Neuro-Critical Care Network
Operational Strategy
August 2008
Index
- Background
- Objectives
- Powers
- Membership
- Termination of Membership
- The Executive Committee
- Nomination and Election of Executive Committee
- General Meetings
- Rules of Procedure at Meetings
- Finance
- Alterations to Operation Strategy
- Dissolution
- Applicable Law
- External Participation
- Joining or Creating a Project
Appendices
Appendix I - Benefits of Membership
Appendix II - Guidelines to Publication
Appendix III - Joint Authorship Guidelines
1. Background
In March 2007 Paddy Yeoman and Keith Girling invited interested parties around the UK to a meeting in Nottingham. There was broad critical care representation including neurosurgery and ICNARC. The general feeling was that neuro-critical care had reached a stage where there appears to be evidence that care given in specific neuro-critical care units for severe traumatic head injuries may lead to better patient outcomes than in general units, and therefore a network of neuro-critical care units was a good idea. This might allow further audit and research to assess the veracity of this, and if so why this might be. It could then extend its view to see if it is true for other serious neurological disease e.g. spontaneous subarachnoid haemorrhage. The basic aims of the group were agreed in principle and that it should be named the Neuro-Critical Care Network – NCCNet
2. Key Objectives
The key objectives of the NCCNet can be defined as follows:
2.1 To develop a national network of critical care units providing neuro-critical care.
2.2 To share evidence and best practice, which may in time and in conjunction with other stakeholders include recommendation of standards for neuro-critical care.
2.3 To develop national comparative audit of patient outcomes from neuro-critical care in co-operation with ICNARC.
2.4 To develop a national network to support multi-centre audit and research.
3. Powers
To further the above objectives, the network may:
3.1 Employ and pay any person or persons to supervise, organise and carry on the work of the network;
3.2 Make reasonable provision, and at the minimum to comply with the law as amended from time to time in relation to the provision of pensions, for the payment of pensions and superannuation to or on behalf of employees and their widows and other dependants;
3.3 Engage and pay fees to professional and technical advisers/consultants to assist in the work of the Network;
3.4 Bring together in conference and work in liaison with representatives of voluntary organisations, government departments, local and other statutory authorities and individuals;
3.5 Take out membership of such organisations as are considered to be in the interests of and compatible with the objects of the Society;
3.6 Promote and carry out or assist in promoting and carrying out research, surveys and investigations and, where considered appropriate, publish the results;
3.7 Arrange and provide for or join in arranging and providing for the holding of exhibitions, meetings, lectures, classes, seminars and training courses;
3.8 Collect and disseminate information on all matters affecting the objects and exchange such information with other bodies having similar objects, whether in this country or overseas;
3.9 Purchase, take on lease or exchange, hire or otherwise, acquire any property and any rights and privileges considered appropriate for the promotion of the objects and construct, maintain and alter any buildings, considered appropriate for the work of the Network;
3.10 Make regulations for the management of any property which may be so acquired;
3.11 Sell, let, grant securities over, dispose of or turn to account, all or any of the property or assets of the Network;
3.12 Borrow or raise money for the objects and accept gifts in such terms and on such security as shall be deemed to be appropriate;
3.13 Raise funds and invite and receive contributions from any person or persons by way of subscription or otherwise;
3.14 Invest the funds of the Network not immediately required for the objects in or upon such investments, securities or property as may be thought fit, subject nevertheless to such conditions (if any) as may at the time be imposed or required by law; and
3.15 Do all such other lawful things as are incidental or conducive to the attainment of the objects.
4. Membership
There are two forms NCCNet membership. Individual Membership and Centre Membership. Centre membership, in addition to individual membership is required because it is a centre or institution allowing local patient data to be used in research or audit. Each centre will have local representation for the NCCNet.
4.1 Individual Membership
Pre-requisites for individual membership are:
4.1.1 Applicants are clinicians, scientists, researchers employed within institutions or organisations supporting the management of brain injured patients.
4.2 Centre Membership
Pre-requisites for centre membership are the same as the criteria for individual membership and:
4.2.1 Must contribute data to ongoing projects.
Details of membership benefits can be found in appendix I
4.3 Annual Subscription
The annual subscriptions payable by Members shall be fixed at each annual general meeting of the network having regard to any recommendation made by the Executive Committee. Any member who has not paid an annual subscription within three months of the renewal date will be removed from membership. They may reapply for membership in the current manner. The method of payment shall be determined by the Executive Committee.
5. Termination of Membership
The Executive Committee shall have the right for good and sufficient reason to terminate the Membership of any person at any time. It shall be considered good and sufficient reason for the purposes of this clause that the Member no longer contributes to the aims of the Network.
6. The Executive Committee
6.1 With the exception of those powers which are specifically stated in this operations strategy to be exercisable by the Members, the management and control of the Network shall be undertaken by the Executive Committee whose duty it shall be to fulfil the objects of the network (subject to any conditions imposed from time to time by the network in general meeting) and to provide for the administrative management and control of the affairs and property of the Network.
6.2 The Executive Committee are authorised and shall have power to take any decisions and enter into policy or business arrangements on behalf of the Network at its own discretion where any matter affecting the Network requires attention before the next general meeting.
6.3 The Executive Committee shall comprise the Chairman, Secretary, Treasurer, Database coordinator, Project Steering Group Lead and up to two Members elected from the membership of the Network.
6.4 Any casual vacancy arising between General Meetings may be filled by the Executive Committee. The new committee member's position must be ratified by the Network at the next General meeting.
6.5 The proceedings of the Executive Committee shall not be invalidated by any failure to effect or any defect in the election, appointment, co-option or qualification of any Member.
6.6 The Executive Committee may co-opt members of the Network for the purpose of conducting specific areas of business. At no time shall the number of co-opted members exceed the number of Ordinary Members. Co-opted members shall not have the right to vote at meetings of the Executive Committee.
6.7 The Network may allocate specific roles to individual members as may be necessary from time to time to conduct the business of the Network. Such roles will include, but not be limited to, areas such as education, training, scientific affairs, publicity and communication.
6.8 The Executive Committee may appoint such special or standing committees or sub-committees as may be considered appropriate and shall determine their respective terms of reference, powers, duration and composition. All acts and proceedings of such special or standing committees or sub-committees shall be reported back to the Executive Committee as soon as possible.
6.9 The Executive Committee shall have power to discuss affiliation of the Network with other learned bodies having related aims, but shall not effect any such affiliation without the authority of the Network in general meeting.
6.10 The Executive Committee shall appoint and fix the remuneration of such staff as may in its opinion be appropriate, save that paid staff shall not be members of the Executive Committee.
Executive Officers
6.11 The Chairman, who shall hold office for a period of two years or, if earlier, until he or she resigns or is otherwise removed. No person shall normally serve more than one term as Chairman, unless the continuation of a further term of up to two years is agreed by the membership to be in the interests of the advancement of the Network. The Chairmans duties shall include the outside representation of the Network and its interests, the general direction of the affairs of the Network, chairing the meetings of Executive Committee and chairing the Annual General Meetings of the Network.
6.12 The Secretary, who shall hold office for a period of three years or, if earlier, until he or she resigns or is otherwise removed. The Honorary Secretary may be re-elected to a second term of office but no person shall serve more than two successive terms as Honorary Secretary. The Honorary Secretary's duties shall include coordinating Network meetings and general meetings, dealing with correspondence on behalf of the Network, maintaining lists of Members and assisting the Chairman in the performance of his or her duties.
6.13 The Treasurer, who shall hold office for three years, or if earlier, until he or she resigns or is otherwise removed. The Treasurer may be re-elected to a second term of office but no person shall serve more than two successive terms as Treasurer. The Treasurer's duties shall include keeping a record of all monies paid and received by the Network, arranging for the auditing of accounts (in the future) and their presentation to the annual general meeting, advising the Executive Committee and the Members generally in matters relating to the financial affairs of the Network and reinvesting surplus funds on behalf of the Network.
6.14 Database Coordinator who shall hold office for three years, or if earlier, until he or she resigns or is otherwise removed. The Database Coordinator may be re-elected to a second term of office but no person shall serve more than two successive terms as Database Coordinator. The Database Coordinators duties shall include the development of any NCCNet database, liaison with external bodies developing databases (e.g. BrainIT, ICNARC). At the AGM developments will be presented to the Executive Committee and Members.
6.15 Project Steering Group Lead who shall hold office for three years, or if earlier, until he or she resigns or is otherwise removed The Project Steering Group Lead may be re-elected to a second term of office but no person shall serve more than two successive terms as Project Steering Group Lead. The Project Steering Group Leads duties shall include Project design, grant application, Ethical approval, Project supervision and Publication. At the AGM developments will be presented to the Executive Committee and Members.
6.16 The foregoing references to terms of office are without prejudice to the right of any Executive Officer to resign office at any time on giving not less than 14 days' prior written notice to the Council, or to the right of the Society in general meeting to remove any Executive Officer from office by means of a simple majority of votes cast to that effect.
Members of the Executive Committee
6.17 Members of the Executive Committee shall hold office for three years, or if earlier, until he or she resigns or is otherwise removed. Executive Committee members may be re-elected to a second three year term of office. For a member who is initially co-opted on to the Executive Committee the three year period shall commence from the General Meeting at which that co-opted Executive Committee members position is ratified.
6.18 Following a second consecutive term, an Executive Committee Member must leave office but he/she may be re-elected as an Executive Committee Member after a minimum period of one year.
6.19 The foregoing references to terms of office are without prejudice to the right of any Members of Council to resign office at any time on giving not less than 14 days' prior written notice to the Council, or to the right of the Society in general meeting to remove any Members of Council from office by means of a simple majority of votes cast to that effect.
7. Nomination and Election of Executive Committee
Executive Officers
7.1 Members of the Council who have served for at least one year shall be eligible to serve as Secretary or Treasurer and those who have served for at least two years shall be eligible to serve as Chairman. Any nomination of a Council Member for appointment as an Executive Officer shall be valid only if received by the Secretary not later than 14 days before the date of the meeting of Executive Committee prior to the Annual General Meeting of the Network. The nomination must be made in writing and proposed by two members of the Executive Committee and accompanied by the written consent of the Executive Committee Member so nominated to stand for election. A member of Executive Committee may not nominate himself or herself. Should nominations exceed vacancies, election shall be by ballot of the Council.
Qualifications for Executive Committee Membership
7.2 Full Members of the Society shall be eligible to serve as Members of the Executive Committee. Nominations for appointment as a Member of the Executive Committee shall be requested by the Secretary on the behalf of the Executive Committee. Nominations will be valid only if made in writing to the Secretary by two Members and accompanied by the written consent of the Member so nominated to stand for election. A Member may not nominate himself or herself. Should nominations exceed vacancies, election shall be by postal or electronic ballot of all Full Members of the Network.
8. General Meetings
8.1 An annual general meeting of the Network shall be held at such time (not more than fifteen months after the holding of the preceding annual general meeting) and at such place as the Executive Committee shall determine, but subject to the annual general meeting being held jointly with the Scientific Meeting unless there is good reason not to do so. At least one month's notice of the meeting shall be given in writing by the Honorary Secretary to each Member. At each annual general meeting, the business shall include the consideration of the annual report on the work of the Network, the approval of the accounts (to be audited in the future), the appointment of an auditor or auditors, motions submitted by the Executive Committee or by Members and the transaction of such other matters as may from time to time be appropriate.
8.2 The Executive Committee may at any time call an extraordinary general meeting of the Network.
8.3 The Secretary shall call an extraordinary general meeting of the Society if requested in writing to do so by at least three Full Members. Such request must be received at least three months before the earliest date proposed for such extraordinary general meeting and must be accompanied by a statement of the reasons for such request and an agenda for the meeting. An extraordinary general meeting need not be held on any of the dates specified in such request but must be held no later than four months (or, where this would result in the meeting being held in August, five months) from the date of receipt by the Honorary Secretary of the request.
9. Rules of Procedure at Meetings
9.1 Quorum. The quorum at a meeting of the Network shall be 15 Members. The quorum at a meeting of the Executive Committee shall be three members, of which two are Executive Officers.
9.2 Voting. Unless it is otherwise specified in this operational strategy, all questions arising at any meeting of the Network shall be decided by a simple majority of the votes cast. In the case of an equality of votes, the person taking the chair at the meeting shall have a second or casting vote. Questions arising at a meeting of the Executive Committee shall be decided by a simple majority of the votes cast and, in the case of an equality of votes, the Executive Chairman shall have a second or casting vote.
9.3 Minutes. The Executive Committee shall ensure that minutes are kept of all general meetings and of all meetings of the Executive Committee and sub-committees containing in each case, a note of those attending and the chair and a record of all proceedings, resolutions and decisions.
10. Finance
10.1 All funds raised by or on behalf of the Network shall be applied to further the objects of the Network and for no other purpose; the preceding provision shall not, however, prevent the payment in good faith of reasonable and proper remuneration to any employee of the Network and fees to professional and technical advisers or the repayment to members of the Executive Committee or any other committee or sub-committee.
10.2 The Treasurer shall keep proper accounting records and shall prepare the proper accounts annually which are necessary to comply with the requirements of all applicable legislation and at such other intervals as the Executive Committee may direct.
10.3 The accounts shall be examined or audited as the case may be at least once a year. (In the future this may be by the auditor or auditors in accordance with the current requirements in force under Charities Commission legislation).
10.4 In the future if the auditor appointed at the annual general meeting (or, if more than one auditor was appointed, all the auditors) ceased to hold that appointment during the period between annual general meetings, the Executive Committee shall have the power to appoint a replacement auditor or auditors, to hold office until the annual general meeting which next follows.
10.5 In the future an audited statement of the accounts for the last financial year shall be submitted by the Executive Committee to the annual general meeting.
10.6 In the future a bank account shall be opened in the name of the Network with such banks and/or building societies as the Executive Committee shall from time to time decide. The Executive Committee shall authorise in writing three members of the Executive Committee (one of whom shall be the Treasurer) to sign cheques on behalf of the Executive Committee. All cheques must be signed by not less than two of the four authorised signatories.
11. Alterations to the Operation Strategy
11.1 A resolution to alter this operation strategyshall not be valid unless:-
11.2 A simple majority of the votes cast by Full Members in relation to the resolution at a general meeting of the Network are in favour; and
11.3 Notice (setting out the terms of the proposed alteration) shall have been given to the Secretary at least two months before the meeting at which the alteration was proposed and such notice shall have been circulated to the Members with notice of the meeting.
11.4 After appropriate legal status has been sought no alteration shall be made which would have the effect of causing the Network to cease to be recognised by the Charities Commission, the Inland Revenue's Financial Intermediaries and Claims Office or such other offices as may replace those offices, as a charity.
12. Dissolution
12.1 If the Executive Committee, by a simple majority, decides at any time that on the ground of expense or otherwise it is necessary or advisable to dissolve the Network, it shall call a special general meeting of the Network, of which meeting not less than twenty one days' notice (stating the terms of the resolution to be proposed at the meeting) shall be given. If such decision is confirmed by a two-thirds majority of the votes cast in relation to the resolution at such meeting, the Executive Committee shall sell such of the assets of the Society as they may consider appropriate for the best price reasonably obtainable and settle the debts and liabilities of the Network. Any assets remaining after the satisfaction of such debts and liabilities shall be given or transferred to such other charitable organisations or organisations having objects similar to the objects of the Network as the Executive Committee may determine.
13. Applicable Law
The Neuro-Critical Network is a “non-profit” organisation. In the future appropriate legal status will be sought. At that time the interpretation of this operational strategy and the acting's of the Network shall be governed by the Law of England and Wales.
14. External Participation
Industry
14.1 Representatives from ‘Industry’ (Medical Device Companies, Pharmaceutical Companies, Profit Making Data Analysis Organisations) can become ‘Individual Members’ and can collaborate on projects with other members.
Public
14.2 The NCCNet website: www.nccnet.org.uk is the interface between the group and the general public. The web site will inform the general public of the key aims of the group, a synopsis of work currently in progress and provide access to the published results of the groups work. The website is not intended as an access point to a panel of experts in brain injury. Currently it is not possible, due to the voluntary nature of the group, to provide support for questions from the general public.
15. Joining or Creating a Project
15.1 The NCCNet is project based whereby any group (brought together and formed using the NCCNet web resources) with a project idea for assessment of STBI in neuro-intensive care can use this site as a research tool. Typically this involves the following steps:
i. To join an existing project see: www.nccnet.org.uk. Send an email to the designated project Principle Investigator to receive further information.
ii. To create your own project: submit a project outline to a member of the NCCNet
ProjectSteering Group Lead.
iii. Selected members of the NCCNetgroup steering committee can assist you, if need be, with the writing of a project proposal for obtaining grant funding from local or international level funding agencies. It is essential that funding be acquired to support project implementation and to allow the hiring of “Data Validation Staff” to help validate any data collected.
iv. Local ethics committee approval must be sought. A copy of the letter of approval
must be sent to the NCCNet ProjectSteering Group Lead before data recruitment
can commence. Any data collected as part of a NCCNetproject will become the joint property of the NCCNet group and may be used in post-hoc analyses by the group to further research into the improvement of methods for the management of brain injured patients.
Appendix I
Benefits of individual membership:
Name and email address added to NCCNet members on-line address book
Added to circulation list of information on group events, meetings and newsletters
Access to participate in project specific forum discussions
Benefits of Centre Membership:
As for individual membership plus link-person from each centre will have access to data collected by NCCNet.
Appendix II
Guidelines to Publication
Data is anonymous and it will not be possible to tell from which centre the data originated.
Data will be searchable by the project title which was responsible for the data to be collected.
As not all projects have funding which will allow data to be validated against original documentation, data will also be searchable upon whether it is "Validated" or "Not Validated".
Only "Validated" data should be used in analyses intended for publication or submission as an abstract to a local or international meeting.
Unvalidated data may be accessed and used in analyses intended for hypothesis generation, but may not be used in analyses intended for publication.
All research studies where the protocols for those studies have been approved by the sending institution’s local ethics committee must send a copy of the letter of approval to the ProjectSteering Group Lead.
Individual patients must not be identifiable from the data and the data collection protocols used must conform to the Helsinki Accords.
Before a completed analysis and manuscript is submitted for publication, the project lead must upload the MS and a summary spreadsheet containing the raw data used in the final analysis. This is required so that the steering group can confirm that only "Validated" data was used in the analysis.
Manuscripts and data must be submitted 3-weeks prior to journal submission. This is to allow members who have contributed data to the database to make comments to the project lead or to contribute to the analysis or manuscript should they wish. There is no requirement for the project lead to respond to any of the comments, but should a member make a significant contribution to the design, analysis or writing of the manuscript, than it is the
responsibility of the Project lead to ensure the member is a "Named Co-author" on the paper.
As part of the normal NCCNet review process. All data contributors will be invited to both review and to contribute towards any abstract or manuscript produced prior to submission to a meeting or for publication. Those data contributors who made a significant contribution to the design, analysis or writing of theabstract/manuscript will also be named co-authors on the abstract or manuscript. The "Vancouver Publication Guidelines" should be adhered to. Where there is uncertainty over whether a significant contribution was made by a given data contributor - a final decision willbe made by majority vote of the steering group. Attempts atpublishing analyses of data from the database without adhering to all the above criteria will result in the sending of a letter by the NCCNet steering group to the editor of the journal. The Project Leads access to the Neuro-Critical Care Network will be revoked.
It is the responsibility of the Steering group to make sure that: Project proposals are focused and detailed. Where similar analyses are already proposed, current proposers will be encouraged to work with the group first proposing the project. Project proposers complete the analysis and publish the results in a timely fashion.
APPENDIX III
Joint Authorship Guidelines
If any data from the joint database was used in the analyses which subsequently formed part of a published abstract or manuscript - reference to the "Neuro-Critical Care Network" must be given in the Authors citation. Eg: A. Author1, A. Author2...& the Neuro-Critical Care Network.
An appendix to the manuscript should list the centre Project Investigator who contributed data to the relevant analysis. A list can be provided by the Project Steering Group.
Attempts at publishing analyses of data without adhering to all the above criteria will result in the sending of a letter by the NCCNet project steering group to the editor of the journal and prevention of future access to the NCCNet.
