Cross-Party Group on Lung Health
Grŵp Trawsbleidiol ar Iechyd yr Ysgyfaint
Minutes from 6 February 2024
MSs
John Griffiths MS (supported by Andrew Bettridge)
Mabon ap Gwynfor MS
Non MSs (19)
Alice Spencer
Andrew Wilson
Ben Coates - Asthma + Lung UK Cymru (Secretariat)
Chloe Hutchinson
Chrissie Gallimore
Claire Jankowska
Danny Grehan
Frankie Toner
Greg Pycroft
Jamie Duckers
Joanne Oliver (Presenter)
Jonathan Morgan
Joseph Carter
Josephine Cock
Kathryn Singh
Laura Dugdale
Monica Fletcher (Presenter)
Pam Lloyd
Rebecca Heathcote
Rhian Pearce
Ryland Doyle
Stephanie Phillips Morgan
Stephanie Woodland
Val Maidment
Val Tweedie
1. Joseph Carter - Welcome and introductions
Joseph Carter started the meeting and thanked everyone for attending. He made attendees aware that John Griffiths MS would be slightly late to the meeting and, as a result, he would open the meeting. He asked if any MSs or support staff wanted to introduce themselves, with Mabon ap Gwynfor MS doing so.
Joseph Carter informed attendees that there would be two presenters, Joanne Oliver, NHS Wales Executive and Monica Fletcher, Asthma UK Centre for Applied Research.
2. Joseph Carter – Apologies
The following MSs have sent their apologies:
Altaf Hussain MS
Buffy Williams MS
Cefin Campbell
Delyth Jewell
Heledd Fychan MS
Jane Dodds MS
Ken Skates
Llyr Gruffydd MS
Luke Fletcher
Mark Isherwood MS
Mike Hedges MS
Natasha Asghar
Peredur Owen Griffiths
Rhianon Passmore MS
Rhun ap Iorwerth MS
Sarah Murphy MS
Sian Gwennlian MS
Sioned Williams MS
Tom Giffard MS
Vikki Howells MS
3. Joseph Carter – Minutes of the last meeting
John Griffiths has signed off on the minutes of the previous meeting. The Secretariat will clarify with Mabon ap Gwynfor’s office if he is happy to second the approval of the minutes.
Action: Joseph Carter/Ben Coates to liaise with John Griffiths MS to sign off the minutes – Pending
4. Joseph Carter – Matters arising
The only action from the previous meeting was to send a copy of the Saving Your Breath report to the Minister for Health & Social Services – Completed
5. Joanne Oliver, Networks Manager (Networks & Planning), NHS Wales Executive: Update on the NHS Executive and Clinical Networks.
John Griffiths MS introduced Joanne Oliver.
Joanne Oliver opened the presentation by detailing the role and purpose of the NHS Wales Executive, which was established on 1 April 2023. She also provided the background and the rationale for the shift to the NHS Wales Executive model, before outlining its governance, accountability and operational structures.
Joanne Oliver then detailed how the NHS Wales Executive will interact with the new National Strategic Clinical Networks. She confirmed that the National Strategic Clinical Networks (NSCNs) will perform the central role in the ‘knowledge-to-practice’ element in the Learning Health and Care System laid out in the National Clinical Framework (NCF) model. These NSCNs will also play a leading role in fulfilling the expectations set out by the NHS Wales Executive’s Mandate and Remit letter.
She noted that each of the NSCN’s were at varied stages of progress. She noted that the relevant NSCF for respiratory care - the National Strategic Clinical Network for Respiratory Conditions – is progressing, with recruitment ongoing and key meetings in the diary to establish terms of reference and priorities for the NSCN. Joanne also detailed the organisational structures of the Core Network Leadership Group and Core Clinical Reference Group. These groups are key to ensuring the priorities of the NSCF align with the Quality Statement for Respiratory Disease.
Q&A Session following Joanne Oliver’s presentation
Joseph Carter asked how the structures, systems and decisions at the NSCN level will impact services and decision-making on the ground-level. Joanne stressed that the NSCN approach allows the NHS Wales Executive and the NSCN’s to collaborate meaningfully with every health board. The Core Network Leadership Group and Core Clinical Reference Group will be the main forums for this engagement.
Pam Lloyd asked how the NSCN’s will be implemented, for example, is there any funding available to help implement the directives that come from the NSCN’s? Pam also asked about what feedback mechanisms there would be for health boards to input their views on how they think the NSCN is working. On funding, Joanne Allen confirmed that the NSCN’s have been given funding to establish themselves. At this stage, the funding has mainly be allocated towards recruitment. Funding for the next financial year has not yet been agreed but it is expected to be discussed imminently. Joanne agreed that feedback mechanisms will also be key and that the NSCN’s must take a collaborative approach, utilising the dedicated funding available.
6. Monica Fletcher, Partnerships Lead for the Asthma UK Centre for Applied Research (AUKCAR)
Monica Fletcher began her presentation by describing the extent of the AUKCAR’s network across the UK’s university sector. Since joining the organisation, a key focus for Monica has been looking at the impact of the research from AUKCAR, i.e. how can we ensure that the knowledge and insights gained from research is applied to the delivery of respiratory healthcare? Relatedly, it has been crucial to consider the question of what barriers are preventing research from being applied.
Monica then provided an overview of other areas of their work, including improving adherence to taking medication as directed by medical professionals and optimising the management of asthma attacks through digital interventions.
She then went into detail on how the IMP2ART programme – an implementation research programme – which aims to help general practices across the UK to embed self-manage of asthma into routine care. The programme involved 144 general practices from across the UK, with the main trial results expected later this year. Monica also detailed her involvement with the Children’s Health in London and Luton (Chill) study. The study aims to evaluate whether the Ultra Low Emission Zone (in London) is effective at reducing air pollution, and improving children’s lung growth, and respiratory health. For reference, Luton has no such clean air zone in operation. She noted that results would be published shortly.
Another key initiative from AUKCAR has been to support the training of the next generation of asthma researchers from a wide range of backgrounds, including clinicians, pharmacists, data scientists, public health academics and health economists. Monica confirmed that there a new expanded network is being launched this year in order to expand these collaborations.
Concluding, Monica outlined the key recommendations from the body of work that has emanated from AUKCAR. These are:
· Prevention
o Back implementation of Clean Air Zones – These need to be implemented with financial support to address public concerns.
o Reduce smoking – increase age limit for buying year-on-year; prevent children’s access to vaping; and ban advertising.
· Diagnosis
o Train practice nurses in FeNO & spirometry and incentivise greater rollout in existing healthcare settings
o Support research into better and fast diagnosis
· Treatment/self-management
o Promote MART regimes and reduce overuse of blue inhalers
o Adopt and implement digital tools to improve adherence
· AI/Risk prediction
o Support integration of AI-enhanced risk tools into patient self care
· Research
o Increase research funding for respiratory health
Q&A Session following Monica Fletcher’s presentation
John Griffiths MS raised a question from Josephine Cock from the meeting’s chat function, which asked what work AUKCAR had done looking at the impact of domestic burning on lung health. Monica confirmed that AUKCAR were doing a lot of work on both indoor and outdoor air quality, including personal monitors that are wearable.
Jamie Duckers raised the issue that Wales has the worst respiratory health across Europe, caused by housing, pollution and poverty. Despite this, there are very few Welsh people involved in commercial trials and he asked what more can be done to address this.
Joseph Carter then put forward the idea that the CPG should write to the Welsh Government asking what steps are being taken to ensure that Wales is a welcoming environment for research – Action to be taken by Secretariat.
7. Ben Coates – Next meeting and the work ahead
Ben Coates confirmed that the next meeting will be held at 9.30 on Tuesday 21 May 2024.
8. John Griffiths MS - Any other business
John Griffiths MS asked if anyone had any other business. They didn’t, so he thanked everyone for attending and brought the meeting to a close.