NICaN Nursing Network
Clinical Nurse Specialist Forum
9th June 2009
Present:
Anne Treanor (Breast) ST
Joanne Oakburn (Haematology) SET
Cherith Semple (Head & Neck) SET
Sheena Stothers (Complex Skin) SET
Mandy Bradley (Palliative Care) WT (Alt)
Roisin Mackle (Early Skin) SET
Iona McCormack (Dermatology) BT (BCH)
Elaine Heaney (Breast) NT (Antrim)
Marguerite Greenhill (Colo-rectal) BT (RGH)
Fidelma O Connor (Community) BT (NW Belfast)
Jenny Kelly (Urology) BT (BCH)
Jennifer Knox (Bone & Soft Tissue Sarcoma) BT (MPH)
Eilish McColgan (Gynae) BT (BCH)
Anne Robinson (Lung) BT (RGH)
Susan Piggott (Haematology BMT) BT (BCH)
Ruth Thompson (Haematology) BT (BCH)
Jackie Quinn (Haematology ) BT (BCH)
Edel Aughey (Oncology NP) BT and WT
Item number
Apologies:
Jenny McMahon
Louise Gribben
Joanne Ogborn
Sylvia Cole
Debra Butler
Caroline McCaughey
Wilma Boyd Carson
Sally Campalani
Medb Bradley
Julie Hanna
Summary of key points / outcomes/ action
Identified Party
& date
CNSF_0609_01 Minutes of planning meeting
The minutes of the planning meeting were agreed
as a true record.
CNSF_0609_02 Remit of CNS Forum
This was discussed at the planning meeting and Liz
Henderson had summarised the discussion into a
Terms of Reference (tabled). This was discussed
and agreed.
With regards to the chair of the meeting, Liz asked
if someone would co-chair with her – which would
enable planning for the meeting, provide a steer as
to where it should go and help ensure an
appropriate focus. Those interested to email Liz
by 8th July (If more than one Liz will discuss
with nominees)
Liz to get copy of forum remit on
www.cancerni.net
Interested CNS
Liz Henderson
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CNSF_0609_03 Members roles and responsibilities
All present agreed that for now the group should be
an open one, with representations from across NI,
and each of the cancer sites (rather than restricted
to core members). To be kept under review.
Members were responsible for bringing issues of
relevance to the group, communicating outwards
the discussions arising from within the group, and
contributing to the work programme of the group.
CNSF_0609_03 Holistic Assessment Tool
Ruth Thompson and Anne Robinson reported back
on the work programme of the group which had
been formed following the last CNS meeting.
Minutes of the HAT group to be forwarded to
CNS Forum members, along with a copy of the
holistic assessment tool.
Liz Henderson
All CNS agreed that it would be very beneficial for
holistic assessment to be linked to CAPPS. This
would enable comparison and communication.
CNSF_0609_04 Register of CNS
Jenny Kelly and Fidelma OConnor reported back
on this workstream. They had engaged with Danny
Sinclair from NICaN team, who had set up a spread
sheet to collate the CNS data.
Following much discussion, it was agreed that the
information was for professional use only. It will be
held on the NICaN web site but be password
protected. To keep this process as simple as
possible it was agreed to begin by collating in the
names and contact details of site specific CNS, and
to use existing networks to do this.
The following CNS agreed to act as conduits to
disseminate to their respective networks
Breast: Elaine
Colorectal: Marguerite
Gynae: Eilish
Urology: Jenny
Skin: Iona
N&N Cherith
Haematology: Ruth T
Sarcome: Jennifer
Palliative Care: Mandy
Anne & marguerite will share with colleagues for
Oesophageal and Neurology
Elaine
Marguerite
Eilish
Jenny
Iona
Cherith
Ruth
Jennifer
Mandy
Marguerite
Anne
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CNSF_0609_05 Implications of the Cancer Service Framework
Liz had circulated the template which summarised
discussions between the lead cancer nurses with
regards to implications for service, for workforce
and for education.
It was agreed that the work programme of the CNS
forum should align to standards within the CSF
(which would ensure strategic fit)
A meeting with key stakeholders is being planned
for October 09.
CNSF_0609_06 New Models of follow up
This is one of the key standards of relevance to
CNS within the CSF. A three pronged model is
advocated – a consultant led follow up for complex
cases, a nurse led collaborative follow up for those
requiring chronic disease management, and a
health and well being assessment and intervention
at the end of treatment to support individuals to
move from sickness mode to return to living mode.
Whist this is on each tumour groups work
programme for this year, it will require significant
CNS input, influence and coordination.
Members who undertook nurse led follow up were
invite to give a brief resume of their clinics.
Edel outlined her outreach oncology review clinics
in Enniskillen and Omagh. She stressed the need
for holistic assessment, communication within the
medical team and clearly developed protocols to
enable diagnostic requests etc.
Iona outlined her dermatology nurse led clinic which
spans the patient pathway from assessment,
diagnosis, surgery, to follow up. She emphasised
the role in education, prediction and prevention.
Protocols drawn from the British Society of
Dermatology proved a useful resource (clear
evidence base)
Elaine reported on her breast surgery nurse led
follow up involving clinical examination and ordering
mammograms.
Jackie & Ruth undertake nurse led clinics within
haematology endorsing the necessity for protocols,
local and national guidelines.
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Jenny carries out nurse led clinics for urology
patients, and suggested that when developing
business cases it was important to align same
within the modernisation frame – quoting how it will
help targets. Liz emphasised the need for political
astuteness when seeking to develop practice.
Iona suggested that separate clinics with clinical
codes and secretarial support was essential, as
otherwise the nurse led work remained invisible
(being credited to medical consultant workloads)
Liz mentioned the recent Macmillan Study Day and
the excellent presentation given by their medical
director Dr Jane Maher which looked at the need
for new models of follow up, moving from sickness
to health and well being frame of reference. The
current models were not effective in meeting patient
need (being further evidenced through work
ongoing in relation to late effects)
All nurse led developments in this front would need
to be subjected to a cost benefits exercise, and
include patient experience feedback.
It was agreed that a working group would
produce a brief paper pulling together the
Benefits, challenges and potential pitfalls in
establishing nurse led clinics
(based on current practice).
Edel
Jackie
Iona
Elaine
The group will share draft one of the paper with all
group members for comment and suggested
amendments
Cherith and Eilish suggested that it would be useful
if each of the CNS explored alternative models of
follow up from within their specific area of practice.
Liz mentioned that Moyra Mills in QUB was
interested in a research study evaluating where we
are currently at in NI in relation to review.
Cherith suggested inviting her to the next meeting
Liz
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Meeting evaluation
Is this forum meeting your needs?
Iona: Its an excellent opportunity for networking and
getting business done
Roisin: Its very supportive especially for folks like
me in a new CNS role – there are shared learning
opportunities
Joanne and Jennifer agreed with Roisin
Fidelma: its raises our awareness of the need to be
politically astute, we can develop a shared focus
and direction
Liz: I don’t want it to become simply a talking shop,
it need products, and evidence of influencing
change, bringing about development. We will
continue to evaluate our effectiveness.
Cherith: It needs to be outcomes led, have clear
agenda items or work programme with clear
timeframes. Its important to have the link (through
Liz) to strategic meetings with key stakeholders,
that way there is a real opportunity for us to
influence change
One suggestion made was to consider a combined
NICaN Nursing Conference next year to share good
practice and report on progress.
Members were encouraged to consider joining
UKONS (UK oncology nursing society), as this not
only affords national networking, but helps shape
the cancer nursing agenda.
Date and time of next meeting:
2pm, 16th September 2009
Venue: Seminar Room 3 Cancer Centre,
BCH
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