Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

Dear Colleagues

Welcome to our first NoECCN newsletter, for all staff working in critical care and outreach services.

The aim of the newsletter is to share information about what is happening across the different services

within Network and also to provide you with news on national and regional issues in Critical Care. We

are very happy to publish information about best practice or other interesting developments that are

happening within your unit / teams. Please get in touch if you have anything you would like us to include

in future issues.

So, for our first issue we thought we would tell you about us. For those of you not familiar with the

NoECCN, we were established in July 2009 as a result of the merger of two previously successful and

well established clinical networks; North East & Cumbria and Tees Valley & South Durham. Paediatric

Critical Care was incorporated in July 2012. NoECCN is now an established high performing Operational

Delivery Network (ODN).

So what is an Operational Delivery Network (ODN)? ODNs are NHS England sponsored, regionally

funded advisory bodies, focussed on coordinating patient pathways between providers over a wide

area, to ensure equity of access to specialist resources and expertise. Provider clinicians dominate their

membership, working closely with patients and other key stakeholders. NoECCN facilitates critical care

service delivery across the Cumbria and North East (CNE) region, promoting collaborative working to

achieve high quality critical care services. This is accomplished through the commitment of the clinical

and management teams from all the CNE constituent critical care services. There is a small Network core

team employed full-time to enable and guide this work. Mr Alan Foster MBE, Lead for the CNE

Integrated Care System (ICS) provides Chairmanship and Northumbria Healthcare hosts the Network.

There is importantly funded sessional commitment from three Medical Leads; two from Adult Critical

Care representing the North East and Cumbria and Tees Valley and South Durham Localities and a third

representing Paediatric Critical Care, providing clinical guidance and expertise.

The Paediatric arm of the ODN also includes NECTAR (North East Children’s Transport and Retrieval)

service which is hosted at Newcastle Hospitals NHS FT. NECTAR ensures that critically ill children (from

birth to 18 years of age) are transported rapidly by an expert team to the appropriate Paediatric Critical

Care environment. The Lead Nurse for NECTAR also works one day a week for the Network.

Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

Alan Foster MBE Lesley Durham Julie Platten

Chair. Lead of Integrated Care System (ICS)

Director and Lead Nurse

(NE & C Locality)

Manager & Lead Nurse

Adult (TV & SD Locality)

David Cressey Isabel Gonzalez Susan Jackson

Medical Lead Adult

(NE & C Locality)

Medical Lead

Adult (TV & SD Locality)

Medical Lead (Paediatrics)

Lynda Pittilla Sarah Gray Jan Malone

Lead Nurse (Paediatrics)

Administrator (TV & SD Locality)

Administrator (NE & C Locality)

The Network is made up of 10 Acute Foundation Trusts, including NEAS; 13 Hospitals and 17 adult

critical care units which include specialised units for neuro-trauma and cardiothoracic along with three

paediatric critical care units.

Cumberland Infirmary West Cumberland Hospital Freeman Hospital Wards 21 (Cardio), 37 & Paediatric (Cardio) Royal Victoria Infirmary Wards 18 (Neuro), 38 & Paediatric (GNCH) Northumbria Specialist Emergency Care Hospital South Tyneside District Hospital Sunderland Royal Hospital Queen Elizabeth Hospital University Hospital North Durham Darlington Memorial Hospital University of North Tees James Cook University Hospital GICU, Cardio & Paediatric Northallerton Friarage Hospital

Adult critical care beds = 259 (50:50) L2 & 3 Paediatric critical care beds = 29

Royal Victoria Infirmary and James Cook University Hospital are Major Trauma Centres.

Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

The Adult Critical Care Service specification (D05) states that “all units should be engaged with their local Adult Critical Care ODN”.

To enable engagement the Network has a number of clinical forums and working groups and all units are invited

to have representation at each of these meetings.

Details can be found on the website www.noeccn.org.uk

Provides overall strategic direction for the development of Adult and Paediatric Critical Care services across the Network in line with current

National guidance.

Executive members who have authority to make decisions for on behalf of their organisation.

The Networks forum for senior Nurses, Doctors and AHPs. Agrees guidance, working practices and projects across the Network. Promotes and shares best practice

Clinical Leads, Consultants, Lead Nurses, Matrons,

AHPs, Pharmacists, Trainees, Managers

Development and implementation of a rehabilitation pathway. Shares best practice. Development of patient

and relative support groups (ICU Steps)

Consultants, Matrons, Staff Nurses, Physiotherapists, HCA’s

Provides support to enable accurate data collection. Monitors quality indicators using Network ICNARC

report.

Staff involved in data collection, Admin Staff, Research Nurses, Data Collection Clerks, Consultants

A forum to discuss pharmaceutical issues in critical care, promoting standardisation of infusions.

Provides an opportunity for group clinical supervision

Critical Care Pharmacists

Implementation of National Competency framework

for Registered Nurses in Adult Critical Care, shares resources and best practice. Provides educational

mentorship support

Nurse Educators, Senior Nurses, Staff Nurses, University Lecturers

To facilitate cross organisational communication and sharing of experiences and clinical approaches in the

management of the deteriorating and recovering patient.

Outreach Staff, Consultants, Physiotherapists

To support the development of end of life guidance in

critical care using the best available evidence, facilitating the sharing of best practice across

organisations.

Anyone interested in improving end of life care for patients and their relatives

Promotes and maintains Network standards to ensure safe and efficient patient transfer. Standardisation of

transfer processes and equipment. Shares best practice.

Consultants, Trainees, Senior Nurses, Staff Nurses

Comparing clinical practice across the Network, sharing best practice and developing guidelines to promote

standardisation

Anyone interested in improving standards of care

Joint Clinical Forum (JCF)

Benchmarking Group

Rehabilitation after Critical Illness (RaCI)

Critical Care Information Group (CCIG)

Pharmacy Group

Outreach Group

End of Life

Stakeholder Board

Education Group

Transfer Group

Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

Facilitates the development and delivery of high quality, evidence based, clinically effective services and

coordinated patient pathways based on local and national guidance and needs within paediatric critical

care and transport services.

Paediatric Medical Leads, Nurse Leads, NECTAR and Specialised Commissioners.

Stand-alone projects to improve the service and improve quality of care for patients and staff.

Reduce the incidence of Pressure Damage

Improve quality of Mouthcare

Procurement Group

Develop an Adult Transfer & Retrieval Service

For further information on any of these groups please contact a member of the team

or via the website

www.noeccn.org.uk

Lesley Durham – Lesley.durham@nhct.nhs

Julie Platten - j.platten1@nhs.net

Sarah Gray – sarah.gray13@nhs.net

Jan Malone – jan.malone@nhct.nhs.uk

Sarah Gray Network Administrator North of England Critical Care Network Adult & Paediatric ODN Hosted: University Hospital of North Tees 2nd Floor, Everley House Hardwick Road, Stockton, TS19 8PE Tel: 01642 624328 Mobile: 07765253098

Jan Malone Network Administrator North of England Critical Care Network Adult & Paediatric ODN Hosted: Emergency Care Centre Room G318 North Tyneside General Hospital Rake Lane, North Shields, Tyne & Wear NE29 8NH Tel: 0191 2934189 Mobile: 07827978559

Paediatric Critical Care Clinical Advisory Group

Service Improvement Projects

Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

Training Events

Dates and registration are available on the website www.noeccn.org.uk

Patient Transfer

Personal Development

Train the Trainers (TtT)

A one day training course

delivering theoretical

knowledge and practical

aspects of delivering the T4T in

NoECCN. Standardising course

delivery and creation of a pool

of trained clinicians able to set

up and run the T4T course

NECTAR Stabilisation

Days

MDT training in stabilisation of the sick child before transfer.

Further information and

registration is via Lyn Scott. Lynn.scott@nuth.nhs.uk

Training for Transfer (T4T)

An interactive one day training

course comprising of lectures,

workshops and scenario based

teaching. Aimed at ACCS Year

2 and ST1 Anaesthesia

Trainees plus ICCU/A&E

Nurses

Senior Staff Nurse

Development Programme

The aim of the programme is to

develop leadership and

managerial skills and awareness

as part of a career progression.

The programme is an interactive

fun filled day followed by a half

day poster presentation where

participants present their service

improvement project

National Adult Critical

Care Nurse Competencies

Supervisor Update

This half day study event

concentrates on the navigation of

the National Adult Critical Care

Competency Framework, providing

standardisation of assessment

across the Network.

Critical Care Outreach

Course

The Critical Care Outreach

Course© (CCOrC© ) is a part

time practice-focused, work-

based educational framework

and competency package

designed to equip Critical Care

Outreach practitioners to meet

the needs of acutely and

critically ill patients outside of

designated critical care areas

and is designed to be

transferrable across the NoECCN.

Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

Quality Assurance

Peer Review

Strategic Resilience & Capacity Management

The following NoECCN documents can be found at www.noeccn.org.uk

Adult Critical Care Escalation Framework

Paediatric Critical Care Escalation Framework

Ethical Framework for Utilisation of Critical Care in response to Exceptional Demand

Guidelines for Escalation of Ebola Virus Disease

Directory of Services (DoS)

NoECCN offers ALL units and providers of Adult Critical Care within the

Network the opportunity to participate in the ‘Peer Review’ cycle.

These occur approximately once every 3 – 5 years; the review itself is

usually conducted within a single day and has the full support of all

CEO’s. They are conducted with the aim of providing quality assurance

across the Network, but more importantly to provide help and support

for critical care units to achieve their aspirations and improve patient

care. The reviews are undertaken by the Network Director, Manager

and a Network medical lead or a senior critical care clinician. They

follow a structured format that review unit data and address a number

of issues including clinical care, organisational factors and staffing

considerations and the units undertake a self-assessment against a

coalesce of evidence based published standards

NEAS ring every Adult unit 4 times a day for an update on bed

availability and transfers (this used to be Norman from NICBIS

for those of you who can remember that far back).

It is important that information given to NEAS is correct as

NoECCN monitor bed pressures and increases in transfers

which are early indicators of pressures within the system.

Units can also update their bed information on DoS after

every admission/discharge. If you have not accessed the

system within 3 months your account is automatically

deleted. In the (draft) D05 Service Specification units will be

expected to update DoS twice daily. NECTAR provide the

same service for Paediatric Critical Care.

Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

Annual Network Conference

Due to the success and growing attendance to the conference we had to find an alternative venue for

the conference so this year we held our conference at the Stadium of Light, Sunderland.

2018 WINNERS!!! - The Innovation Award

This was awarded to

Northumbria Specialist Emergency Care Hospital (NSECH) for their

“Critical Care Team Away Days”

Please submit your great work and join us next year

Tuesday 15th October, 2019.

Following the amalgamation and relocation of critical care services to NSECH,

there was an increase in staff leaving critical care and morale was noted as being

low. Dr Karen Connelly, Matron Debbie Whiteman and other members of the

senior team recognised this and wanted to provide staff with a team building

opportunity and take staff out of their usual working environment. To enable all

staff to attend two days were organised, both attended by the senior clinical

team. A motivational speaker was booked for the morning which helped staff

understand more about each other and in particular, provided insight into real

or perceived behaviours. In the afternoon team games were played on the

beach which served as a great mechanism to get to know each other and work

together as smaller teams in different ways.

The ‘away days’ were deemed as a great success by all who attended and has

helped to bring the wider team together. They achieved the aim of gaining a

greater understanding of each and every team member and their characteristics

and strengths. All agree that this has undoubtedly improved morale, with the net

effect of continuing to deliver great care to patients, relatives and each other.

WINNERS!! - Special Recognition Award

This was awarded to Malcolm Woods and Team at

NEASUS. This was for their continued support in the

maintenance of the critical care transfer trolleys.

WINNERS!!! – Poster Award

This was awarded to “Acute Intervention Team Reduces Cardiac Arrests.”

Lisa Ward and Team

Early Detection & Resuscitation Lead Nurse CCD&D FT

Visit our website (free to join) www.noeccn.org.uk NoECCN December 2018 No: 1

ICU Steps Support Groups

ICUsteps (www.icusteps.org) is a registered charity and was founded by former intensive care patients,

relatives and health professionals. The North of England Critical Care Network has been working

alongside the Critical Care Units within the region to set up ex-patient/relative satellite support groups

of which we currently have five within our region.

Dates on the website www.noeccn.org.uk

National Links

CC3N – Critical Care National Network Nurse Leads www.cc3n.org.uk

NOrF – National Outreach Forum www.norf.org.uk

ICS - Intensive Care Society www.ics.ac.uk

NEICS – North East Intensive Care Society www.neics.org.uk

FICM – Faculty of Intensive Care Medicine www.ficm.ac.uk

BACCN –British Association of Critical Care Nurses www.baccn.org

If you would like to contribute to our next Newsletter please email one of the team

Follow us on Twitter

@noeccn

We would like to take this opportunity to wish everyone a very

Happy Christmas

and

Peaceful New Year

Thank you for your continued support and hard work in all our

Network groups - we have achieved so much!