Dr S J Desilva
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12 – 1pm Registration and Lunch
Start 1pm
1. Update and summary Dr S J Desilva
 Review of learning and Actions from previous peer review 2014
 New suspected angina referral form – Joint feedback and
recommendations
 e-consultations - update
 Wakefield cardiology network – summary
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2. Peer review of cases NA/SDS
3. Medicines optimisation team, ImPP (KM)
Break
3. MYDIAGNOSTICKS update – SDS
4. AF/Grasp and stroke – quick updated (Gillian Richardson)
5. RAIDR - quick summary – CH
6. Big white wall – update - CH
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All practices are required to take part in two
external peer reviews of outpatient
specialities with consultants - in relation to
the “OUTCOMES AND VALUE FOR MONEY”
domain of NDF
The purpose of the peer review is to improve
QUALITY and SAFETY OF CARE .
By improving quality we can achieve
efficiencies.
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Part one - practices to capture discussions at
practice meetings to identify case studies
prior to external peer review
Part two - Network /target session to capture
discussions with consultants and clinicians
Part three - used to identify key learning
points and develop action plans.
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If patients don’t have suspected angina, DO
NOT TEST FOR IT! Testing can result in
unnecessary non invasive and invasive
procedures – which are associated with risk.
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Screening questions for angina – If answer
NO for the 3 suspected angina questions,
then Highly unlikely patient has angina.
Referral, imaging and testing not necessary.
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New suspected angina form presented to
network who agreed to pilot it
Why stable angina needs to be seen quickly
and those with severe CAD need to be
identified
Angioplasty will not stop heart attacks (no
tests which will identify which plaques will
rupture),but for improvement of symptoms.
Stenting supports symptom control but does
not save lives.
1. Implement and pilot of NEW “Rapid access”
suspected angina clinic forms
 2. participate in audit and feedback (via survey
monkey)
 3. support the joining up of services and ways of
working together between specialities to stop
patients being passed around the system.
 4. Arrange a 2nd follow-up peer review and
update with Dr Nigel Artist (Consultant
cardiologist)
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Feedback and discussion
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Feedback
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From Aug changing to NT-BNP
Reference values changing
Currently B-BNP levels 100
New range NT-BNP levels 400
Paul Brooksby - Consultant Cardiologist MYHT
Som de Silva – GPwSI Cardiology and Network 6
Representative (Wakefield)
Pravin Jayakumar (GP) – Network 5
Nigel Artis – Consultant Cardiologist MYHT
Dwayne Conway – Consultant Cardiologist
MYHT
Gillian Richardson – Public Health
Emma Smith – Health Improvement Specialist,
Wakefield Public Health
Viv Nicholson – Senior Commissioning Manager
NKCCG
Caroline Ellis – Locala Cardiology and
Admissions Avoidance Team Leader
Alison Carr – Senior Cardiac Technician MYHT
Ged Oliver – Strategic Clinical Network
Representative
Sharon Stockdale – Heart Failure Nurse - Locala
Principal, Wakefield CCG and Public Health
Keith Marshall – Patient representative
Representative (Wakefield)
Gill McDonald – Medicines Optimisation
Wakefield CCG
David Fearnley – Heart Failure Nurse, Locala
Hazel White – Consultant Cardiologist MYHT
Fiona Dudley - Lead Nurse, Cardiology Services
MYHT
Phil Batin – Consultant Cardiologist MYHT and
Strategic Clinical Network Clinical Lead
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Current ongoing agenda items
New stable angina pathway
e-Consultations
Community heart failure pathway/clinic
Enhance-HF
Grasp AF
Heart failure guidelines
Community IV diuretics pathway
Familial Hypercholesterolemia (FH) /genetic
testing
Northkirklees community cardiology service
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Dr Nigel Artis – Consultant cardiologist MYT
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UPDATE – finally ready to go !
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Gillian Richardson
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Dr Clive Harries
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Dr Clive Harries