South East Wales Critical Care Network

Dr George Findlay, Lead Clinician

Jennie Willmott, Network Manager

Presentation Overview

Critical Care Network - contextQuality Requirements for Adult Critical

CareStructure of the NetworkAchievements in the first year

Critical Care Network - Context

All Wales Critical Care Development Group 2001 Designed for Life South East Wales Regional Plan WHC (2006) 009 – Quality Requirements for Adult

Critical Care. 5 Levels of Adult Critical Care WHC (2007) 023 – Commissioning Guidance

recognises role of Networks as key to engaging with clinicians and influencing commissioning

South East Wales Critical Care Network established Sept 07.

All Wales Critical Care Advisory Group

Why Critical Care?

Increasing demand unrecognised. Current ad hoc organisation, developments & guidelines European Working Time directive Standards & guidelines – Colleges, Societies, WAG Risks to patient care Network approach – multi professional, formalising best

practice to improve clinical quality across organisational boundaries

Strategic and regional approach to service redesign and redirecting current resources across critical care Levels.

Strengthened and co-ordinated commissioning

Quality Requirements for Critical Care

Implementation in 3 strategic frameworks. Core by 2008, 2008 to 11, 2011 to 2015

Core, Priority and Developmental Requirements Monitoring Respiratory support Other organ support Access to Diagnostics Patient Transport Medical staff Nursing staff Other health professionals Policy & governance

6 monthly audit of all QRs reported to Trust Clinical Governance Committee & to Trust Board annually

South East Wales Critical Care Network

Network Board Chair, LHB CEO, Trust CEO, CHC CO, Regional

Commissioning Director, Consultant Nurse, Network team. Quarterly meetings

Service Improvement Group Chair – Network Lead Clinician Main source of specialist advise to the Board Clinical Directors, Senior Nurse & Directorate Manager

Clinical/Topic groups – as required Establishment Agreement, Governance Framework,

Work Programme, Communication Strategy Network budget £120k pa

1st Year of the Network

Audit against Quality Requirements. Gaps:- Medical workforce (weekly working & weekend

cover) Nurse: patient ratio (1:1 for Level 3 & 1:2 for Level 2) Transfer equipment & training Outreach Intensive Care National Audit & Research Case Mix

Programme (ICNARC) Critical Care Delivery Groups Policies & procedures

1st Year of the Network

Transfer Guidelines (North Wales Network) Transfer – audited equipment and activity Outreach – service model Renal patients – audit & Renal Network

guidance to be developed Cancer Network – Upper GI review Neuroscience review Planning Workshop

1st Year of the Network Critical Care Minimum Data set – review and reports Data definitions, including Delayed Discharges Draft Admission & Discharge policy Guidance issued:-

Cancelled operations Critical Care Delivery Groups

Communications – website, newsletter Service Development Plan approved Network Funding

Ward Watcher £73k Transfer Trolleys £15k 1 year funding for Improvement leads £47k

Critical Care Network

SE Wales Critical Care Network Website:-http://www.wales.nhs.uk/sites3/home.cfm?o

rgid=736WHC (2006) 009 Quality Requirements

for Adult Critical Carehttp://www.wales.nhs.uk/sites3/documents/7

36/D4LCritCare.pdf