Christie NHS foundation Trust Administration Department 2 Level 3, Room 6 Time: 2-4pm. Consultant & Pathway Director CMFT

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1 Head and Neck Pathway Bard 3 rd September Minutes f Meeting Christie NHS fundatin Trust Administratin Department 2 Level 3, Rm 6 Time: 2-4pm Attendance Representatin Gillian Hall Cnsultant & Pathway Directr CMFT Francis Asctt SLT, CMFT Suzi Bningtn Cnsultant Radilgist, Christie FT Mr Andrew Baldwin Surgen, PAT Mazhar Iqbal Maxill Facial Surgen, UHSM Maria Rund Macmillan Head & Neck CNS, PAT Chetan Katre Cnsultant, PAT Miss L. Ramamurthy Thyrid Surgen, Stckprt FT Helen Dran Cnsultant General Surgen, SRFT Miss Susi Penney Cnsultant ENT surgen, Tameside FT Kathleen Mais Head and Neck Nurse Clinician, Christie Cath Camern Head and Neck CNS, WWL Aplgies Prfessr Jarrd Hmer Cnsultant, CMFT Mr Manu Patel Cnsultant Oral Maxill Facial Surgen, ECFT Kate Garcez Onclgist, Christie FT Kate Hindley CNS, SRFT Mr V Pthula Cnsultant Head and neck surgen, WWL Philip Bryce CNS, CMFT David Makin Patient Lead Debbie Ellitt Thyrid CNS, Christie FT Katie Fster Dietician SRFT In attendance Tahier Kazim, Macmillan Head and Neck Prject Manager Stckprt Hannah Kulbacki, ENT CNS WWL 1

2 Agenda Item 1. Aplgies Actin Aplgies were nted and Welcme t Kathleen Mias, Nurse Clinician at Christie 2. Minutes frm the last meeting Cnfirmed as an accurate accunt and true descriptin f the meeting. 3. Matters Arising frm the frmer netwrk meeting TR, n further feedback has been received frm members this will be fllwed and review in March WW referral frm, survey is currently ut HN received 4 respnses will reprt the finding at the next meeting. Tariffs issue was raised at the last meeting, Pennine has shared their current tariff and the negtiatin which has taken place with CMFT and UHSM. GH feedback t the members if there are tariff discrepancies which have an impact n patient care members need t raise at this bard. MI suggested will share the infrmatin f UHSM hwever they have nt released figures despite requests. Successful utcme f Pennine challenge culd be used as a drive t try t btain these 4. Annual plan and reprt GH described in detail the bjectives f the annual plan belw; Objective 1: Imprve all aspects f data recrding fr Head and Neck by March This is t be achieved by ; Assessing the current practice f data flw in MDTs and identify new mdels f cllectin and recrding t supprt Trusts and the Pathway Bard. Identify measures utside f the natinal requirements t prvide mre up t date lcal intelligence t gain additinal understanding f the current services. T extract data frm current systems t assess current stage f disease at presentatin yearly t allw assessment f impact f educatinal prgram with intentin that disease is picked up earlier. Members agreed t use CMFT template develped by SP t d a shrt audit f MDTs t access the quality f infrmatin shared frm diagnstic centres t surgical MDT sites. The DAHNO minimum data set will be used t access the quality and all items are included in the CMFT template. AB, MI and SP vlunteered t supprt bjective 1. Members have identified LS, % delayed peratins and theatre utilisatin, TNM staging at presentatin as additinal items f data t cllect that will prvide further infrmatin n current service. TNM staging at presentatin can be used as a benchmark against which t assess the impact f educatinal prgrammes aimed at early detectin and diagnsis. HN t share the plan and template with vlunteers, upn agreement f the plan HN will attend ne MDT per surgical site t map data flw and quality. 2

3 Objective 2: Ensure patient is able t fully access all aspects f care pre, during and pst treatment and is fully infrmed by 31 st f March Map current service prvisin with respect t CNS, dieticians, speech and language and dental care frm diagnsis thrugh t fllw-up t identify gaps and inequities. - T assess rganisatin f the abve services, ease f crss referral and flw f infrmatin. - T assess availability, quality f patient infrmatin and apprpriateness - T fully engage with the Living with and Beynd and Palliative Care service mapping t ensure full assessment f Head and Neck delivery f care. The Living with and Beynd Cancer Bard are mapping the Natinal Cancer Survivrship Initiative survivrship recvery mdel using a tl, bard members agreed the CNS t cmplete n behalf f Head and Neck pathway bard. GH prpsed a mapping event f CNS, Dietetics, speech therapist and dental t map the prcess and interactins with patient in rder t highlight the barriers and share gd practice. CNS t cmplete the LW&BC mapping n behalf f Head and Neck HN t arrange a mapping within the first tw weeks in Octber and invite the listed disciplines. 5. Perfrmance - 2 week wait target: GH presented waits reprted in Quarter 1 f 2014 and cnfirmed will sn have access t mre up t date data fr 31 and 62 day waits by prvider and pathway. - Recrding metastatic surgery as primary treatment query frm Wythenshawe: GH highlighted the matter raised by Wythenshawe patients with tnsil cancer r unknwn primary wh need de-bulking neck dissectin fllwed by nnsurgical treatment. They may nt have surgery t the primary site at the time f neck dissectin fr a number f reasns; the tnsillectmy may have been carried ut as part f the diagnstic prcess and there is n residual primary disease (in which case the tnsillectmy cunts a first treatment); r the primary may be deemed t be best treated nly with nn-surgical treatment; r there may n be a detectable primary. Pennine and CMFT have been cunting surgery f the neck as the first definitive treatment with therapeutic intent which clinically seems entirely reasnable. The bard agreed that in this situatin, the neck dissectin shuld be cnsidered as the first treatment with therapeutic intent (which is a better ptin fr the patient rather than neck salvage after therapy). It is imprtant t check fr a diagnstic tnsillectmy as this culd cunt as first definitive treatment. GH t write t Chair f Directr f Operatins in Greater Manchester t give guidance. GH t draft letter t DOH raising the impact f patient care n 18ww guidance. GH t write t the Chair f the Directr f Operatins t prvide the abve advance and draft a letter t the DOH fr sign ff by highlighting the apprach t 18 week wait guidelines t neck cancers. 3

4 6. Audit and Research - Clinical Trails Reprt GH shared the current clinical trials data and the H&N are in line with the prjected target fr this financial year. GH has identified a list f clinical trials pened that are nt n the list t discuss with the research lead (JH). - Dental service feedback GH gave a lecture t a grup f GDPs in July t intrduce and its bjectives, t discuss the imprtance f early detectin/diagnsis and t seek ideas as t what educatinal needs GDPs in primary care have. There is perceived educatinal need in hw t refer / t wh and by what mechanism as well as a need fr updates n suspicius lesins. - CNS feedback based n a survey mnkey t identify challenges and psitives f the rle f CNS. Challenges are the areas will be fcused t address at the mapping meeting. 7. Peer review Thyrid MDT surgical numbers GH has request fr updated numbers f surgens and has received sme respnses. GH will attend a Thyrid MDT meeting / the annual business meeting t request this infrmatin t meet peer review requirements. Attendance will als need t be discussed. 8. update - User invlvement strategy shared with all members f the bard any feedback need t be sent t HN - Annual Plan synpses f all pathway bards shared fr infrmatin. 9. Clinical Educatin event prpsal fr discussin Pathway members have identified early preventin and detectin as the fcus area fr an educatin event, is currently develping an educatin plan in partnership with a number f ther pathway bards. The draft specificatin belw was develped in partnership with CCG Cancer Lead in Greater Manchester. Tp 5 tips fr query cancer patients - 30 minute presentatin excluding Q&A - Present n mre than tw case studies - Open questins t delegates n what actins they wuld take fr discussin - Share tp five things fr query cancer - Avid specialist clinical details fcus presentatin n general practice presentatins. 10. Date f the next meeting 6 th Nvember pm UHSM, Educatin and Research Centre, Seminar 7 4

5 13 th January pm Seminar Rm 1, Level 1, May Building SRFT 5

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