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1. Welcome, apologies and introductions

The Chair made introductions and noted apologies.

2. Action points and previous minutes

The previous minutes were agreed as a true record. The group agreed to publish action points and meeting notes of future meetings.

Action completed - DNACPR letter issued from Welsh Government. Secretariat to share with members:

Decisions on do not attempt cardiopulmonary resuscitation (DNACPR): age, disability and long term conditions

Penderfyniadau ar beidio â cheisio dadebru cardio-anadlol (DNACPR): oedran, anabledd a chyflyrau hirdymor

An easy read version has been created and being published. Welsh Government to consider BSL version.

3. Clinical ethics committees and national network

Discussion paper was provided by Government regarding the form and function of NHS Wales Clinical Ethics Committees and the role of a national network. Discussion included whether local ethical committees should be mandated or voluntary. The group agreed the latter position, with all health boards and Trusts being strongly encouraged to provide support of this nature, especially as all must have access to Research Ethics Committees.

In addition to  local ethical committees, it was agreed that national clinical ethics support is needed, building a Wales wide framework bringing together expertise from current committees rather than a separate new structure.

One option discussed was regional ‘buddying’, with ethical support covering neighbouring health boards and trusts in South East, South West and North Wales. As there are already some local clinical ethics committees in place, existing arrangements could be built upon and support areas that do not currently have them.

The membership of the current local ethical committees are volunteers. Discussion held on how members are and would be appointed, either through a public appointment process or otherwise. Discussion held regarding expertise needed, including equality and human rights expertise and advice covering communities, faiths, disabilities and workers voices. To aid with the consideration of how to create and implement local committees, each health board has a Director for Equality who could be approached.

The function of committees needs to be considered, with principles being considered, such as being open and transparent, provided ongoing training and how available the committee would need to be when required.

Questions were raised as to whether the committee would respond to individual cases in a timely or urgent manner, or to provide scrutiny and overview to national approaches to health and healthcare.

Action: all members to consider membership and form of local ethical committees.
Action: Terms of reference of existing ethical committee to be sourced and shared.

4. Advanced care planning

Presentation provided on a draft advanced care planning tool being developed by Hospice UK. The tool is a template to begin conversation in an improved, personable manner. Any comments on the document to be sent to Baroness Finlay (or via CMEAG.wales@gov.wales). Members asked not to share further at this point.

5. BAME COVID-19 Review

The Welsh Government is concerned of the disproportionate effect of CCOVID-19 on BAME communities, in relation of care and numbers of deaths. A separate group has been established to focus on this, working with NHS England and receiving advice from related organisations such as BAPIO. Communication on this due in near future.

6. Any other business

No AOB. Next meeting 30th April 2020.

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