1. South East Wales Critical Care Network Dr George Findlay, Lead Clinician Jennie Willmott, Network Manager

2. Presentation Overview Critical Care Network - context Quality Requirements for Adult Critical Care Structure of the Network Achievements in the first year

3. Critical Care Network - Context All Wales Critical Care Development Group 2001 Designed for Life South East Wales Regional Plan WHC (2006) 009 – Quality Requirements for Adult Critical Care. 5 Levels of Adult Critical Care WHC (2007) 023 – Commissioning Guidance recognises role of Networks as key to engaging with clinicians and influencing commissioning South East Wales Critical Care Network established Sept 07. All Wales Critical Care Advisory Group

4. Why Critical Care? Increasing demand unrecognised. Current ad hoc organisation, developments & guidelines European Working Time directive Standards & guidelines – Colleges, Societies, WAG Risks to patient care Network approach – multi professional, formalising best practice to improve clinical quality across organisational boundaries Strategic and regional approach to service redesign and redirecting current resources across critical care Levels. Strengthened and co-ordinated commissioning

5. Quality Requirements for Critical Care Implementation in 3 strategic frameworks. Core by 2008, 2008 to 11, 2011 to 2015 Core, Priority and Developmental Requirements Monitoring Respiratory support Other organ support Access to Diagnostics Patient Transport Medical staff Nursing staff Other health professionals Policy & governance 6 monthly audit of all QRs reported to Trust Clinical Governance Committee & to Trust Board annually

6. South East Wales Critical Care Network Network Board Chair, LHB CEO, Trust CEO, CHC CO, Regional Commissioning Director, Consultant Nurse, Network team. Quarterly meetings Service Improvement Group Chair – Network Lead Clinician Main source of specialist advise to the Board Clinical Directors, Senior Nurse & Directorate Manager Clinical/Topic groups – as required Establishment Agreement, Governance Framework, Work Programme, Communication Strategy Network budget £120k pa

7. 1 st Year of the Network Audit against Quality Requirements. Gaps:- Medical workforce (weekly working & weekend cover) Nurse: patient ratio (1:1 for Level 3 & 1:2 for Level 2) Transfer equipment & training Outreach Intensive Care National Audit & Research Case Mix Programme (ICNARC) Critical Care Delivery Groups Policies & procedures

8. 1 st Year of the Network Transfer Guidelines (North Wales Network) Transfer – audited equipment and activity Outreach – service model Renal patients – audit & Renal Network guidance to be developed Cancer Network – Upper GI review Neuroscience review Planning Workshop

9. 1 st Year of the Network Critical Care Minimum Data set – review and reports Data definitions, including Delayed Discharges Draft Admission & Discharge policy Guidance issued:- Cancelled operations Critical Care Delivery Groups Communications – website, newsletter Service Development Plan approved Network Funding Ward Watcher £73k Transfer Trolleys £15k 1 year funding for Improvement leads £47k

11. Critical Care Network SE Wales Critical Care Network Website:- http://www.wales.nhs.uk/sites3/home.cfm?o rgid=736 http://www.wales.nhs.uk/sites3/home.cfm?o rgid=736 WHC (2006) 009 Quality Requirements for Adult Critical Care http://www.wales.nhs.uk/sites3/documents/7 36/D4LCritCare.pdf http://www.wales.nhs.uk/sites3/documents/7 36/D4LCritCare.pdf