14th September 2007 by stariya



                   Specialist Services Clinical Advisory Group
                           Friday 14th September 2007
                   2pm, Conference Room, Templeton House

Attendees:          Dr Frank Casey (Chair)             Belfast Trust
                    Roisin O’Hare                      Belfast Trust
                    Dr Carol Wilson                    Belfast Trust
                    Alison Kearney                     Belfast Trust
                    David Fulton                       Patient Rep
                    Dr Diane Corrigan                  SHSSB
                    Gillian Wells                      Service Delivery Unit
                    Marshall Riley                     Belfast Trust
                    Andrew Sands                       Belfast Trust

In attendance:      Zoe Smith                          Service Delivery Unit

1.    Welcome and Apologies
Dr Frank Casey welcomed new members to the group; David Fulton a patient
representative and Alison Kearney from the Belfast Trust.

Apologies were received from Norma Smith, Dr Stephen McMechan, Anita Smyth.

2.    Previous Minutes
The minutes from the previous meeting, held on Friday 1st June 2007 were agreed.

3.     Matters Arising

4.    Update on Questionnaire Distribution
The questionnaires will be sent by email from the Service Delivery unit on behalf of
Dr Frank Casey. They will be circulated to Cardiologists, Rheumatologists and
Respiratory Physicians.

5.    Adult Congenital Heart Disease
The current services were discussed and the following issues were raised

(a) Available support and advice for patients and carers. It was agreed that a sub
group would be convened to look at the needs of both the patients and their carers. It
is hoped that some focus groups / discovery interviews will be set up to assess the

Action: Gillian Wells to convene a group.

(b) The transition process from childhood to adulthood and the need to trigger a
services support a year before the transition of services is due to commence. Joy
Youart informed the group about the work that she had been involved in Manchester.
She agreed to contact their liaison nurse to see what there current service
encompasses and what documentation they use. It was felt it would also be useful to
benchmark our services against theirs in relation to population services and staffing

Action: Joy Youart to contact Manchester unit for information.

(c) The provision of a possible hub and spoke service with physicians with a special
interest. This would involve patients being categorised into complex care that
required specialist treatment and care, intermediate care, which may involve shared
care between the tertiary centre and local secondary care services and simple care,
for mild VSD’s that could be looked after in Local secondary care. It was agreed a
survey of current patients in the system would be undertaken to assess the numbers
in each category.

Action: Anne Graham and Christina McMaster to undertake a survey on current
information to break it down into the suggested categories to assess numbers.

6.     Pulmonary Hypertension

(a) Various algorithms for the diagnosis and treatment of care of patients with the
differing causes of pulmonary hypertension were tabled and discussed (enclosed). It
was felt that they were very similar and could be presented in one algorithm

Action: Dr Marshall Reilly agreed to undertake this work.

(b) The role and relationship that Northern Ireland has with NSCAG was discussed
and it was agreed that it was important that we linked to their service. Dr Corrigan felt
that for governance reasons that this was important as due to the low numbers of
patients presenting on an annual basis it would be hard to maintain a level of
speciality in this field. Dr Wilson informed the group that the current services links
closely with both Newcastle and Papworth, both NSCAG centres. Dr Sands raised a
concern re a delay in commencement of appropriate treatment if all cases has to
formally go through NSCAG and it was felt that it may be more appropriate to link to
Dr Sean Gaine in Dublin. It was agreed that the services should be viewed in line
with the document Service Specifications for the National Pulmonary Hypertension
Service, Jan 03 (enc)

7.     AOB
Dr Casey raised the issue of including inherited cardiac disease within the remit of
this group. It was recognised that there was a high degree of cross over with the
EPS and Pacing clinical advisory group.

Action: Dr Pascal McKeown and Dr Fiona Stewart to be invited onto the group

8.     Date of Next Meeting
Friday 9th November 2007 at 2pm in the Conference Room, Templeton House,
Service Delivery Unit, 411 Holywood Road.

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