RHWYDWAITH Y CARDIAIDD GOGLEDD CYMRU NORTH WALES CARDIAC NETWORK

1.

Network Affiliation with new LHB

1.1

Review of Network establishment agreement

March 2010

Catrin Hanks

2.

Guidelines/Care Pathways/Clinical Governance

2.1

Heart Failure

Palliative Care

Explore feasibility and cost effectiveness of providing BNP to North Wales patients and advise RCU of commissioning implications – updated report to go to Network Board Nov 09

Develop baseline of the provision of palliative care services for Heart Failure patients across region.

Hold HF Palliative Care Competences Day

Nov 2009

March 2009

2010

Dr Graham Thomas working the Clinical Topic Work Group

Jenny Welstand

2.4

Acute Myocardial Infarction

Develop guidelines for the diagnosis and management of acute AMI.

Develop chest pain awareness campaign to include the development of clinical pathways for the out of hospital management of acute cardiac chest pain

July 2009

Dr Richard Cowell with Clinical Topic Work Group

Catrin Hanks/Dr Graham Thomas/BHF/Lucy Bull/Kate Novotny with BHF

3

Service Development

3.1

Reperfusion Strategy

Primary PCI/Provision of elective PCI at Ysbyty Glan Clwyd

70% of ‘CTN’ times to continue to be within 60 minutes (AOF19)

1. To develop a regional strategy to deliver Primary PCI for

patients

2. To optimise the PHT service

Audit MINAP data to ensure consistency and to advise the business case for primary PCI as well as audit the implementation of AMI guidelines

To support health communities in the development of robust action plans and ensure input from LHBs, Trusts and WAST.

Respond to Network MINAP Audit:

1. Host MINAP data workshop

2. Collaborative Case Review

To identify resource implications through Regional Action Plans and advise planners the investment necessary to meet the CTN target

CHD NSF QRs 22,37,73,77,143

July 2009

CTN Information analysed quarterly

Dr Richard Cowell and Catrin Hanks working with the Clinical Topic Work Group and HCW.

Linking with All Wales Group in terms of the all Wales strategic direction.

Catrin Hanks, Dr Richard Cowell working with the CTN/PPCI Work Group as well as RO, All Wales CTN Sub Group and WAG Cardiac Implementation Group in respect of total waits

3.2

Familial Hypercholesterolemia

Develop an action plan to identify and treat systematically those patients with familial hypercholesterolemia (FH) through cascade testing and offer services which meet the Quality Requirements. This includes the establishment of an FH register.

CHD NSF QR 136

tbc

Dr Khalid Khan

Linking with All Wales Group.

3.3

Non invasive Cardiac Imaging

To develop a strategy for non-invasive imaging - CT, MRI and MPI.

Make recommendations to planners.

March 2010

Prof Rees/Jon Falcus working with the CTG/CNCG and linking with the Imaging Network and All Wales Group.

3.4

Arrhythmias

To develop guidelines for implantation of ICD/CRT based on NICE guidance

To develop Syncope Guidelines and current service provision

CHD NSF & Arrhythmias QR 152 & 153

March 2010

Dr Richard Cowell/ Dr Mark Payne/ Emma Williams/Nick Waterfield/NEWT Arrhythmia Nurses working with the CTG (to be confirmed).

Dr Khalid Khan and Clinical Topic Work group

3.5

Cardiac Rehabilitation

Support the implementation of the Cardiac Rehabilitation NPHS tool to assess different models of care

CHD NSF QR 148 & 151

March 2010

Cardiac Rehab Leads and NPHS

3.6

Adult Congenital Heart Disease (ACHD)

To develop ACHD services for North Wales patients to ensure seamless management of care for paediatric to adult secondary and tertiary care support.

Options paper.

Identify patients lost to follow up in primary care.

Develop ACHD pathways.

Development of Standard 7 for ACHD and associated QRs.

March 2010

Dr Richard Cowell, Catrin Hanks in partnership with the North West Cardiac Networks

4.

Workforce/Training

4.1

Access to diagnostic training

To agree work plan and identify clinical content to ensure year one priorities are met for the new BHF CP training post.

To work with the academic institutions to explore the development and provision of local courses.

March 2010

Catrin Hanks

4.2

Education/ and Training to support the CHD NSF

Provision of Network Clinical Education Training days per year.

Support the Network ECG training programme

Training to include all Network Agreed Guidelines to assist with implementation.

To ensure links with current Post grad and Primary care training programmes.

CHD NSF QR 162 to 164

Next Training Day October Ongoing

Catrin Hanks working with the Network Support Team and Lead representative of the CHD Sub group of the WIG

4.3

CHD Workforce Planning

To continue to participate in the all Wales CHD Workforce Planning Group to identify shortages, training needs, promoting Skills for Health Competences for job redesign.

Catrin Hanks

4.4

British Heart Foundation

Co-ordinate and support bids for CHD posts as funds become available.

To secure recurrent funding of posts beyond the BHF tenure through recommendations to RCU.

Chest pain awareness campaign.

Catrin Hanks

5.

Information/Benchmarking/Audit/ Performance Management to inform planning

5.1

To manage and monitor

AOF Targets on a quarterly basis

Referral to Treatment target

To monitor Referral to Treatment target to inform the Network with regard to service development and equity issues and to comply with WAG/NWRO performance management requirements.

Quarterly

Catrin Hanks/Julie Green/BSC Information

5.2

Cardiac Disease Strategic Framework (AOF 19)

Undertake baseline self assessment of current services against the NSF using the Quality Requirements tool.

Production of a Local Delivery Plan (specialised services a National Delivery Plan) to map journey and milestones to full compliance by 2015.

Establishment of Quarterly progress reports to start period ending June 2010 to Chair of National Delivery Board.

Further periodic formal self assessments will be required.

March 2010

Quarterly

Catrin Hanks

6.

Involving Patient & Carers

6.1

Putting Public and Patient Involvement Strategy (PPI) into practice

To ensure PPI integrated in the Network work streams through the development of the Network Patient Reference Group (NPRG).

Identify patient lead as well as a resource to continue PPI as and run the NPRG group twice yearly

March 2010

Catrin Hanks/Dr Graham Thomas

Leads to be identified

6.2

Board representation

To ensure that PPI is represented at Board level.

November 08

NPRG

7.

Network Communications

7.1

Produce Newsletter - 3 editions per year

To improve communications and share best practice.

WHC (2005) 076 Clinical Networks

Next Edition August 2009

Julie Green

7.2

Update Website (Intranet)

To widen access.

WHC (2005) 076 Clinical Networks

Ongoing

Julie Green

7.3

Update Network Internet Site

Launch internet site to widen access.

Autumn 2009

Julie Green

8.

Collaboration with CNCG and all Wales initiatives

8.1

Participating in Cardiac Network Co-ordinating Group (CNCG) initiatives

Representing North Wales at bi-monthly CNCG meetings with regard to clinical & policy developments at the all Wales level, Cardiac Reference Group and audit days.

WHC (2005) 076 Clinical Networks

Catrin Hanks, Network Lead Clinicians and CNCG