MINUTES OF THE MEETING HELD ON
                                    22ND JANUARY 2009


Present:                 Mike Burrows                    Dr. Jeremy Dick
                         Harry Golby                     Chris Entwistle
                         Jo Purcell                      Mike Harnor
                         Julie Rigby                     David Stockdale
                         Jude Adams                      Candice Barber
                         Phil Bazley                     Bev Hopcutt
                         Ashleigh Knowles                Russell Sheldrick
                         Deidre O’Brien

Apologies:               Helen Powell                    Alan Campbell
                         Gill Pearl                      Lisa Spencer

       ITEM                             NOTES                                 ACTION   SfBH
1. Introduction Mike Burrows noted the apologies, welcomed everyone
   & apologies and introduced himself as Chairman of the GMNNB.

                 Purpose of the Board:
                 To support the delivery of the national service
                 Framework for Long Term Neurological Conditions.

                 Key tasks today:
                 Revisit the TOR and Workplan for the next 12 months.

2. Minutes       The Minutes of the previous Meeting, held on the 12th
   from last     December 2008, were agreed as being a true record.

3. Matters       JR has written to Roy Dudley-Southern to thank him for
   Arising       all of his kind assistance and contributions to the Board.
   (not on
   Agenda)       JR has visited Oldham’s NSF Group and will visit with
                 Heywood, Middleton & Rochdale PCT in the near future.

                 JR has commenced contact with the Acute Trust and the
                 Neuro Department in general and will progress.

GMNNB Minutes 22.1.09                        1
       ITEM                           NOTES                                        ACTION   SfBH
4. Terms of The main purpose of the Board is to facilitate the delivery
   Reference of the NSF for Long Term Neurological conditions across
   (2)       Greater Manchester.

                 Following changes agreed:
                  Include local authorisation into objectives and
                      functions.                                                    JR
                  Under the heading ‘Secondary Objectives’, item 5, to
                      change the word ‘agree’ to ‘recommend’ new clinical
                      procedures and drugs for patients
                  Quorum increased to 10.


                 Dr Kulkarni is to be approached with an invitation to the          MB
                 membership. MB has written to him.                                         C6
                 One of the Acute Trust representatives, Paul Bannister,
                 did not attend the last meeting, nor has he attended this          JR
                 meeting. He will query his membership with the Acute
                 Medical Director and JR will liaise.

                 The second representative of the Acute Trust, John
                 Saxby, has expressed a wish to become a member. JR                JR, MB
                 will draft an appropriate letter of invitation to him on behalf
                 of MB.

                 JD reported that he has been unable to contact a GP. It
                 was suggested that Peter Fink be invited to the Board. JR         JR, MB
                 will make contact with him, but if not available MB will
                 approach the Chair of the PECC to request membership
                 from that direction. ACTION FOR MB.

                 The TOR were agreed with these changes.

GMNNB Minutes 22.1.09                          2
     ITEM                               NOTES                                 ACTION   SfBH
5. Review   The draft workplan was discussed.
            Objective 1 – Neuro-rehabilitation:
            At the last meeting the Board agreed that it is timely to
            review the model for neuro-rehabilitation as the 1999
            model has not been fully implemented at all levels.                        D2
            It was suggested that a sub group be set up to look at
            neuro rehab, perhaps with the involvement of CBS. This
            is supported by a letter from Dr. Walton at SRFT.
                 ACTION: Respond to Dr. Walton

                 Sub-group to review report by Alan Tennant. DH
                 research studies due to report next year.
                 GM Neurosciences Supra-district Audit Group may be
                 able to assist in this work.

                 ACTION: Establish sub-group with clear TOR to review          JR
                 model, evidence and current activity.

                 Objective 2 – Neurology:
                 MB identified that the work plan for this objective should
                 be realistic since it is a major piece of work. Also there            D2
                 may be issues for diagnostic services with any change
                 in neurology service delivery. It was noted that
                 diagnostics have worked well in Salford, due mainly to
                 the personnel involved. JA identified that it is important
                 to learn from each process as work progresses.

                 ACTION: A full programmed approach will be discussed         MB, JR
                 at the next meeting.

                 Objective 3 – Network Infrastructure:
                 Clinical engagement conference to be arranged for April
                 / May. Needs to include representation from other
                 relevant Networks - Stroke, Cancer and Children’s

                 ACTION: Confirm with Alan Campbell if this would fit          JR
                 with the AGM PCTs clinical engagement events.

                 The Board agreed the objectives. It was also agreed
                 that neuro-surgery should continue to be reviewed
                 within this group despite the migration of commissioning
                 to the North west Specialist Commissioning Team in
                 April 2009.

                 It was agreed the Board will work closely with the rest of
                 the North West regarding emerging treatments, to
                 ensure a consistent approach.
                 The Workplan was approved and signed off.

GMNNB Minutes 22.1.09                        3
       ITEM                                NOTES                               ACTION   SfBH
6. Any Other 1. Epilepsy surgery
   Business JR informed the meeting of an email received from the
             Neuro Surgeon at SRFT regarding epilepsy surgery. The
             enquiry concerned changes to pre-surgery diagnostics. A
             request has been made for funding in the sum of £30,000
             for a pilot to be undertaken, consisting of 20 patients to
             compare accuracy of 2 tests (WADA and fMRI). It was
             noted that epilepsy surgery is carried out in approximately
             9 hospitals in England. Need to clarify where the
             commissioning responsibility for this would fall in view of
             the migration of neurosurgery.

                 Discussion also focussed on the need to address all
                 aspects of the pathway e.g. videotelemetry, access to the
                 David Lewis Centre rather than look at discrete elements
                 of pathway in isolation. It was agreed that a separate sub-
                 group is needed and membership should include Epilepsy
                 Specialists. MH raised issues from recent publication and
                 the management of epilepsy particularly with respect to
                 older people. It was decided that services for older people
                 should be addressed at the Clinical Congress.

                    Get further information from Clinical Psychologists.        JR
                    JA to visit David Lewis Centre
                                                                               JA, JD
                    Draft proposal to be submitted to the Board – liaise
                       with Mr. Josan.
                    JR to send out papers provided by MH
                 Website for information regarding workforce available at:

                 2. New medicines / treatments
                 Policies on the use of rare or expensive medicines and
                 treatments should be developed as appropriate in liaison
                 with the NWSCT in order to ensure equity and
                 3. FES
                 There is discrepancy on the provision of FES across
                 Greater Manchester. A more consistent approach would           JR
                 be beneficial. JR is awaiting feedback from the GM
                 Effective Use of Resources Group. Recommendations
                 can then be taken to the GM Directors of Commissioning.
                 4. Paper to AGM PCTs
                 This would provide an opportunity for any concerns to be
                 identified to senior managers in the Association e.g.
                 progress with implementing the collaborative
                 commissioning arrangements for neurology.

                 ACTION: Prepare paper for the AGM PCTs regarding the          MB, JR
                 proposed actions for the Network

GMNNB Minutes 22.1.09                        4
      ITEM                             NOTES                            ACTION   SfBH
7. Future   It was agreed that meetings should take place every other
   Meetings month and therefore the next meeting will be scheduled
            for March 2009. A full programme of meetings will be         JR
            scheduled, up to 2010.

                 Next meeting
                 Monday 16th March             10.00am – 12.00 noon

                 Dates for 2009:
                 Friday     22nd May           2.00pm – 4.00pm
                 Friday     24th July          2.00pm – 4.00pm
                 Monday 28th September         2.00pm – 4.00pm
                 Friday    27th November       2.30pm – 4.30pm

                 All meetings to be held in the Salford Suite at St.
                 James House

GMNNB Minutes 22.1.09                      5

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