NBTC Education Working Group - Transfusion Guidelines
NBTC Education Working GroupTelcon – 8 March 2019Minutes and action pointsPresent: Lise Estcourt (LE) - Chair, Paula Bolton-Maggs (PB-M), Fatts Chowdhury (FC), Anne Davidson (AD), Dora Foukaneli (DF), Jane Graham (JG); Shruthi Narayan (SN), Helen Witham (HW)Sue Katic (SK) – MinutesACTION1Welcome and apologiesApologies received: Peter Baker (PB), Cath Booth (CB), Ruth Evans (RE), Suzy Morton (SM)LE welcomed a new lay member to the group, Helen Witham. Helen is looking forward to joining the group as a patient representative. She has regular blood transfusions, since she was a baby, as she has Diamond-Blackfan anaemia.Correction to the details for Helen Witham, the new patient representative lay member to the group. Helen was steroid dependant as a child; she is now transfusion dependant but still needs steroids.LE asked the group to introduce themselves to Helen.LE is a Consultant Haematologist and Clinical Tutor for NHSBT.PB-M was Medical Director of SHOT until she retired last year. She is now Chairperson of the RCPath Transfusion Medicine SAC.FC is a Consultant Haematologist at Imperial NHS Trust and part of the Patient Blood Management Team at NHSBT. She also looks after red cell exchange in LondonAD is Education Lead for the PBM TeamSN is the current Medical Director of SHOT and a donor consultant at NHSBTJG is a Consultant Haematologist at University Hospitals of North Midlands, she is the clinical lead for transfusion medicineDF is a Consultant Haematologist with a joint post at Addenbrooke’s Hospital and NHSBT as part of the PBM Team. She represents transfusion at the JRCPTB.2Minutes and Matters ArisingMinutes from the 9 November 2018 meeting were accepted as a true record with one correction. Paula Bolton-Maggs’ name incorrectly written as Paul, this will be corrected.Actions:Courses clashing with ITM course in Filton - CB sent a list of large courses held for SpR’s in Bristol that could clash with the Filton courses. LE forwarded on to RE to hopefully avoid clashes for the future.RE was to provide paper-based panels for cases to be worked around. This is ongoing.PowerPoint story boards - LE to contact Lisa Johnson re story boards as at the moment only have a basic one. LE has seen ones in use by BBTS and would like to create a framework for story boards for NHSBT. All to be similar and to go on the Education on-line platform which has been delayed until Autumn 2020. LE speaking to Lisa Johnson but won’t know until June when it might be ready for external users. Due to IT issues any non-essential work has been delayed. LE explained that anything created in PowerPoint will be translated in to Articulate to go on the education tool, i.e. technical documents, create imaginary scenarios.AD was to put a link to the active cost of blood on the PBM App. She is currently compiling a list of all the changes that need to be made and these will all be done at the same time.LE emailed Shubha Allard regarding the Clinical Fellow post business case that was previously submitted to the CDSMT. LE will create an updated business case and will apply for an education fellow within the fellows doing Masters of PhD in Education. FC will assist with this, needs to go to the CDSMT when ready.LE to talk to Mike Murphy regarding transfusion camps – on going.3Medical EducationFoundation Doctors Transfusion Education course run by SN, JG and SM was run successfully in 2018. Will now re-group to look at running another session with some changes. Have had an oral presentation of the course accepted at the BSH Conference in Glasgow in April 2019. LE would like to attend the next course as an observer, this will probably be in Autumn 2019.Action: JG to invite LE as an observer on next courseJG4Training Haem SpRs / NHSBT Training coursesF2F teaching, plan to turn some of the ITM lectures to on-line training. Lisa Johnson is speaking to Health Education England to put some of it on e-learning for Health, generic things only until 2020. LE will update once she has heard back from Lisa.FC said that when teaching on the ITM it is sometimes difficult to set the level as some students are more advanced than others. LE had taught in Filton recently and agreed there was a wide variation in level of knowledge. It was felt that it would be a good idea for people to have shown that they have done an amount of work in a Lab before being allowed on the course as this will help them to make the most of the course. It is hoped if there is improved general medic e-learning, students will start with greater knowledge. Initial thoughts as to what should be known - cross matching; electronic issue; group and save; antibody panel; screen and batch reports.Action: All to let LE know what they think people need to learn in the Lab and how long they should spend. LE to discuss with RE: having to confirm training in the lab prior to starting intermediate training courseDF said we need to see where gaps are in the training and through this group, the College, BSH etc develop a strategy of how to improve training. Transfusion training is one of the most significant concerns.LE spoke about funding for transfusion videos, HEE funding will be available in the next year. Suggested topics: manual exchanges for sickle cell patients – children and adults; SHOT videos; consent and sampling videos as part of University work, JG is waiting for people to share this info.Action Need to put in a bid for HEE Funding 2020/21 in the summer. All to let LE or AD know of any suggested videos or tools. Other training matters mentioned:PBM reviewing updating the course for Doctors net “Transfusion for Everybody”. A useful basic transfusion course for doctors in general. PBM will send a link if possible.Contact from BMA for rudimentary education, BMA ‘evidence on the go’.The Blood Choices App will now be marketed as an educational tool.Choosing Wisely – linked to evidence.Action PBM to send link to doctors net transfusion courseAllLE/REAll5Education Team update Jan, 2018Education Team update for NBTC Education Working group Nov, 2018Patient information leaflets (PILS):Under review: “Will your child need a blood transfusion?”; in progress “Will I need a blood transfusion?”; in progress Information for patients with sickle cell disease who may need a blood transfusion; following feedback a review has commenced.QR codes are being added to the PILS as they are reviewed; it was hoped to do this at reprint, but this would necessitate a point revision and this was felt to misleadingly indicate that the content had been reviewed.A complaint was received regarding the decision to make the children’s comics and parents leaflets available as separate items instead of the pack of all three (to reduce wastage as comics aimed at different age groups). The complainant felt there had been inadequate consultation with high users; unfortunately, due to the time between the decision and implementation, evidence of consultation was not available. The review process has been amended accordingly. NHSBT NMA courses 2018Enquiries received from other HCPC registered professionals. Applications are accepted from registered, regulated professionals (as per BSH administration guideline) on acknowledgement that they will have additional learning needs which are their responsibility to meet.6 courses planned for 2019Huntingdon 1-3 MayBirmingham 13-15 MayManchester 10-12 JuneBristol 16-18 SeptemberLeeds 19-21 NovemberLondon 2-4 DecemberThere is no capacity within the PBM teams for additional courses2020; demand for the course is greatest in Birmingham and Manchester: therefore, the proposal is to have two courses in each of these locations plus two additional courses (? Newcastle and London) Presentation content updated October 18 and planned for Summer 2019 (with effect from November course)Accreditation: application in progress with the RCNLE asked for comments. There is significant difficulty for some areas to obtain funding. LE asked if there is anything this Group could do to support other areas.PBM Newsletter:11th Edition; request for content has been circulatedNMCNew “Standards of proficiency for registered nurses” are now effective and include “manage and monitor blood component transfusions” ( Annexe B, p.32), available at: and You tube videosBlood components app; updates will be required if NBTC indication codes change in line with recent BSH guidelines and published research.Use of the app continues to exceed expectations; Leeds medical school to promote the app to students (? similar opportunity with other medical schools)Blood Choices app; to be launched as an educational App not a medical deviceNew administration app; proposal for development approvedHEE bids; funding for 1-3 has been brought forward to 2018-19 and development is about to commence, the remaining are for consideration for 2019-20 fundingBlood sampling videoManual red cell exchange (adult) videoManual red cell exchange (paediatrics) videoLeadership training for TPsAnaemia education for midwivesLBT development Education toolkitNegotiations to resume, following updating of the Hospitals and Science website platform.LearnbloodtransfusionLBT User Report; passes in recent 12 month period (previous 12 month)Learn proNLMS% change(combined)Safe Transfusion Practice15376 (13988)10215(9939)+7%Blood Components and indications for use11205(10358)4510(4078)+9%Safe Transfusion Practice Paediatrics2865 (3009)752(938)-8%Transfusion Laboratory – safe practice617(545)70(56)+14%SNBTS has expressed concerns regarding the sustainability of LBT in view of their escalating staffing costsInterim funding arrangements for 2019-20 have been agreed.LBT strategy and funding to be discussed at next BT network meeting.Some developments will be put on hold as a result.6Technical training and Higher Specialist Scientific Training (HSST)Lab scientists training to become consultant specialists, this takes five years and the plan in future is to take over consultant haematologist roles. One trainee taking the FRCPath Part 2 exam soon; two taking FRCPath Part 1 in the Autumn. There are currently five trainees and funding is available for six more:2 x Red Cell Immunology1 x Bioinformatics (Big Data); 1 x Microbiology1 x Virology1 x IBGRL7 GMC Survey Results / Training for TrainersGMC Survey 2018: DF reported the results of the survey. We cannot influence the 2019 survey but would be able to, until September 2019, for the 2020 survey. Action: DF will circulate a paper on the GMC Survey 2018. Post meeting note: Circulated by SK 08.04.19Action: All to let DF know of anything for the 2020 survey.Training for Trainers: DF said that the concerns are around hospital based training. Perhaps instead of approaching trainees, DF suggested approaching trainers to ask how difficult it is for them to get training to be trainers. DF and a trainee have created a checklist for Labs/pathologists, along the lines of the Transfusion Training Checklist.Action: DF to circulate a draft of the checklist to the group.Suggestions:LE asked whether the training could be done at RTC level, via NBTC.JG agreed better training is needed but not sure if it needs to be national. Could this Group do anything to support local training? PBM The Intercollegiate Committee will be meeting soon.Transfusion Medicine SAC meeting soon, will look at Haematology Trainees not getting sufficient trainingHaematology Trainees trying to make some improvement with the curriculum, there will be a new one in three years. Still in basic form at early stages.DF would like the group to let her know the ten basic things that haematology trainees should know. Not a competency but an idea.Action: DF will put down a few ideas and circulate to the group who can add to this.Michaela Lewin has been working on Transfusion Practitioners competencies.Action: DF will share this with the group.LE reported that the NBTC has tasked a group to come up with transfusion competencies for different roles and what people should have competency for. Take forward next year but concentrate on Transfusion Practitioners first as this is already partly done.Action: JG will circulate objectives for undergraduates.Action: All to think about what transfusion objectives/goals we should have for different roles in hospital. All to think about this.DFAllDFDFDFJGAll9Next meetingNext telcon arranged for Friday, 24 May at 11am ................
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