1. Dr S J Desilva

2.  12 – 1pm Registration and Lunch  Start 1pm  1. Update and summary Dr S J Desilva  Review of learning and Actions from previous peer review 2014  New suspected angina referral form – Joint feedback and recommendations  e-consultations - update  Wakefield cardiology network – summary  2. Peer review of cases NA/SDS  3. Medicines optimisation team, ImPP (KM)  Break  3. MYDIAGNOSTICKS update – SDS  4. AF/Grasp and stroke – quick updated (Gillian Richardson)  5. RAIDR - quick summary – CH  6. Big white wall – update - CH

3.  All practices are required to take part in two external peer reviews of outpatient specialities with consultants - in relation to the “OUTCOMES AND VALUE FOR MONEY” domain of NDF  The purpose of the peer review is to improve QUALITY and SAFETY OF CARE.  By improving quality we can achieve efficiencies.

4.  Part one - practices to capture discussions at practice meetings to identify case studies prior to external peer review  Part two - Network /target session to capture discussions with consultants and clinicians  Part three - used to identify key learning points and develop action plans.

5.  If patients don’t have suspected angina, DO NOT TEST FOR IT! Testing can result in unnecessary non invasive and invasive procedures – which are associated with risk.  Screening questions for angina – If answer NO for the 3 suspected angina questions, then Highly unlikely patient has angina. Referral, imaging and testing not necessary.

6.  New suspected angina form presented to network who agreed to pilot it  Why stable angina needs to be seen quickly and those with severe CAD need to be identified  Angioplasty will not stop heart attacks (no tests which will identify which plaques will rupture),but for improvement of symptoms.  Stenting supports symptom control but does not save lives.

7.  1. Implement and pilot of NEW “Rapid access” suspected angina clinic forms  2. participate in audit and feedback (via survey monkey)  3. support the joining up of services and ways of working together between specialities to stop patients being passed around the system.  4. Arrange a 2 nd follow-up peer review and update with Dr Nigel Artist (Consultant cardiologist)

8.  Feedback and discussion

10.  Feedback

11.  From Aug changing to NT-BNP  Reference values changing  Currently B-BNP levels 100  New range NT-BNP levels 400

14. Paul Brooksby - Consultant Cardiologist MYHT Som de Silva – GPwSI Cardiology and Network 6 Representative (Wakefield) Pravin Jayakumar (GP) – Network 5 Nigel Artis – Consultant Cardiologist MYHT Dwayne Conway – Consultant Cardiologist MYHT Gillian Richardson – Public Health Emma Smith – Health Improvement Specialist, Wakefield Public Health Viv Nicholson – Senior Commissioning Manager NKCCG Caroline Ellis – Locala Cardiology and Admissions Avoidance Team Leader Alison Carr – Senior Cardiac Technician MYHT Ged Oliver – Strategic Clinical Network Representative Sharon Stockdale – Heart Failure Nurse - Locala Principal, Wakefield CCG and Public Health Keith Marshall – Patient representative Representative (Wakefield) Gill McDonald – Medicines Optimisation Wakefield CCG David Fearnley – Heart Failure Nurse, Locala Hazel White – Consultant Cardiologist MYHT Fiona Dudley - Lead Nurse, Cardiology Services MYHT Phil Batin – Consultant Cardiologist MYHT and Strategic Clinical Network Clinical Lead

15.  Current ongoing agenda items New stable angina pathway e-Consultations Community heart failure pathway/clinic Enhance-HF Grasp AF Heart failure guidelines Community IV diuretics pathway Familial Hypercholesterolemia (FH) /genetic testing Northkirklees community cardiology service

16.  Dr Nigel Artis – Consultant cardiologist MYT

18.  UPDATE – finally ready to go !

19.  Gillian Richardson

20.  Dr Clive Harries