NES Medical Quality Management Group

Date: Tuesday 1 October 2013

Time: 1 pm – 3 pm

Venue: Kelvin Room, Clifton House, Glasgow MINUTES

Attendees: Rowan Parks (RP) [chair], Angela Gregg (AG), Niall MacIntosh (NM), Clare McKenzie (CM), Alastair McLellan (AM), David Reid (DR)

VC Links: Heather Carnegie (HC), Simon Edgar (SE), Adam Hill (AH), Donna Kelbie (DK), Ronald McVicar (RM), Harry Peat (HP), Kim Walker (KW), Sharon Weiner-Ogilvie (SWO)

In attendance: Steven Irvine (SBI) [minutes]

Apologies: Gordon Birnie, Duncan Henderson, Stewart Irvine, Eileen Peebles, Brian Robson, Hazel Scott

Item Action

1 Welcome RP welcomed participants to the meeting and introduced Niall MacIntosh the central QIM and Heather Carnegie who was covering maternity leave in NoS.

2 Minutes of Previous Meeting

2.1 Minutes of last meeting: 14 February 2013 The minutes were adopted as an accurate record.

Actions Item 4: RP reported that TQL money was being used appropriately. NM would produce a report on how the funding is being used this year.

Item 9: RP advised that Mark Russell was working with the QIMs to produce a reporting system for the PAQ/STS results. AM requested a project timeline. RP stated that this could be discussed at the QLG on 16 October. The data provided needs to be robust and useful to Boards and other stakeholders.

3 Consideration of Matters Under Any Other Business None.

4 Use of TQL funding: Report and Framework NM circulated the pro forma in August which had been agreed by the group. After feedback from DMEs, there would be a few amendments next year. NM had received reports from Lothian, Fife, Borders, Forth Valley and Dumfries & Galloway, and was chasing the others. A report will be produced for the QLG and circulated to deaneries and the MQMG. RP thought the money was being well spent, to support quality at a local level, and will feedback to MDET. There has been no indication that this funding would not continue.

5 National

5.1 GMC Review of the Quality Assurance of Medical Education and Training

5.1.1 Discussion Paper: QA Inspections

5.1.2 Discussion Paper: Approving Educational Environment RP advised that the GMC QA review had been ongoing for about 12 months. The consultations have been circulated to the QLG and responses sent to the GMC. These documents give an indication of the direction of travel for the GMC. The GMC will report the results of the consultation around the beginning of next year. The QLG had an informal meeting with the GMC a few weeks ago.

RP stated that the indications were the GMC wanted to make visits multiprofessional with an increased role for college representatives. SE was concerned about introducing more layers of bureaucracy. The group discussed the role of colleges at visits and the difficulty getting externality. The GMC was looking to professionalise the role of colleges rather than them taking on a regulatory role.

5.2 GMC National Training Survey 2013

5.2.1 NTS Key Findings

5.2.2 NTS Summary Report for Scotland RP advised that Scotland scored better that the rest of the UK in most areas and has remained the same or improved compared to last year.

6 Regional (For Information)

6.1 April 2013 Deanery Reports and Feedback

6.1.1 EoS DK reported that two items had been added to the DR in April. Both these sites had been visited and action plans put in place.

CM was concerned about the GMC not allowing items to be closed off in the DR and about the process used to moderate the PSI. KW had raised this at the meeting with the GMC and was assured that issues would be closed off. 6.1.2 NoS

6.1.3 SES HP reported that five specialties in SES had been identified as outliers for ARCP results and would be monitored. HP has tried to close off an issue at one site that no longer has any trainees but the GMC keep asking for confirmation.

6.1.4 WoS AG was concerned about the GMC asking about an outlier in ARCP data which wasn’t in the deanery’s data and about not being allowed to close off or RAG an issue as green.

RP stated that Rachel Daniels would attend the October QLG meeting as an observer and could be asked these questions beforehand so she can feedback at the meeting.

SE asked that Boards are given access to a rolling DR. EoS and NoS provide their rolling DR at the DQMG meetings that has representatives from their local Boards.

Action: RP asked all deaneries to consider providing their rolling DR at the DQMG meetings. QIMs

6.1.5 GMC Feedback to EoS

6.1.6 GMC Feedback to NoS

6.1.7 GMC Feedback to SES

6.1.8 GMC Feedback to WoS

6.2 Visit Tracker RP stated that a high proportion of externality from lay representative had been achieved but less so from colleges and not many were requested to attend. The vast majority of visits were triggered, but a few in NoS and EoS were routine/good practice.

AH asked for proportionality around using college representation. Visits were difficult to organise and to mandate college representation would make them virtually impossible. Where there is a major issue, the college should be involved. Specialists from other boards could be used where appropriate.

The group discussed the different standards for externality at ARCP and visits. It is easier to get college representatives at ARCPs because the dates are fixed far in advance. KW found it very difficult and costly to get college representatives to come to the NoS.

The group agreed that the QIM group should look at externality at visits as part of the vision process mapping exercise. 6.3 Visit Reports

6.3.1 EoS - Ninewells Hospital, Endocrinology & Diabetes, 31st October 2013

6.3.2 EoS - Aberdeen Royal Infirmary, Otolaryngology, 8th March 2013

6.3.3 EoS - Ninewells Hospital, Obstetrics & Gynaecology, 24th May 2013

6.3.4 EoS - Perth Royal Infirmary, General Internal Medicine, 30th May 2013

6.3.5 WoS - Wishaw General Hospital, Surgery (General & T&O), 15 June 2012

6.3.6 WoS - Glasgow Royal Infirmary, Foundation Medicine and Surgery, 27 June 2012

6.3.7 WoS - Hairmyres Hospital, Medicine, 29 June 2012

6.3.8 WoS - Royal Alexandra Hospital, Paediatrics, 25 June 2012

6.3.9 WoS - Royal Alexandra Hospital, Medicine & Geriatrics, 10 June 2012

6.3.10 WoS - Southern General Hospital, Neurosurgery, 26 October 2012

6.3.11 Wos - Monklands District General, Trauma and Orthopaedics, 31 October 2012

6.3.12 WoS - GRI/PRMU & SGH, O&G, 30 January 2013

6.3.13 WoS – SGH, Medicine, 27 February 2013

6.3.14 WoS – SGH, Surgery, 27 February 2013

6.3.15 Wos – Inverclyde Royal, Medicine, 13 March 2013

6.3.16 Wos – Inverclyde Royal, Surgery, 13 March 2013

6.3.17 Wos – FVRH, Surgery, 20 March 2013

6.3.18 Wos – Beatson, Medicine, 27 March 2013

6.3.19 Wos – Ayr, General Surgery, 28 March 2013

6.3.20 Wos – FVRH, Emergency Medicine, 02 May 2013

6.3.21 Wos – GRI, Medicine, 05 June 2013

6.3.22 Wos - GRI, Surgery, 05 June 2013

6.3.23 SES - Ninewells, Clinical Oncology, 10 May 2012

6.3.24 SES - Astley Ainslie, Rehabilitation Medicine, 16 January 2013

6.3.25 SES - Borders, Trauna and Orthopaedic, 1 May 2013 6.3.26 SES - Borders, Medicine, 10 May 2013 The reports had been provided for info and were discussed in detail at the regional DQMG meetings.

Action: HC/KW would provide reports from NoS visit for the next meeting. KW/HC

RP reported that the Scottish Government has set up a rapid response group to carry out a review of Lanarkshire hospitals because they were identified as an outlier in HSMR data. NTS and PAQ data had been provided to the group. The group expressed concern about the possibility that the PAQ/NTS data being misused or used to rank the Boards.

6.4 Deanery QM Meetings

6.4.1 SE QM group minutes: 30 January 2013

6.4.2 SE QM group minutes: 27 March 2013

6.4.3 SE QM group minutes: 29 May 2013

6.4.4 SE QM group minutes: 31 July 2013

6.4.5 EoS - DQMG Minutes, 1 March 2013

6.4.6 EoS - DQMG Minutes, 17 May 2013

6.4.7 EoS - DQMG Minutes, 16 August 2013 RP thought there was a lot of good work done at these meeting and they were well attended.

Action: AG would provide reports from the WoS specialty panel meetings for the next meeting. AG

6.5 GP Trainer/ Training Practice Quality Management

6.5.1 SE Scotland - GP QA Activity 2012-13

6.5.2 East - Practice Reapproval Meeting - 14th March 2013

6.5.3 East - Practice Reapproval Meeting - 10th May 2013

6.5.4 East - GP Quality Management Subgroup – 30th July 2013

6.5.5 NoS – GP QM Group, 22 May 2013 Action: The WoS report will be provided for the next meeting. AG/RM

RM reported there was a robust national process for all practices that had been revisited over the past nine months. There were two elements still to be refreshed; the GP element of the PAQ/STS and the self submission documents for GP and practice approval. There were three different standards that had to be followed; GMC, College and NES.

The reports were summarised and full reports could be provided. The group discussed what level of reporting on visits/approvals would be useful. RM did not think these reports would have much information about the culture in the wider health board.

Action: RP asked NM to consider how to capture the output of the visit reports and GP approvals in a way that would provide Boards with useful information on good practice and solutions to issues. NM

7 Any Other Business RP would produce a draft wording for section 9, Recognition of Trainers, of the October DR. RP asked for draft DR for the QLG meeting on 16 October. RP would look at the agenda for the QLG, the STS was also an item to discuss. It was agreed that the QLG meeting should be face to face if possible. RP would discuss with Mark Russell how much time the STS should have on the agenda and whether to extend the meeting.

8 Date of Next Meeting Action: SBI to set meeting dates for next year. SBI

Summary of actions

Action: RP asked all deaneries to consider providing their rolling DR at the DQMG meetings. QIMs

Action: HC/KW would provide reports from NoS visit for the next meeting. KW/HC

Action: AG would provide reports from the WoS specialty panel meetings for the next meeting. AG

Action: The WoS report will be provided for the next meeting. AG/RM

Action: RP asked NM to consider how to capture the output of the visit reports and GP approvals in a way that would provide Boards with useful information on good practice and solutions to issues. NM

Action: SBI to set meeting dates for next year. SBI