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RE: Clinical Networks
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Hughes, Dermot
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Sep 28, 2006 03:28 PDT
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We in Gwent have and always will support any discussions to optimise the provision of Critical Care for ours and our neighbour's patients.
Over the last three years there have been several informal discussions I have attended with WAG/NPHS where attendance has been variably representative of Trusts' interests.
Mark was indeed the only intensivist invited to the SE Planning forum last year as this meeting was designed to address not just critical care but a host of other specialties/subspecialties in need of a regional perspective.
Any suggested meeting either nationally or regionally may well prove a beneficial vehicle to advance the development of whichever MCN we feel suits our services but we must ensure that there is a mechanism for issues arising to fall on receptive ears.
I'd welcome opinions on which central agency would be the most facilitative in advancing the agenda of managed clinical networks for Critical Care in Wales,
Dermot Hughes
Chief of Anaesthesia & Critical Care
Gwent Healthcare NHS Trust
-----Original Message-----
From: SMITHIES Mark [mailto:mark.sm-@cardiffandvale.wales.nhs.uk]
Sent: 26 September 2006 21:32
To: wi-@topica.com
Subject: RE: Clinical Networks
Weekend style preferred
-----Original Message-----
From: Mark Smithies [mailto:ma-@bareppa.fsworld.co.uk]
Sent: 22 September 2006 18:50
To: wi-@topica.com
Subject: Re: Clinical Networks
In South East Wales the most recent activity (this month) has been a
meeting of critical care nurse managers from all of the acute Trusts and
interest from WAG in the proposed Terms of Reference etc, for that
group.
At public health and intensivist level not a lot has happened recently
but clinical colleagues from the old Bro Taf HA (Woodsford, Jenkins and
Smithies) have publicly stated together their support for networked
provision, having all attended a preliminary meeting (as I recall it
they called it a 'shadow network meeting' - perhaps Paul and Brian can
confirm) organised by LHB and Regional Public Health Colleagues. Sadly
Gwent colleagues were unable to attend that meeting - a little while
ago, it must be admitted. I know they are interested in engaging in a
network.
I was the only intensivist to attend the large SE Wales Regional
Planning forum at the end of last year. A pity other Trusts did not get
their intensivists involved. This was particularly unfortunate because
the meeting included a critical care workshop for a lot of LHB managers
(and two Trust Medical Directors - not Cardiff & Vale's), all of whom
were learning rather than leading. Nevertheless it was clear that
Regional Officers (or perhaps their facilitators who helped them
organise the meeting) considered the provision of critical care services
a key issue in the provision of hospital care throughout the region. As
far as I am aware there has been radio silence since, anyone heard
anything different?
Given the paltry budget I am concerned about the proposed job plans for
Network Managers, what grade and remit?. Bob Winter spoke very good
sense at the WICS summer meeting; do we need 3 network managers for a
population of 3 million? That is a huge slice of the total budget,
whatever level they are paid at.. Would a more senior manager supporting
the 3 relatively small networks, and seeking economies of scale
e.g.Wales-wide purchasing etc make more sense? It might also make the
project more attractive for Regional Offices and LHB Execs to become
involved. We need Regional Offices and LHB's to engage with the process,
otherwise developing critical care in Wales will not lift off. Worse, a
lack of strategy is likely to lead to money being removed from critical
care altogether. I well remember being shocked to learn that Colin
Wise's CRI ICU had a bed closed because of hospital overspending despite
the fact that data published in the peer reviewed literature
demonstrated a desperate need for more ICU beds at CRI. I am concerned
that this will happen in SE Wales in the next year or so if we do not
get our act together, because the LHBs are insufficiently sophisticated
(and have no incentive) to recognise how critical care services change
with hospital case mix.
I am happy to organise (or host) a regional meeting for SE Wales
intensivists to discuss how we progress this issue regionally. How about
it?
Perhaps someone else is interested in organising this?
Dave, given recent discussions and previous experience, are all relevant
consultants intensivists on this list or should I re-post this directly?
I would appreciate learning who I am speaking to!
thanks
Mark Smithies
Clinical Director, Critical Care, Cardiff and Vale
----- Original Message -----
From: "dave hope" <dave.-@swansea-tr.wales.nhs.uk>
To: <wi-@topica.com>
Sent: Friday, September 22, 2006 4:21 PM
Subject: Clinical Networks
| | I met with Cathy White, policy lead in critical care at WAG, the other
day and asked her what's happening. Answer 'not much'. They have
prepared job plans for the Chairs and Network Managers. They have had
expressions of interest for the manager posts but have yet to persuade
any LHB Chairs to apply for the Network Board Chair jobs - although
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they
| | haven't tried very hard because of other issues.
I encouraged her to get things moving. My interest was in continuing
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the
| | work of the care bundles initiative after the funding runs out next
March. The networks could have a major role in monitoring standards of
care.
I am aware that a clinical meeting has happened in North Wales to
discuss some of the issues. Richard Self has recently written to me
suggesting a SW Wales joint audit meeting. It seems that many people
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are
| | quite keen on the idea of networks and are waiting for leadership from
the centre. Hopefully more of a direction will follow the meeting of
the Critical Care Advisory Group in early November.
Maybe WICS members could be more pro-active in preparing the
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ground....
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