National Renal Advisory Board Meeting
MEETING DETAILS
Date and time:
Venue:
9.30am to 2.30pm Friday 13 March 2015
Conference Room 3, Manukau Super Clinic, 901 Great South Road, Manurewa
Committee Members
Murray Leikis (Chairperson), Michael Papesch, Rachael Walker, Tonya Kara, Kay McLaughlin, Fredric Doss, Jo-Anne Deane, Janine Cochrane, John Schollum, Ian Dittmer,
Chris Hood, Nick Cross, Max Reid
Janine Cochrane, Nick Cross
Apologies
Wilfred Rodriguez, Ross Darrah (Health Alliance; Item 16)
By Invitation
Minutes Taken By Chris Hood/Tonya Kara
No.
Item
Discussion/Action
Responsibility
Minutes
1
2
Review of the Board
minutes recorded at
the previous meeting
held on 21
November 2014,
and subsequent
correspondence –
Open Discussion
Review of the action
points recorded on
15 August 2014 –
Open Discussion
The previous NRAB minutes (attached) were taken as true by all present.
ALL
Murray
Item 5: Murray has written a letter of thanks to Nick Polaschek for his significant contribution to the NRAB and renal
services in New Zealand. Murray attended a farewell at the Ministry of Health.
Item 9: Murray has written to Medsafe and Jansen-Cilag regarding administration of Eprex via subcutaneous route. No
reply received as yet. Murray will forward his letter to Tonya who may raise it at PTAC if appropriate.
3
Review of the public
version of NRAB
minutes from the
meeting held on 21st
November, 2014
Discussion held over the previous decision to dispense with a separate public version of the minutes. After seeing the
benefits in preparation of the public version of the November meetings it was unanimously agreed that a public version
of the minutes should be continued. Michael will continue to prepare these.
Murray/Tonya
Michael
Regional Roundup
4
Northern
Chris Hood presented a project performed by Wing Cheuk Chan (Public Health Physician) linking MoH and Testsafe
data and aiming to establish the prevalence of CKD in the Auckland region. Initial work looking at diabetes prevalence
has been completed and published. Pilot proposals for potential uses of this information & ethics discussed. Potential for
Chris
looking at CKD prevalence and public health initiatives likely to be relevant for NRAB as well as use for modelling for
service requirements. Agreed to invite Wing to next Auckland NRAB meeting. Rachel to send Chris details of previous
project work with Ministry.
Waikato
The assisted care programme has been successful and is expanding. Nocturnal HD program active and working well.
A renal/palliative combined clinic has now been set up.
Central
CSI nephro workshop set-up. This is a combined project with Wellington and Auckland Hospital Renal and Palliative
Care Services to provide communication skills training for renal staff. May become a nationwide programme if success
continues.
Starship
There is an aim to increase national outreach service. This would be helped by GPs and other hospitals increasing
secondary care service to Auckland patients. Tonya will liaise further with Max.
Southern
No new reports.
Tonya
New Business
5
Vaccination
Schedule
Murray expressed concern that suggested vaccination schedule relied on GP provision for the majority of recommended
vaccinations. The Dunedin renal service negotiated with their immunisation service to provide this service. Peter
Sizeland, Tonya and Paul Manley will meet regarding the suggested vaccination schedule for renal transplant and
provide a recommendation. Tonya pointed out that there is a risk of discrepancy between paediatric and adult provision.
Tonya
Max Reid, the new CEO of Kidney Health New Zealand was formally welcomed to the NRAB. Murray will include Max
as the KHNZ representative on the website.
Murray
General
6
NRAB Structure,
Composition, and
Function
A Ministry of Health representative to replace Nick Polaschek is still to be identified.
Michael’s term as consumer representative on the NRAB is due to end this year and a process to search for a
replacement will be initiated. John Schollum and Frederick Doss are also coming to the end of their terms.
The terms of reference have been updated on the website.
Terms of reference
February 2015.doc
7
NZ Chapter of the
ANZSN
Murray has written to ANZDATA expressing concerns about the tardiness of annual reports and the possibility of a
separate data lock for NZ data. Awaiting response.
8
Nephrology
Advanced Training
Tier 2 document
There was a discussion of the proposed national training scheme being developed by Janak De Zoysa and Jo Dunlop,
head of the New Zealand SAC. A formal proposal is still awaited.
Ian has been continuing to work on this. Old Standards document is in Dropbox. Once the working group has revised
9
Auckland District Health Board – Templates – March 2010
Murray
Ian/Tonya/
10
update – Nick P
the document it will be sent out for consultation to HODs.
PTAC Nephrology
subcommittee Murray
Tonya will pursue the issue of subcutaneous administration of Eprex through PTAC. Tonya will also follow-up with
regard to progress on the renal multivitamin pill.
CKD pilots /
Symposium /
National Strategy –
Nick P/Kelvin
RRT Access in NZ
The CKD consensus statement was officially released yesterday. Rachael will continue to move forward with CKD
National Strategy potentially incorporating Auckland CKD data presented today and KCAT resources.
Kay
Tonya
CKD
10
11
Rachael
ALL
Access to RRT in NZ
Feb 2015 changes clean.doc
Murray has circulated a revised document (also attached) and would like feedback from NRAB Board members before
circulating to departmental heads and the MOH.
Dialysis
12
Electrical Standards -
The Electrical Standards Document has now been published. This has been forwarded to all departmental heads. It is
though unlikely to have a major impact on HHD. Of note circuit breakers are required for APD. The standards
document will be placed on NRAB website.
Murray
Electricity and Home
Dialysis Combined Feb 2015.pdf
13
Management of
ineligible patients
within NZ –
Janine has sent around document to Unit Managers regarding eligibility for dialysis. Still awaiting a response from some
units. Of those units who have replied, it appears that non-resident numbers are low. It is thought that with such low
numbers it is unlikely that any further work will be required. Janine to report on final numbers at next meeting.
Janine
14
PD Registry Update /
PDOPPS update
All units, with exception of Christchurch, were confirmed as currently uploading data to PD registry. Uncertainty as to
whether Christchurch is uploading data. Murray to check with Christchurch.
Murray
15
Disaster Planning,
patient and service
preparedness –
The Northern Regional Disaster Plan remains in development. Murray suggested that all regional disaster plans should
be collated into a summary document for publication.
16
Health Alliance
Contracts
Health Alliance Presentation. (Wilfred Rodriguez, Ross Darrah)
Health alliance has been tasked to perform a national procurement service. In the longer term plan this may transfer to
Pharmac after approx. 3 years (end 2016). Health Alliances role is to working between suppliers and DHBs. They aim to
look at DHB, regional and national level contracts for different services and areas with the aim of achieving one price for
one stock item for one country. Data was provided on contract costs and end date for all DHB dialysis contracts
demonstrating the disparity between current contracts. Health Alliance may request expert advice from the NRAB in
Auckland District Health Board – Templates – March 2010
future negotiations. All board members agreed we were happy to liaise with Health Alliance as required. Currently there
are 4 regions that could provide the starting point for agreement of essential requirements for contracts. This would
need to start in early 2016 for contracts due in 2017.
Transplant
17.
National Tx activity
The TSANZ have published a public consultation document regarding the ethics of organ donation. Nick Cross and
Murray have sent a response to this.
18.
Kidney Exchange
26 pairs are now enrolled. 6 exchanges have been performed. Ian attended the Australian Kidney Exchange Program
meeting to investigate merging of programs.
19
National Renal
Transplant Service.
The National Renal Transplant Advisory group meeting have had their first meeting which was very successful. Current
work streams involving KPIs for live transplantation work-up and waiting times. Other quality performance indicators are
being developed.
Standard Report Updates
20
Report on Kidney
Health New Zealand
The board welcomed new CEO Max Reid. Nick Polaschek has been welcomed on to the KHNZ board. Colin Hutchison
has been welcomed as an ex-officio member in the medical adviser role spending a day a month in Christchurch
working with KHNZ.
A new educational video resource has been released “Understanding Kidney Disease”. Copies were circulated to board
members. The resource is available via the website and Facebook. The videos will also be translated into Samoan and
Tongan.
KHNZ will also be running an educational programme in Palmerston North for health care professionals and patients in
May 2015. This will be modelled on the successful experience in Hawkes Bay.
21
Subcommittee
reports
1. Standards &
Audits
Update on S+A committee: 2012 and 2013 data are now available. A report will hopefully be available by Baxter meeting
in May.
2. RSA / Nursing
Interest Group
There has been no Nursing Advisory Group meeting since last NRAB. The central conference will be in Perth and a
New Zealand conference will also be running in Wellington in November.
3. NZ Board of
Dialysis
Practice
An e-portfolio online service is being introduced for performance appraisal and CPD requirements for members. MIT
course is going well. All candidates passed first semester. A New Zealand registration exam is being developed.
Melbourne renal units have been in contact as they do not have a formal accreditation system and may wish to partner
with the New Zealand model.
22
Ministry of Health
No replacement for Nick Polaschek as Ministry representative has been confirmed. Murray will attempt to identify
possible Ministry contacts.
23
Update for National
The ANZSN is actively looking in to developing relationships with Pacific Renal Services.
Auckland District Health Board – Templates – March 2010
Murray
Strategy for Pacific
Renal Service
Development
Other Business
24
New Work Streams
for 2014/15
ALL
The discussion centred around:




Tier 2 documents and access to dialysis need completing in 2015.
Health Alliance issues to be kept abreast of.
Workforce issues could be examined.
Home Dialysis numbers going down to be looked at. Needs to look at barriers to home dialysis and changes
over time. . This can be done at staff and service level. Water and power to be looked at. This should be
standardised. The discussion should however accept that Centre Dialysis is a reality and facilitate people to
become independent.
Next Meeting:Date: Friday 8th May 2015
Auckland District Health Board – Templates – March 2010
Time: 9.30am
Venue: Wellington Hospital