GYNAECOLOGY NETWORK SITE SPECIFIC GROUP ANNUAL REPORT. April March 2012

Transcription

1 GYNAECOLOGY NETWORK SITE SPECIFIC GROUP ANNUAL REPORT April March 2012 Version 2012v1.0F Agreed by: Mr Ram Athavale, Consultant Gynae-Oncologist, University Hospitals Coventry and Warwickshire, Chair, Arden Gynaecology NSSG Date: March 2012 Agreed by: Arden Cancer Network Gynaecology NSSG members Date: 6 March 2012 Agreed by: Arden Cancer Network Eecutive Group members, (with delegated authority by the Network Board and Network Chair as agreed at the Board Meeting on 14 th December 2009) with inclusion of approval of PCT Leads and Trust Lead Cancer Clinicians. Date: September 2012 Status: Final Version: 2012v1.0F Publication Date: September 2012 Epiry Date: March

2 CONTENTS 1.0 CONTEXT & INTRODUCTION OVERVIEW MEETING DATES AND ATTENDANCE LIST ANNUAL REVIEW FOR CHAIR OF THE ARDEN CANCER NETWORK GYNAECOLOGY SITE SPECIFIC GROUP ACTIVITY OVERVIEW CANCER WAITING TIMES NETWORK AUDIT CLINICAL LINES OF ENQUIRY PATIENT & CARERS FEEDBACK AND INVOLVEMENT CLINICAL GUIDELINES ACHIEVEMENTS AGAINST WORK PROGRAMME TO INFORM YEAR SERVICE DELIVER PLAN

3 Peer Review Measures Measure 11-1C-101e.5,6 Measure 11-1C-102e...12 Measure 11-1C-104e.9 Measure 11-1C-105e 11 Measure 11-1C-107e and 11-1A-204e to 11-1A-209A..12 3

4 1.0 CONTEXT & INTRODUCTION The report relates to the period 1 st April 2011 to 31 st March Dr Ram Athavale, Consultant Gynaecologist and MDT Lead at UHCW is the Chair of the Arden Cancer Network Gynaecology Network Site Specific Group. Professor Chris Poole was appointed Vice Chair on 21 st June There is representation from all Trust sites at the NSSG and from all professional groups. During the defined period the team welcomed a Peer Review visit and received a positive report which reflected the hard work and commitment to the delivery of high quality cancer services across the Network. The NSSG members reviewed and approved the Network Gynae-oncology clinical guidelines and the reconfiguration of services has enabled IOG compliance for the Network. 2.0 OVERVIEW ACHIEVEMENTS Gynae Oncologist<appt (to commence Summer 2012 Screening TAT greatly improved Laparoscopic surgery at UHCW, GEH & SWFT New oncologist at SWFT Gynae onc nurse representation at national level Increased Gynae onc hours at GEH ACST attendance Funding for 2 nd Gynae CNS in Worcs approved HPV Triage Arden/Worcester combined Clinical Review Day VTE Prophylais poster CNS Participation in national launch of new Target patient booklet CONCERNS CNS vacancy at Warwick Radiology cover at each Trust BENEFITS Equitable workload distribution Patients receiving result letters in timely manner Oncology cross site cover Preparation for new nurse led follow up clinic Users actively involved in reviewing docs for CNSs NEXT STEPS Image guided brachytherapy to commence May 2012 Roll out of across Network VTE guidelines MDT working with colorectal for comple procedures Encourage enhanced recovery procedures and laparoscopy at all units Audit of FIGO staging 4

5 3.0 MEETING DATES AND ATTENDANCE LIST During this period the Gynaecology Network Site Specific Group met four times. Meeting Dates & Attendance: April 2011 March June2011 Ram Athavale, Consultant Gynae Oncologist, UHCW [Chair] Sylvia Hamilton, Cancer Service Redesign Manager, ACN Becky Whiteman, Associate Network Director, ACN Margaret Pearson, User Representative Sue Concannon, User Representative Paul Okojie, Consultant Gynaecologist, GEH Robert Jackson, Consultant Gynaecologist, Warwick Mr L Sant Cassia, Consultant Gynae Oncologist, UHCW Alison Duncan, Consultant Radiologist, UHCW Chris Poole, Professor Medical Oncology, UHCW Donna Halliman, Research Manager, Clinical Trials, UHCW Ruth Capewell, Gynae CNS, UHCW Kirsty Cottrell, Gynae CNS, UHCW 14 th December 2011 Ram Athavale, Consultant Gynae Oncologist, UHCW [Chair] Sylvia Hamilton, Cancer Service Redesign Manager, ACN Becky Whiteman, Associate Network Director, ACN Nawaz Walji, Consultant Oncologist, UHCW Joseph Uhiara, Consultant Gynaecologist, Redditch Paul Okojie, Consultant Gynaecologist, GEH Mark Dunderdale, Consultant Gynaecologist, UHCW Sue Concannon, User Representative Chris Poole, Professor Medical Oncology, UHCW Vicki Jones, Gynae CNS, UHCW Tina Sunderland, Gynae CNS, SWFT Ruth Capewell, CNS, UHCW Emma Seaton, CNS, GEH Sandeep Gill, Clinical Trials, ACRN Val Ross-Gilbertson, Hospital Based Co-ordinator, UHCW Alison Duncan, Consultant Radiologist, UHCW 6 th September 2011 Ram Athavale, Consultant Gynae Oncologist, UHCW [Chair] Sylvia Hamilton, Cancer Service Redesign Manager, ACN Becky Whiteman, Associate Network Director, ACN Nawaz Walji, Consultant Oncologist, UHCW Joseph Uhiara, Consultant Gynaecologist, Redditch Steve Ferryman, Consultant Histopathologist, UHCW Sue Concannon, User Representative Karl Olah, Consultant Gynaecologist, Warwick Chris Poole, Professor Medical Oncology, UHCW Val Robson, GP Cancer Lead, NHS Coventry Vicki Jones, Gynae CNS, UHCW Tina Sunderland, Gynae CNS, SWFT Kathleen Taylor, Colposcopy Nurse, SWFT 6 th March 2012 Ram Athavale, Consultant Gynaecologist, UHCW [Chair] Nawaz Walji, Consultant Clinical Oncologist, UHCW Vikki Jones, CNS, UHCW Ruth Capewell, CNS, UHCW Kirsty Cottrell, CNS, UHCW Robert Jackson, Consultant Gynaecologist, SWFT Joseph Uhiara, Consultant Gynaecologist, Redditch (pm only) Val Ross-Gilbertson, Cytology Manager, UHCW Chris Poole, Consultant Medical Oncologist, UHCW Alison Duncan, Consultant Radiologist, UHCW (pm only) Sarah Askew, WMCIU (pm only) Sylvia Hamilton, Cancer Services Redesign Manager, ACN Becky Whiteman, Nurse Director, ACN Mary White, Project Manager, Supporting Primary Care, ACN Georgios Iatropoulos, SpR Oncology, UHCW Three Counties Cancer Network Rob Gornall, Consultant Gynaecologist. Gloucester [3CCN Chair] Jayne Tyler, Clinical Trials, Worcester David Pickrell, Consultant Gynaecologist, Worcester 5

6 21/06/ /09/ /12/ /03/2012 NSSG Attendance Membership Name Role TOTAL Surgery Mr Ram Athavale/ Mr Mark Dunderdale/ Mr L Sant-Cassia Mr Paul Okojie Mr Joseph Uhiara Mr Karl Olah/Mr Robert Jackson Consutant Gynae Oncologist (Chair), UHCW Consultant Gynae- Oncologist, UHCW Consultant Gynaecologist, GEH Consultant Gynae Oncologist, Redditch Consultant Gynae Oncologist, SWFT CNS Vikki Jones/Ruth Capewell/Kirsty Cottrell Emma Seaton/Celine Boylan Tina Sunderland Nicky Plant CNS, UHCW CNS, GEH CNS, SWFT CNS, Redditch Oncology Prof Chris Poole Dr Nawaz Walji/Dr Mark Hocking Consultant Medical Oncologist Consultant Clinical Oncologist Radiology Dr Alison Duncan Consultant Radiologist 75 Pathology Dr Steve Ferryman Consultant Histopathologist 25 Research Donna Halliman/Sandeep Gill Research Manager, Clinical Trials Sister, UHCW 50 User Representatives Margaret Pearson Sue Concannon # Network Representatives Additional Becky Whiteman Sylvia Hamilton Dr Val Robson Kathleen Taylor Val Ross-Gilbertson Nurse Director, Arden Cancer Network Cancer Service Redesign Manager GP Cancer Lead, NHS Coventry Colposcopy Nurse, SWFT Hospital Based Co-ordinator (cervical screening) X # Left Trust

7 4.0 ANNUAL REVIEW FOR CHAIR OF THE ARDEN CANCER NETWORK GYNAECOLOGY SITE SPECIFIC GROUP This review of the NSSG Chair, Dr Ram Athavale, will take place on 12 June 2012 at UHCW and will be conducted by Dr Peter Handslip, Medical Director, who is a member of the Arden Cancer Network Board. This review is fully documented and can be found in the Office Gynaecology NSSG Peer Review folder. 5.0 ACTIVITY OVERVIEW Tabled below are numbers of new cancers diagnosed and treatment given across the network by MDTs within the period from 1 st April 2011 to 31 st March New Cancers Diagnosed SWGH UHCW* GEH WAHT** *the total figure at UHCW NHS Trust will include cases of shared care ** It should also be noted that data collated for WAHT refers to the whole of Worcester and not specifically to the Aleandra Hospital Redditch [i.e. the Arden element] 7

8 6.0 CANCER WAITING TIMES The Gynaecology NSSG Cancer Waiting Times is a standing agenda item and is reviewed at each meeting against the GFoCW standards: The NSSG members seek to identify solutions to highlighted issues and will review patient pathways to support the delivery of the waiting times standards when necessary. During the defined period, the NSSG noted an improved and sustained delivery of the standards across the Network and the performance eceeds the national performance against the targets. Copies of the meeting notes are available in the Portfolio of Evidence. GYNAE GEH South Warwickshire Hospitals FT NHS Trust University Hospitals Coventry & Warwickshire NHS Trust Worcestershire Acute Hospitals NHS Trust Arden Cancer Network Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 14 day (93) day FT (96) day ST (94-98) day (85) d screen upgrade (n/a )

9 7.0 NETWORK AUDIT A programme of planned future audits can be found in the 3 year Service Delivery Plan Incorporating the Work Programme. The two audits below were discussed at the meeting held in December It was agreed to revisit the Vulval audit in December A Patient satisfaction audit proforma has been discussed with the service users on the group and an audit will also be presented in December CLINICAL LINES OF ENQUIRY The lines of enquiry aim to identify some key aspects that reflect the quality of gynaecological cancer services. The data below has been provided by West Midlands Cancer Registry (WMCIU) in relation to services provided by Arden Cancer Network. 1. Surgical caseload Gynae-oncology surgeons caseload of at least 15 ovarian cancer cases per annum Ovarian Cancer Surgical Caseload: Number of Consultants with Low and High Caseloads, by Trust Based on 2008 diagnoses with relevant surgery (obtained using NCDR heslink table) Trust Number of Consultants < cases cases Total Consultant Workloads for Trust Consultants RKB UHCW NHS TRUST RWP WAH NHS TRUST Cancer Network Number of Consultants < 15 cases 15+ cases Total N12 Arden England Gynaecological Oncology Staging FIGO The matter of missing staging has been addressed within the Network between available and an audit will take place within the net year. N12 Arden CN Stage Cases Cases Missing Staged Total

10 3. Surgical Enhanced Recovery/Length of Stay Trust (Specialist Centres) Number of Stays Total Duratio n Med ian Stay Electiv e 4 days (Median) Elective Stays Eceeding Elective > 4 6 days (Upper Quartile) Elective > 6 England (Specialist Centres) 3,197 18, , RKB UHCW NHS Trust Trust (Non-Specialist Centres) Number of Stays Total Duration Median Stay Elective Elective Stays Eceeding 4 days (Median) Elective > 4 5 days (Upper Quartile) Elective > 5 England (Non-Specialist Centres) 1,948 9, RJC S W NHS Foundation Trust RLT GEHl NHS Trust RWP WAH NHS Trust Survival Relative survival by cancer network, Arden Cancer Network Arden Cancer Network Relative Survival LCI UCI Registry Uterine 1-Year WM Uterine 2 - Year WM Uterine 5 - Year WM Cervical 1 - Year WM Cervical 2 - Year WM Cervical 5 - Year WM Ovarian 1 - Year WM Ovarian 2 - Year WM Ovarian 5 - Year WM 10

11 5. Clinical Nurse Specialists Cancer Network Provider ARDEN RKB UHCW Question No Q20 Q21 Q24 Cancer Type Gynaecological Number of responses 69 Patient given the name of the CNS in charge of their care Patient finds it easy to contact their CNS 74.0 Last time seen, time spent with CNS about right 94.2 RESEARCH The NSSG members discuss the Gynaecology clinical trials at each meeting as a standard agenda item and copies of meeting notes can be found in the Portfolio of Evidence. The portfolio was discussed in June 2011 and copies of the signed NSSG and Trust trials portfolios sign off sheets can be found in the office Peer Review Evidence folder. The NSSG will agree a common approach to research and development working with the Arden Cancer Research Network, participating in nationally recognised studies whenever possible. The trials portfolio will be kept under review to ensure that: There is equity of access to trials across the Arden Cancer Network There is equity of funding across the Arden Cancer Network Barriers to recruitment are minimised Good practice is shared. 9.0 PATIENT & CARERS FEEDBACK AND INVOLVEMENT Following the introduction of new Peer Review Measures for User Groups, the Network User Partnership Facilitator has reconfigured the structure of the group in order to provide a more robust and effective service. Our service users continue to play an important role within the Network Site Specific and Cross Cutting groups and we now have representation on each of the sites. We have recently recruited several new members, who are currently being inducted into the various groups, and where identified a buddy has been allocated to them. To comply with our User Partnership Peer Review measures we require at least two service users per group and we have almost achieved this. The service user representatives have stated that the information and strategy days have been very useful and provided them with a much clearer insight into the forthcoming work programmes. 11

12 The Network Facilitator continues to seek further training opportunities for group members in order to support them in the planning process for service delivery and evaluation CLINICAL GUIDELINES The Gynaecology members revised and agreed the Gynaecology Guidelines (inclusive of imaging and pathology guidelines) in March 2012 and these can be found in the Office Portfolio of Evidence ACHIEVEMENTS AGAINST WORK PROGRAMME TO INFORM YEAR SERVICE DELIVER PLAN Objective Introduce enhanced recovery procedures into Gynae services in all Trusts Implementation of IOG Record Clinical Lines of Enquiry Cervical Screening: TAT reporting HPV vaccination and testing Maintain the delivery of CWT standards: 14, 31 and 62 day Ensure user involvement at NSSG Level Maintain and increase clinical trial recruitment Network wide audit Complete Annual Report Complete Constitution NAEDI increase awareness of early signs and symptoms of cancer. Update Clinical Guidelines Service Improvements: Image Guided Brachytherapy VTE Guidelines Status Partially achieved: UHCW and GEH Achieved: SMDT is established and functions well Achieved Achieved: After early setbacks now meets the target regularly. Implemented September 2011 Achieved: Discussed at each NSSG. Occasional slippage on 62 days but constantly under review Two users assigned and standard item on NSSG agenda Achieved: Discussed at each NSSG. Portfolio reviewed on regular basis Achieved: Initial patients audited. Audit to be repeated in December 2012 Achieved Achieved: New Arden Army character General Girlibits. Signs and symptoms promoted at all health and well being events. Achieved: All departments now updated inc NICE Ovarian guidelines Partially achieved: Resources in place. To commence May 2012 National Poster Abstract submitted. Follow up that guidance has been implemented in Trusts December