise/ lack of engagement
Education supported by Network Lead Nurse
Opportunities
Childrens Faculty Cardiac BRHC
Adult Southbank University, (UWE)
RCN competencies for Band 5 and 6
Shadowing in Level 1 centre
Conferences, BCCA.,ACHD, EuroGUCH
MSc, PhD
Workshop at future board
Year 1 (2017)
Identify nurse Level 3 centres
Clarify senior support in Level 2/3 centre
Shadowing in Level 1 on ward and OPD
Meet Level 2 CNS teams
Gap analysis 31 surveys
Book onto appropriate course
‘Congenital Network Nurses’ group for comms, training, peer support
Year 2 (2018)
First nurses attending Adult and Paed courses
Participate in local clinics
Explore ‘Helpline’ options
Set up 3-6monthly Link Nurse Meetings – hub meetings
Charity funding to support
RCN competences completed
Year 3 (2019)
All attended courses.
Local education to up skill other RGN
Helpline established
In patient support established
Set the scene
Study days are purely an introduction to know what you don’t know.
Module 1 Foundation
Module 2 Advanced
RCN competencies
Take booklets
B5(L3) The network Children’s Cardiac Nurse Specialist Team will provide support, education and a link to the outpatient and ward nursing staff at the Local Children’s Cardiology Centre. A local link nurse will be identified who can be a point of contact within the Local Children’s Cardiology Centres
B29(L1) Each Specialist Children’s Surgical Centre will employ a minimum of 1 WTE children’s cardiac specialist nurse per catchment population, whose role will extend throughout the Congenital Heart Network, ensuring that both an in-hospital and outreach service is provided.
B10(L2) Specialist Children’s Cardiology Centres must have locally designated registered children’s nurses with a specialist interest in paediatric cardiology, trained and educated in the assessment, treatment and care of cardiac children and young people. Immediate
B11(L2) There must at all times be a minimum of two registered children’s nurses allocated to the operational children’s cardiology beds who are trained according to the Royal College of Nursing competency framework. Immediate
B12(L2) Each Specialist Children’s Cardiology Centre will provide skilled support to undertake blood pressure and oxygen saturation monitoring accurately and effectively. Immediate
B13(L2) The network Children’s Cardiac Nurse Specialist Team, will support the Specialist Children’s Cardiology Centre. An appropriate number of Children’s Cardiac Nurse Specialists will be based at the Specialist Children’s Cardiology Centre (the number will depend on geography, population and the congenital heart network).
B5(L3) The network Children’s Cardiac Nurse Specialist Team will provide support, education and a link to the outpatient and ward nursing staff at the Local Children’s Cardiology Centre. A local link nurse will be identified who can be a point of contact within the Local Children’s Cardiology Immediate
Training
E2(L1) All members of the cardiac and PICU medical and nursing team will complete mandatory basic training on end-of-life care, breaking bad news and supporting children, young people and their families through loss. Identified members of the medical and nursing team will need to undergo further in-depth training.
E2(L2) All members of the cardiac and PICU medical and nursing team will complete mandatory training on end-of-life care, breaking bad news and supporting children, young people and their families through loss. Identified members of the medical and nursing team will need to undergo further in-depth training.
E2(L3) All members of the cardiac medical and nursing team will complete mandatory training on end-of-life care, breaking bad news and supporting children, young people and their families through loss. Identified members of the medical and nursing team will need to undergo further in-depth training.
E6(L2) Sufficient Clinical Nurse Educators must be provided across each Congenital Heart Network to deliver standardised training and competency-based education programmes. Each Specialist Children’s Cardiology Centre must have one clinical educator who is responsible for ensuring the continuing professional development of nursing staff in the Specialist Children’s Cardiology Centre. The competency-based programme must focus on the acquisition of knowledge and skills such as clinical examination, assessment, diagnostic reasoning, treatment, facilitating and evaluating care, evidence-based practice and communication.
Skills in teaching, research, audit and management will also be part of the programme.
E5(L3) Sufficient Clinical Nurse Educators must be provided across each Congenital Heart Network to deliver standardised training and competency-based education programmes. They will be responsible for ensuring the continuing professional development of nursing staff in the Local Children’s Cardiology Centre and community paediatric nurses. The competency-based programme will focus on the acquisition of knowledge and skills such as clinical examination, assessment, diagnostic reasoning, treatment, facilitating and evaluating care, evidence-based practice and communication.
B4(B3) ACHD Specialist Nurses from the Specialist ACHD Surgical Centre or Specialist ACHD Centre will provide support, education and a link to the outpatient and ward nursing staff at Local ACHD Centres. A local link nurse will be identified who can be a point of contact within the Local ACHD Centre.
E2(L1) All members of the cardiac and ICU medical and nursing team will complete mandatory basic training on end-of-life care, breaking bad news and supporting patients and their partners, families and carers through loss. Identified members of the medical and nursing team will need to undergo further in-depth training.
E2(L2) All members of the cardiac and ICU medical and nursing team will complete mandatory training on end-of-life care, breaking bad news and supporting patients and their partners, families and carers through loss. Identified members of the medical and nursing team will need to undergo further in-depth training.
E2(L3) All members of the cardiac medical and nursing team will complete mandatory training on end-of-life care, breaking bad news and supporting patients and their partners, families and carers through loss. Identified members of the medical and nursing team will need to undergo further in-depth training.
B5 L3 The network Children’s Cardiac Nurse Specialist Team will provide support, education and a link to the outpatient and ward nursing staff at the Local Children’s Cardiology Centre. A local link nurse will be identified who can be a point of contact within the Local Children’s Cardiology

12. RCN – Competency framework

13. To support adult standards, guidelines from RCN for nursing published
Knowledge and skills framework
Competencies for Band 5, 6 and 7 nurses will be helpful.

14. Doctors’ training Adult programme x 4 over 2 years No Paediatric day
Annual day for Drs
Survey Drs for topics
General cardiologist
PECS

15. Network Work Plan Timings

16. Upcoming Network Activity
Site visits and patient listening events:
March ’17: Gloucester adult, Musgrove park children’s
April ‘17: Plymouth, Taunton adult
May ‘17: Exeter, Truro, Barnstaple
Jun ’17: Glangwili adult
TBC: Cardiff adult listening event
Newsletter Mar ’17
Annual report – May ‘17
Upcoming Board dates and topic focus:
Date
Afternoon workshop focus
Tuesday 13th June 2017
Website final test
Psychology – tiered support between information giving, primary care, local hospital and specialist cardiac psychologist
Thursday 28th September 2017
Annual M&M / audit
Tuesday 12th December 2017
Transition and learning disabilities
Thursday 22nd March 2018
Research strategy