Care of Burns in Scotland ANNUAL REPORT 2018/19 · Dumfries & Galloway and NHS Grampian) which...

Care of Burns in Scotland

ANNUAL REPORT 2018/19

Lead Clinician: Mr Stuart Watson

Programme Manager: Mrs Lisa Stewart

Programme Support Officer: Mr Richard Crawford

Data Analyst: Mr James Thom

Care of Burns in Scotland (COBIS): Annual report

Contents

1. Executive Summary .................................................................................................................................. 1

2. Introduction ............................................................................................................................................... 1

3. Report on Progress against Network Objectives in 2018/19...................................................................... 2

4. Plans for the Year Ahead ........................................................................................................................ 11

5. Detailed Description of Progress in 2018/19 ........................................................................................... 13

6. Proposed Work Plan for 2019/20 ............................................................................................................ 16

Appendix 1: Steering Group Membership ................................................................................................... 20

Appendix 2: Finance ................................................................................................................................... 21


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1. Executive Summary During this reporting period the Care of Burns in Scotland (COBIS) network has consolidated its engagement with a broader range of stakeholders including emergency services, hospital emergency departments and services providing burns care outwith the specialist burns centres. The network has been committed to increasing the skills and knowledge in the acute management of burns through the development of new clinical guidelines and national and regional education events.

The network has been working to support the implementation of the national burns hub – focusing on referral pathways and universal patient information.

Going forward the network will continue to facilitate the sharing of skills, knowledge and national standards across burns services to ensure better outcomes for patients.


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2. Introduction Since designation in 2007 the Care of Burns in Scotland (COBIS) network has enhanced the delivery of care to patients who have suffered a severe burn injury.

It aims to:

• improve resources available for patients – adults and children – as well as their families and carers

• support the maintenance of a skin bank to ensure there is safe and satisfactory supply of skin allografts that have been stored and processed in accordance with all the appropriate regulations

• initiate and maintain training and educational events to meet the skill requirements of those involved in the management of patients with burns

• ensure that, should an adverse event occur, there is a comprehensive plan in place in Scotland to manage mass casualties

• establish and maintain a database of complex burn injury in Scotland

• set up mechanisms to regularly audit outcome of burn treatment against nationally agreed standards of care

• maintain a website to provide guidance and access to national protocols for those managing burn injuries in Scotland, as well as patients and carers, which will also be accessible to the general public for information purposes.

In 2015, having gathered data on patient numbers over six years, the network proposed a review of burn services in Scotland. Outputs from staff and patient surveys carried out during the review helped to inform the network workplan for 2018-19 (Point 5). Following a Minor review of the network undertaken in 2017 NHS Boards and the Scottish Government Health and Social Care Directorate (SGHSCD) endorsed a further cycle of national commissioning, with a specific remit around supporting the implementation of the Review of Burns Services in Scotland (2017).

Network Objectives 1. Design and ongoing development of an effective network structure that is organised, resourced and

governed to meet requirements in relation to the SGHSCD’s Guidance on MCNs (currently Chief

Executive Letter (2012) 29) and national commissioning performance management and reporting arrangements.

2. Support the design and delivery of services that are evidence based and aligned with current strategic and local and regional NHS planning and service priorities.

3. Deliver effective stakeholder communication and engagement through design and delivery of a written strategy that ensures stakeholders from health, social care, education, the third sector and service user are involved in the network and explicitly in the design and delivery of service models and improvements.

4. Improve capability and capacity in burn care through design and delivery of a written education strategy

that reflects and meets stakeholder needs. 5. Ensure effective systems and processes to facilitate and provide evidence of continuous improvement

in the quality of care, including the development of a written quality improvement strategy.


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6. Generate better value for money in how services are delivered.

7. Support the development of a national burns hub and facilities model, in line with the recommendations

from the Review of Burns Services in Scotland.

3. Report on Progress against Network Objectives in 2018/19 3.1. Effective Network Structure and Governance The Steering Group meets three times each year and is chaired by Mr Stuart Watson, COBIS Lead Clinician (NHS Greater Glasgow and Clyde). Mr Watson has been the Lead Clinician since May 2017 and brings a strong teaching background to the role.

Steering Group members include consultants in burns and plastic surgery, emergency department consultants, specialist nurses, allied health professionals, psychologists, and service managers from burns services, in addition to emergency services, third sector organisations and patient representatives. They have a key role to play in ensuring effective two-way communication between the network and their NHS Board colleagues and that progress continues against the workplan. Through the management structure and terms of reference for the network Steering Group and sub-groups, COBIS meets the core principles of national managed clinical networks as set out in CEL (2012) 29.

Sub-groups include:

• Communication and Engagement Group

• Education Group

• Data Group

Workplans and reports are published on the network website, and any documents produced by the network are publicly available for clinicians and patients to view.

Over the last year, delivering progress on the 2018-19 workplan was challenging owing to the extensive period of sick leave (eight months) taken by the Programme Support Officer.

3.2. Service Development and Delivery 3.2.1 Burns Service Model The network was consulted in the Review of Burns Services carried out in 2016 and its recommendations have informed the 2017/18 and 2018/19 annual workplans. The implementation of the national burns hub and facilities model remains a standing item on the agenda for each Steering Group meeting. The network has supported the move towards a national burns hub in 2019/20, through discussion of triage and referral criteria, follow-up and rehabilitation requirements. 3.2.2 Burn Care Standards In 2018 Mr Stuart Watson was invited to review the UK National Burn Care Standards, which have been shared with the Steering Group. The Burns Centres are currently assessing their facilities against the standards as a baseline and to identify gaps in service provision. Standards cover areas including patient centred care, the multidisciplinary team, the environment and the Specialised Burn Care Operational Delivery Network. 3.2.3 Emergency Medicine Clinical Guideline posters for the immediate management of burns in adults and children were produced by the Communication and Engagement Group and, in September 2018, sent out to every Emergency Department and Minor Injuries Unit in Scotland.


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3.2.4 Mass Casualty Planning The network has developed a Patient Dispersal Plan for use in the event of a major incident in Scotland. Ongoing partnership with the Scottish Government Resilience Unit, the Scottish Ambulance Service and the Scottish Trauma Network will ensure that incidents involving mass casualties that include burns are managed with an effective and planned approach. This extends to close working with the Scottish National Blood Transfusion Service, for regular and exceptional supply of allografts. 3.2.5 Clinical Guidelines The network has produced a range of clinical guidelines (7 adult and 11 paediatric), which are accessible on the website and provide evidence-based practice on the management of burns – including fluid resuscitation, analgesia and smoke inhalation. Figure 1 demonstrates that the clinical guidelines pages are the most accessed areas of the COBIS website. In response to clinical demand a new guideline ‘Non Accidental Burns and Scalds in Children’ was developed in 2018 in collaboration with Dr Alison Gray, Consultant Paediatrician (NHS Greater Glasgow and Clyde).

Page Views

Home Page 1,371 (23%)

Clinical Guidelines 847 (14%)

Paediatric Clinical Guidelines 513 (8.7%)

Adult Clinical Guidelines 336 (5.7%)

St Johns Hospital Livingston 201 (3.4%)

Glasgow Royal Infirmary 187 (3.2%)

Emergency Department Posters 164 (2.8%)

Contact Us 202 (2%)

Latest News 112 (1.9%)

Glasgow Royal Hospital for Children

98 (1.7)

Page Views (total): 5, 909 Users: 2,122 Figure 1 Pages Accessed on COBIS Website

3.3. Stakeholder Communication and Engagement During 2018-19 COBIS has engaged with a broader range of stakeholders including the emergency services (Scottish Ambulance Service and the Scottish Fire and Rescue Service), NHS 24, Emergency Departments, rehabilitation services, remote and rural services, youth and third sector organisations (Royal Society for the Prevention of Accidents, St Andrews First Aid). Services have been engaged through face-to-face meetings and videoconferencing. The network has updated its Communication Strategy to include the scope and type of communications required; including use of social media (the COBIS Twitter account has generated over 400 new followers since November 2017).

A more inclusive range of clinicians and services is now represented on the COBIS Steering Group (Appendix 1) and sub-groups which shape delivery of the network objectives, and ensure comprehensive support of the burn care review recommendations. The network has progressed the 2018-19 workplan in


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collaboration with emergency and rehabilitation services, patient representatives, third sector partners and other key organisations to ensure safe, effective and person-centred care. The COBIS Communication Strategy provides the strategic context and direction for the Communication and Engagement group – an active group which meets quarterly and has produced tangible outputs, including the Emergency Department posters for the acute management of burns in adults and children. The group recommends resources and sign-posting on the COBIS website for patients and families and consulted with the Scottish Burned Children’s Club on their website requirements. The website hosts over twenty patient and family information leaflets covering all aspects of burn management including skin grafts, dressings, nutrition and mental health. The network is progressing an objective to ensure consistent information is provided to patients and families following discharge from hospital. The vision is to have a universal document for all burns units covering all aspects of burn care by 2020. Another key output is the group’s collaboration with youth organisations in Scotland (including Youth Scotland, Boys Brigade and the Duke of Edinburgh’s Award) to develop a burns awareness campaign for children and young people. The brief will include a call for the design of a social media poster which can be shared across organisations and circulated widely during Burns Awareness Day on 16th October 2019. 3.4. Education The COBIS network Education Strategy has four key themes:

• building a specialist workforce within burns care

• improving patient experience and supported self management

• supporting burns hub and facility services and promoting education beyond burns care, for example, in primary care

• enhancing educational infrastructure, including educational opportunities in a range of formats.

3.4.1 Regional Education Events The network’s key priority over the last year has been the implementation of the strategy and has included the delivery of regional education sessions to the wider burn treatment community in Scotland. Between April-November 2018 the network delivered the following education activities:

• five regional education events (hosted by NHS Ayrshire & Arran, NHS Fife, NHS Forth Valley, NHS Dumfries & Galloway and NHS Grampian) which covered the medical and nursing management of burns, and demonstrations of practical patient assessment and burns dressings

• collaboration with the Royal Society for the Prevention of Accidents (RoSPA) to jointly host a national community safety conference on 25th April 2018 at Hamilton Fire Department, when members of the COBIS Steering Group presented on current burns management, reducing risk of fire and scalds in the home, and psychosocial impact of a burn injury

• clinical placement opportunities in October 2018 for 2 members of the NHS Fife burns and plastics nursing team to consolidate their burns competencies through teaching and shadowing the burns team at Glasgow Royal Infirmary

• additional content for the COBIS website including links, patient information leaflets, podcasts and updated clinical guidelines.

The regional events provide Emergency Department clinicians with the skills and knowledge for the emergency management of patients presenting with burns. This covers the medical management – focusing on fluid resuscitation, pain relief and treatment of the burn. Clinicians are given the opportunity to carry out a practical assessment of a patient and to observe and practice burns dressings.


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Almost 200 clinicians attended the regional education events in 2018. Feedback highlights the value of these sessions – particularly the practical approach. The network asked participants to identify how this will influence practice. Comments include:

‘Great information about types of dressing’ ‘More careful/thoughtful fluid management’ ‘Knowing to de-roof all blisters’ ‘It was good to see the burns protocols at this stage in my training’ ‘More understanding of emergency treatment of burns’

3.4.2 National Education Event The network held its national annual education event on 12th November 2018 - targeting those working within specialist burns units. The programme included presentations, practical demonstrations, case studies and a patient’s experience. Mrs Wilma Strachan (from Grampian), who experienced serious and complex burns as a child, provided an account of her numerous hospital admissions and ongoing surgery over the years – and highlighted what mattered to her as a patient. The final session of the afternoon focused on child protection to coincide with the launch of COBIS’s latest Clinical Guideline ‘Non Accidental Burns and Scalds in Children.’ The annual event held in November 2017 was attended by 56 delegates – in 2018 this rose to 89 (registration was closed at 90). The 60% increase in participation reflects the value placed on those presenting and the improved rate of engagement with the burns community through the regional education events.

Figure 2 Representation at COBIS Regional and National Education Events 2018 (Burns units are located in NHS Grampian, NHS Greater Glasgow and Clyde, NHS Lothian and NHS Tayside. NHS Fife provides a Nurse-Led burns and plastics out-patient service)

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Representation at COBIS Regional and National Education Events 2018


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Figure 3 Representation by Role at COBIS Regional and National Education Events 2018

Feedback from the event was very positive:

‘Useful day and all important topics covered’ ‘Very interesting day and essential for staff in burn care’

After the event, Mrs Lorna Gillan, Clinical Nurse Educator, Paediatric Intensive Care Unit (NHS Greater Glasgow and Clyde) sent the following email ‘the course has improved my knowledge of the basic needs and guidance in burns management but also the importance of team work and steps to minimise secondary complications’. Comments and views collated from the national education event will be used to inform future education sessions. The key clinical areas include:

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Representation by Role at COBIS Regional and National Education Events 2018

Case reports Assessment Fluid resuscitation Surgery Allied Health Professionals Psychology Practical sessions Patient experience Follow-Up


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3.5. Audit and Continuous Quality Improvement 3.5.1 Clinical Audit System (CAS) The network’s newly-established Data Group held its first meeting in October 2018, chaired by Dr Charlotte Gilhooly, Consultant in Anaesthesia (NHS Greater Glasgow and Clyde). Its remit is to:

• improve the quality of the Clinical Audit System data

• improve reliability with the collection and reporting of data

• link with other databases (e.g. Information Services Division), which will be useful for audit and research purposes

• utilise burns data for benchmarking against network standards and against other burns units. The network is collaborating with the Information Management Service (IMS) to improve and validate the data recorded through the Clinical Audit System. Figure 4 illustrates some burns units have difficulty in submitting data on a regular basis and the data group will support these units to improve their data collection. Despite this challenge, of all the clinical networks, COBIS has the highest number of patients recorded on CAS (3,163).

Figure 4 Patients Entered onto CAS by Year

IMS is leading on data management, liaising directly with clinical users of CAS, providing training where required and producing shared data reports, which provide an opportunity for clinicians to monitor progress and make improvements with data collection. The percentage of Total Body Surface Area (TBSA) burn is significant as, if a patient has a burn of 15% (adult) or 10% (child) or higher, then a care bundle of interventions is clinically recommended. If the TBSA is not recorded on CAS, then completion of the care bundle data cannot be measured. The Data Group


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focused on improving the TBSA completion rate. A CAS report was circulated to the CAS users, highlighting where data was missing from the previous 7 years. Figure 5 demonstrates that, following feedback and discussion with the clinicians, completion rate increased from a median of 83.5% to 89.5%. In 2018/19 95% of patients had their TBSA recorded.

Figure 5 Total Body Surface Area Burn - % Recorded on CAS

Figure 6 shows cause of burn or scald injury. This data is useful to support other COBIS workstreams. For example, The Scottish Burned Children’s Club is leading a campaign to reduce injury by fireworks and has found it helpful to have data to support its campaign.

Figure 6 Number of patients on CAS - Cause of Injury

Median = 89.5% After Steering Group

Meeting

Median = 83.5% Before Steering Group

Meeting

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Years from 2012-2019

Total Body Surface Area Burn - % Recorded on CAS

464

278

134101

22 19 18 13 13 11 9 3 10

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Cause of Burn or Scald Injury 2016-2019 Scotland


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3.5.2 Quality Improvement (QI) In 2017-18 the Steering Group produced and approved its Quality Strategy – driven by the Communication and Engagement Group, which included a QI project. The network set an aim to improve interaction with its website by all stakeholders by 20% by December 2018. A QI template, driver diagram (Figure 7) and data and measurement plan were approved.

Figure 7 COBIS Website Engagement Driver Diagram


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Figure 8 Number of visitors to COBIS website per month

In 2017 the network QI project aim was to improve interaction with the website by 20% by December 2018. In 2018 the number of visits to the COBIS website increased by 30% (Figure 8). 3.6. Value The aim of the COBIS national and regional education events is to provide clinicians working in NHS Scotland with the relevant skills and knowledge to deliver the best care for patients following a burn or scald. Providing clinical guidance on the medical and nursing management of burns will ensure evidence-based practice and equity of access to high quality care to reduce harm and unwarranted variation.

COBIS produced a branded postcard and fridge magnet with clear instructions on the immediate management of a burn. The network maximises opportunities to promote this targeted first aid information at National Network Management Service events and on National Burns Awareness Day in October and around the 5th November. The prompt and effective application of burns first aid has been shown to positively impact on the burn outcome, preventing further tissue damage and reducing subsequent morbidity (British Burn Association First Aid Clinical Practice Guidelines).

Specialist Burns Nurse

Training

Baseline median = 189

Revised median = 246.5

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Months from January 2017-November 2018

Number of visitors to COBIS website per month


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4. Plans for the Year Ahead It was highlighted in the Review of Burns Services that, owing to the reducing number of patients presenting each year in the local burns facilities, it is challenging for medical, surgical, nursing and rehabilitation clinicians to maintain their skills and knowledge in the management of burns. The network has a key role in providing the strategic framework for the ongoing provision of specialist education and clinical guidance to ensure safe, effective and person-centred care. A sub-set of the UK National Burn Care Standards will be agreed by the network for benchmarking of services in NHS Scotland. Monitoring progress against the standards will be audited through the Clinical Audit System. In 2019/20 peer review site visits will be carried out to assess the units’ facilities and to support service improvements. During 2019/20 the Communication and Engagement Group will seek feedback from clinicians on how the Emergency Department guidelines on the immediate management of burns (developed by the group) have influenced decision-making for evidence of added value. In line with the NHS National Services Scotland guidance on guideline development and governance for National Managed Clinical Networks (which states that guidelines need to be reviewed every 3 years to ensure that they are still fit for purpose and up to date), all COBIS guidelines will be included in the 2019/20 workplan for review.

Building on 2018’s successful national education event, COBIS is collaborating with the Scottish Trauma Network and the Scottish Acquired Brain Injury Network to deliver a high profile national two-day conference in June 2019. COBIS Steering Group members are to be congratulated for their clinical posters, which will be on display at the conference and shared with delegates from across Scotland. The 2019-20 workplan was formulated by the network Steering Group and each of this year’s anticipated outcomes is linked to the principles of Realistic Medicine.


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5. Detailed Description of Progress in 2018/19 Objective Number

Smart Objective Linked Dimensions of Quality

Planned start/ end dates

Detailed Plan Available / Owner

Description of progress towards meeting objective as at 31/03/2019

Anticipated Outcome

RAGB status

2018-01

By 2019 patients will be provided with best practice information on discharge from burn care.

1, 2, 3, 5, 6 01/04/2018-31/03/2019

Communication Group

Examples of discharge information have been sought from burns units across Scotland and will be merged into a single document

Patients will be provided with information appropriate for their care at discharge.

G

2018-02

By 2019 COBIS will adopt an agreed set of BBA National Burn Care Standards UK against which burn services in Scotland can be monitored.

2, 3, 4 01/04/2018-31/03/2019

Steering Group

The burns centres are assessing their facilities against the UK National Burn Care Standards and a subset of standards will be agreed for Scotland

Burn care services in Scotland will be able to be monitored against suitable standards.

G

2018-03

By 2019 COBIS will improve completion of Clinical Audit System data for Burns Care Bundle by 10%.

1,2,3,5 01/04/2018-31/03/2019

Data Group

The Data Group is working with clinicians to complete a full data set for one financial year (2017-18)

COBIS will have a more complete data set for burn care patients which can be used for making improvements.

G


14

2018-04

By December 2018 COBIS will improve interaction with the website by 20%.

1, 3 01/07/2018-31/12/2018

Communication Group

Over 2018 the number of visits to the COBIS website has increased by 30%

Network stakeholders will be better engaged with the network, and have a better understanding of how to manage patients with a burn injury.

G

2018-05

By 2019 COBIS will establish an education strategy and implementation plan for increasing education opportunities for the wider burn community in Scotland.

1, 2, 3 01/04/2018-31/03/2019

Education Group

The Education Group has delivered one national and five regional education events and supported two clinical placements

The burn community, patients and carers in Scotland will have access to appropriate education opportunities as required.

G

2018-06

By 2019 COBIS will agree standard patient referral and transfer information to be shared between referring and receiving hospitals

1, 2, 3, 4, 5, 6 01/04/2018-31/03/2019

Lead Clinician/

Programme Manager

Current referral information is being gathered from burn units across Scotland – eHealth consulted on electronic access to clinical information

There will be clear communication regarding the individual management (including transfer) of the patient’s burn care.

G


15

2018-07

By December 2018 COBIS will review all clinical guidelines to ensure they remain best practice.

1, 2, 3, 5 01/04/2018-31/12/2018

Lead Clinician

All clinical guidelines are on new templates and beginning to be reviewed. One new guideline on non-accidental injury has been developed.

The burn community will have access to best practice clinical guidelines to ensure safe, patient-centred and effective care.

G

2018-08

By 2019 COBIS will raise awareness and participate in burn and scald prevention work.

1, 2 01/04/2018-31/03/2019

Communication Group

COBIS is working with primary care, partner organisations including RoSPA, SFRS and third sector organisations

The wider community will have increased awareness of scald and burn safety.

G


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6. Care of Burns in Scotland (COBIS) Network Proposed Workplan – 2019/20

When defining network objectives please consider the Institute of Medicine’s six dimensions of quality, which are central to NHS Scotland’s approach to systems-based healthcare quality improvement:

1. Person-centred: providing care that is responsive to individual personal preferences, needs and values and assuring that patient values guide all clinical decisions;

2. Safe: avoiding injuries to patients from healthcare that is intended to help them; 3. Effective: providing services based on scientific knowledge; 4. Efficient: avoiding waste, including waste of equipment, supplies, ideas, and energy; 5. Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location or socio-

economic status; and 6. Timely: reducing waits and sometimes harmful delays for both those who receive care and those who give care.

Key RAGB status Description

RED (R) The network is unlikely to achieve the objective by the agreed end date.

AMBER (A) There is a risk that the network will not achieve the objective by the agreed end date but progress has been made.

GREEN (G) The network is on track to achieve the objective by the agreed end date.

BLUE (B) The network has been successful in achieving the network objective to plan.

Objective Number

Smart Objective Planned start/ end dates


Description of progress towards meeting objective as at 31.03.2019

Anticipated Outcome

RAGB status

1. Effective Network Structure and Governance [linked to Quality Dimensions 3,4,5,6]

2019-01 The network will organise 3 Steering Group and 3 of each sub-group meetings by March 2020 to ensure effective delivery

01/04/2019-31/03/2020

Steering Group and Sub-Group

Steering Group meetings are planned for 2019-20 and sub-groups are arranged

Effective delivery of the COBIS network workplan

G


17

Objective Number




Anticipated Outcome

RAGB status

of the 2019-20 workplan. member-ship

throughout the year to ensure continuation of progress

2. Service Development and Delivery [linked to Quality Dimensions 1,2,3,4,5,6]

2019-02 By March 2020 review existing and develop new clinical guidelines relevant to burns services

01/04/2019-31/03/2020

Education Group

Current review of adult and paediatric guidelines and scoping of emerging requirements.

Planned review of Guideline on Fluid Resuscitation

Delivery of evidence-based practice and equity of access to high quality care across Scotland to reduce harm and unwarranted variation

G

2019-03

By September 2019 review patient and family burns information, with the aim of developing a single Scottish information leaflet

01/04/2019-30/09/2019

Communi-cation & Engage-ment Group

Current review of all information leaflets available

Patients and families are supported to manage their condition and to share in informed decision-making

G

3. Stakeholder Communication and Engagement [linked to Quality Dimensions 1,3,4,5,6]

2019-04

By June 2019 review and update the COBIS Communication Strategy to meet the needs of all stakeholders, including provision of information and effective sign-posting through the website

01/04/2019-30/06/2019

Commun--ication Group

Current review of Communication Strategy identifying broader range of stakeholders, including primary care

Stakeholders across Scotland will inform the annual workplan to ensure a personalised

G


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Objective Number




Anticipated Outcome

RAGB status

approach to care

2019-05

By October 2019 develop a collaborative youth campaign to raise awareness of burns risk factors for young people

01/04/2019-31/10/2019


Current collaboration with Third Sector Organisations to scope a youth campaign

Through joint working the campaign will reduce risk of injury to young people

G

4. Education [linked to Quality Dimensions 1,2,3,4,5,6]

2019-06

By March 2020 deliver one national conference and two regional teaching events

01/04/2019-31/03/2020

Education Group

The network is liaising with the Scottish Trauma Network and the Scottish Acquired Brain Injury Network to deliver a two-day national conference in June 2019, which will raise the profile of COBIS

Healthcare professionals across Scotland share and increase their knowledge and skills in burns management

G

2019-07

By September 2019 review and update the Education Strategy to support stakeholders’ learning needs in response to the emerging burns service model

01/04/2019-30/09/2020

Education Group

The Education Strategy is operational but requires review to include specific requirements of the medical workforce

The workforce is valued and has access to evidence-based specialist burns training and resources for improved health and care

G


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Objective Number




Anticipated Outcome

RAGB status

5. Audit and Continuous Quality Improvement [linked to Quality Dimensions 1,2,3,4,5,6]

2019-08 By December 2019 improve the quality of the Clinical Audit System dataset and provide clinical access to dashboard

01/04/2019-31/12/2019

Data Group

Data Group has identified actions to engage clinicians in CAS training and review of dataset.

Key areas identified for improvement

Clinicians are able to access their data and audit patient outcomes to drive improvement

G

2019-09

By March 2020 agree a subset of the UK National Burn Care Standards for implementation in Scotland and audit performance against these to drive improvement

01/04/2019-31/03/2020

Steering Group

The four burns centres have been asked to assess current provision against UK standards as a baseline.

Steering Group has agreed to carry out peer review site visits to assess against Standards

Patients will benefit from burns centres working together to provide optimum care and manage risk better

G

6. Value [linked to Quality Dimensions 1,2,3,4,5,6]

2019-10 By July 2019 audit the impact of the Emergency Department burns algorithms to gather evidence of clinical value

01/04/2019-31/07/2019


The acute burns management posters have been distributed to all Emergency Departments and Minor Injury Units in Scotland

Effective communication between those involved in patient decisions and contribute to patient care

G

Specialist Healthcare Commissioning COBIS NMCN 2019-20

Page 20

Appendix 1: COBIS Steering Group Membership

Name: Role/Organisation:

Hilal Bahia Consultant, Plastic & Burns, NHS Lothian

Lisa Black Consultant - Emergency Medicine, NHS Ayrshire & Arran

Gillian Calder Physiotherapist, NHS Greater Glasgow and Clyde

Rebecca Crawford Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde

Richard Crawford Programme Support Officer, National Network Managed Services, NHS National Services Scotland

Alain Curnier Consultant Plastic Surgeon, NHS Grampian

Stella Digba Senior Charge Nurse, NHS Tayside

Jackie Dunlop Lead Nurse, NHS Greater Glasgow and Clyde

Julie Freeman Consultant in Paediatric Anaesthesia, NHS Lothian

Murray Geddes Clinical Lead for Critical Care, St John’s, NHS Lothian

Charlotte Gilhooly Consultant in Anaesthesia, NHS Greater Glasgow and Clyde

Julie Gordon Consultant - Emergency Medicine, NHS Ayrshire & Arran

Jacqui Ivison Charge Nurse, NHS Greater Glasgow and Clyde

Heather James Deputy Charge Nurse, NHS Lothian

Claire Lawrie Programme Manager, Information Management Service, NHS National Services Scotland

Peter Lindle Consultant Paramedic, Scottish Ambulance Service

Alan Masterton Vice Chair-Person, The Scottish Burned Children’s Club

James MacBrayne Consultant, Critical Care & Anaesthesia, NHS Grampian

Breeda McCahill Burns Nurse Practitioner, NHS Greater Glasgow and Clyde

David McGill Consultant Plastic Surgeon, NHS Greater Glasgow and Clyde

Valerie McIntosh Senior Charge Nurse, NHS Grampian

Joanne McPeake Senior Staff Nurse, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde

Kirsty Munro Consultant, Plastic Surgery, NHS Tayside

Vacancy Changing Faces Representative

Kaz Rahman Consultant Plastic Surgeon, NHS Grampian

Specialist Healthcare Commissioning COBIS NMCN 2019-20

Page 21

Sharon Ramsay Paediatric Nurse Specialist, NHS Greater Glasgow and Clyde

Thomas Reekie Plastic Surgeon, NHS Greater Glasgow and Clyde

Samantha Seeds Station Manager, Prevention and Protection (Community Safety Engagement), Scottish Fire & Rescue Service

Alley Speirs Senior Programme Manager, National Network Management Service, NHS National Services Scotland

Lisa Stewart Programme Manager, National Network Management Service, NHS National Services Scotland

Alastair Turner Consultant Paediatric Intensivist, NHS Greater Glasgow and Clyde

Stuart Waterston Consultant Plastic Surgeon, NHS Tayside

Stuart Watson

(Lead Clinician)

Consultant Plastic Surgeon, NHS Greater Glasgow and Clyde

Daniel Widdowson Consultant Plastic Surgeon, NHS Lothian

Appendix 2: Finance

Ms Mickala Robinson (Assistant Management Accountant, NHS National Services Scotland) has identified that the ‘Purchase Computer Software’ was charged to COBIS in error and that COBIS remained within its 2018-19 annual budget allocation.

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