SCAN Skin Group Friday 1 st November 2013

Transcription

1 SCAN Skin Group Friday 1 st November 2013 Dermatology Seminar Room, Lauriston Buildings with videolinks to Oncology Seminar Room, Western General Hospital and Borders General Hospital. MINUTES Present Sandy Burnham Ewan Brown Lorna Bruce Val Doherty Sheena Dryden Alex Holme Alastair Law Sheena Mackenzie Marie Mathers (Chair) Neil Pryde Jonathon Rees In Attendance Mark Allardice Apologies Mark Butterworth Shirley Douglas-Keogh Simone Laube Pam Muir Lisa Naysmith Omar Quaba Jackie Stevenson Patient Representative Consultant Medical Oncologist, Edinburgh Cancer Centre Audit Manager, SCAN Clinical Nurse Specialist, NHS Lothian Consultant Oncologist, Edinburgh Cancer Centre Network Manager, SCAN SCAN Groups and Communications Co-ordinator Consultant Pathologist, NHS Lothian Consultant Dermatologist, NHS Fife Lead Cancer GP, NHS Fife Audit Facilitator, NHS Lothian Professor of Dermatology, University of Edinburgh Assistant Programme Manager, Strategic Planning & Modernisation Consultant Plastic Surgeon, NHS Lothian Service Manager, NHS Lothian Consultant Dermatologist, NHS Borders SCAN MDM Co-ordinator/Patient Tracker, NHS Lothian Consultant Plastic Surgeon, NHS Tayside Cancer Audit Facilitator, NHS Fife A full membership list can be found on Item Action 1 Introductions / Minutes The minutes of the meeting on 31/05/13 were approved. 2 SCAN Issues updated the Group on national and regional developments, including: SCAN Office, Pentland House, 47 Robb s Loan, Edinburgh EH14 1TY T: W: Sheena.mackenzie@nhslothian.scot.nhs.uk Page 1 of 5

2 Radiotherapy A report on radiotherapy demand and capacity work in South East Scotland will be completed and circulated (to SCAN Group Chairs and others with an interest) in the near future. The South East and West of Scotland Cancer Networks are currently providing support to the North of Scotland, where there are specific radiotherapy staffing issues. Transforming Care After Treatment (TCAT) SCAN will be submitting 6 proposals, including one relating to melanoma, in the first phase of the TCAT programme. Macmillan will review proposals from across Scotland at the end of November. The Scottish Government is seeking submissions from the NHS, industry, academia and the third sector for innovative ideas that will transform care outside hospitals. The deadline is 2 nd Dec 2013 and information has been circulated to SCAN Groups. Edinburgh Cancer Centre Reprovision NHS Lothian s Strategic Planning Department is leading work to plan the future accommodation requirements for the Cancer Centre. Regional boards will be involved in the planning process. CEL 30 (2012): Guidance for Safe Delivery of Systemic Anti Cancer Therapy Board self assessments are due to be submitted by the end of September and action plans will be developed to address any areas of non compliance. SEAT Demand and Capacity Event: 31 st Oct 2013 Dermatology was one of the specialities discussed at a recent regional meeting organised by the South East and Tayside Regional Planning Group (SEAT). A report on the event will be produced and Kate offered to circulate the sections relating to dermatology to SCAN Skin Group members. Action: to circulate sections of the report on the SEAT Demand and Capacity event relating to dermatology, when available. 3 Workplan Audit Melanoma comparative report 2012 Group members discussed the draft melanoma comparative audit report for Table 2: Breslow Depth It was noted that Fife continued to have a greater proportion of thicker lesions than other boards in 2012, although the percentages in Borders and Dumfries & Galloway also seemed to be rising. said late presentation appeared to be an issue affecting all tumour types in Fife and that Clive Preston, Fife s Lead Cancer Clinician, was liaising with public health locally about this. The Group discussed possible sources of support for carrying out Page 2 of 5

3 further analysis on the Breslow Depth data. Alex Holme said that projects funded by the Chief Scientist Office (CSO) received analytical support from ISD and that the deadline for the next round of applications was Jan offered to investigate another possible funding source. Action: to investigate potential source of funding to support further analysis of regional data on Breslow Depth. Table 6: Method of diagnosis Alex Holme advised the Group that he was looking at whether punch biopsies have an impact on 5-year survival and/or 5-year disease-free survival (compared with incisional or excision biopsies). Table 7a: Time from Biopsy to Issue of Pathology Report Jon Pullman noted that there were some changes to make to this table. It was agreed that, once these changes had been made, the revised version should be forwarded to Marie Mathers to check the Lothian data in more detail. Action: to update Table 7a and forward the revised version to Marie Mathers to check the Lothian data in more detail. Marie Mathers Table 8: Mitotic Rate It was noted that mitotic rate is expected to be included in the melanoma QPIs and agreed that should circulate a letter to the Pathologists about this once the QPIs have been finalised to highlight which elements of QPIs are relevant to pathology and request that all melanoma pathology reports use a standardised proforma that includes all elements of the pathology dataset. Action: Once melanoma QPIs published, to circulate a letter to the Pathologists. Table 10: Pathological T Stage agreed to flag up to Pathology leads in Fife that levels of pathological T stage reporting in Fife are relatively low. (NB A request for inclusion of pathological T stage in all melanoma pathology reports will be included in the pathology letter to be written post QPI launch.) Action: to flag up to Pathology leads in Fife that levels of pathological T stage reporting in Fife are relatively low. Table 13a: Wait in Days for Second Stage of Treatment Following Diagnosis by Excision Biopsy It was noted that, in the absence of any national guidelines on timescales, the analysis had focused on waits of 90 days or more. Group members agreed that 90 days was an excessive time for patients to wait and Sheena Dryden noted that a cut off point of 60 days was being considered for QPIs. It was agreed that an action point should be added to the report to conduct a detailed examination of patients waiting more than 56 days. Action: and Jackie Stevenson to undertake Page 3 of 5

4 analysis of all patients waiting >56 days from time of diagnostic biopsy to definitive treatment. ( for Lothian, Borders and to contact Dumfries & Galloway, Jackie Stevenson for Fife.) Jackie Stevenson It was noted that 11 private patients had been excluded from the table and agreed that there should also be an action point to attempt to obtain their data. Action: Attempt to attain data for the 11 patients treated in private sector. Table 17: Contact with Cancer Nurse Specialist It was agreed that Dumfries & Galloway should be asked to check whether patients being sent to Glasgow contributed to the low percentage of patients having contact with a CNS. Action: to ask Dumfries & Galloway to check whether patients being sent to Glasgow contributed to the low percentage of patients having contact with a CNS. It was also agreed that ongoing work by Sheena Dryden to establish support links for patients in Borders and Dumfries & Galloway should be added to the report as an action point: Action: Sheena Dryden to continue to work to establish support links for patients in Borders and Dumfries & Galloway. Action: and to revise the draft comparative melanoma report for 2012 as discussed. Sheena Dryden Quality Performance Indicators (QPIs) Sheena Dryden and Alex Holme reported that the Melanoma QPI Development Group had held a second meeting and a set of draft QPIs would be published for consultation in the near future. Kate Macdonald emphasised that the associated dataset and definitions documentation would also require careful review. advised the group that additional patient experience QPIs were designed to demonstrate patients input into service improvement and that use of the toolkit which had been developed was optional. Kate also said that the question of whether there should be QPIs for clinical trials was under discussion. Excision of Malignant Melanomas by GPs in NHS Fife in 2012 The group noted the paper on excision of malignant melanomas by GPs in NHS Fife in 2012 and in particular that there had been an improvement in documenting clinical diagnosis. said that she would be providing feedback from the audit to GP colleagues in Fife. Action: to provide feedback from the audit of Excision of Malignant Melanomas by GPs in Fife in 2012 to GP colleagues. Page 4 of 5

5 Oncology Trials The Group noted the paper from Ewan Brown on current oncology trials in Edinburgh and Glasgow. Action: Ewan Brown to contact Dundee and Aberdeen for update re trials they are registered for. to forward paper on Oncology trials to all skin cancer MDM leads in Scotland. Ewan Brown SCAN Website Sheena Mackenzie reported that the SCAN website had been commended in the BMA Patient Information Awards for 2012 and said this award recognised the efforts of clinical colleagues across the region to produce and review material on the site. Sheena M advised the group that revised versions of the skin cancer leaflets had been ratified by NHS Lothian s Communications team, a single version of each leaflet would be used across the region and the skin section of the website would be amended accordingly. Sheena M thanked colleagues who had submitted information for the Meet the Team section and said that, to meet data protection requirements, colleagues submitting material for publication on the website would be asked to sign a consent form. 4 Forthcoming meetings The Group noted the list of forthcoming meetings which had been circulated with the papers. 5 Any other business Alex Holme advised the Group that the Scottish Government was co-ordinating a review to streamline GP referral processes for skin cancer. said that the British Association of Dermatologists (BAD) and Cancer Research UK had produced some resources to help GPs to identify malignant skin lesions (see attached). 5 Dates of future meetings 21 st March 2014 (note change from date proposed at meeting) 13 th June st October 2014 All meetings will start at 8.30am. Venues: Dermatology Seminar Room, Lauriston Buildings and/or Oncology Seminar Room, Western General Hospital with videolink to Borders General Hospital. Page 5 of 5