SCAN Colorectal Group

Transcription

1 SCAN Colorectal Group Friday 9 th August pm Oncology Seminar Room, WGH with videolink to Dumfries Present Lorna Bruce Sarah Buchan Paul Fineron Martin Keith Christina Lilley Joyce Livingston Sheena Mackenzie James Mander (Chair) Karol Pal Hamish Phillips Apologies Ibrahim Amin Angie Balfour Lesley Dawson Stephen Glancy Anne Haston Mohammad Hosny Maureen Lamb Kate Macdonald Maureen Morgan Lynn Smith Ali Stewart Satheesh Yalamarthi MINUTES SCAN Audit Manager SCAN Audit Facilitator Consultant Histopathologist, NHS Lothian Senior Cancer Information Officer, NHS D&G SCAN Modernisation Manager Colorectal CNS, NHS Lothian SCAN Groups and Communications Co-ordinator Consultant Colorectal Surgeon, NHS Lothian Consultant Surgeon, NHS Borders Clinical Oncologist, ECC Consultant Surgeon, NHS Fife ERAS Nurse Practitioner, NHS Lothian Consultant Oncologist, ECC Consultant Radiologist, NHS Lothian CNS, NHS Lothian Consultant General & Colorectal Surgeon, NHS Borders Cancer Audit Facilitator, NHS Fife Network Manager, SCAN CNS, NHS Fife Cancer Audit Facilitator, NHS Borders Colorectal Cancer Co-ordinator, NHS Lothian Consultant Surgeon, NHS Fife A full membership list is available on HUwww.scan.scot.nhs.ukU Item 1BAction 1 0BIntroductions, apologies, minutes The minutes of the meeting on 7 th December 2012 were approved. Fife nurse-led follow-up protocol As agreed at the last meeting, a copy of this protocol had been circulated for information. James Mander noted that patients in Fife who undergo curative resection for colorectal cancer are followed up for 5 years, compared with 3 or 4 years in Lothian. No Fife clinicians were present to provide their rationale for a 5-year follow-up period and Mr Mander suggested that this difference in practice would be worth exploring. Referral guidelines for colorectal cancer James Mander advised the group that the revised national referral guidelines for colorectal cancer would be circulated in the near future and there were no substantial SCAN Office, Pentland House, 47 Robb s Loan, Edinburgh EH14 1TY Tel: E: sheena.mackenzie@nhslothian.scot.nhs.uk W: Page 1 of 5

2 changes compared with the previous version. 2 SCAN Issues Christina Lilley gave an update on regional and national developments. Detect Cancer Early (DCE) There are plans for repeats of the bowel cancer screening TV campaign during Sept/Oct 2013 and a further burst of media activity late Jan/mid Feb A national group is considering the order in which the DCE initiative might be rolled out beyond the initial three tumour types (lung, colorectal and breast) and has asked the SCAN Group Chairs to contribute to the scoring process. As yet no further national funding has been committed for the programme. Transforming Care After Treatment (TCAT) Macmillan Cancer Support will be providing 5 million over 5 years to support clinical teams and other partners to review, redesign and test new approaches to providing support for patients who have completed their initial treatment for cancer. Information has been circulated to all SCAN tumour-specific group members about the process and timescale for submitting development proposals. Macmillan anticipates that a maximum of 10 bids from across Scotland will be supported in the first phase of the initiative. The National Cancer Survivorship Initiative (NCSI) has produced a report Living with and Beyond Cancer: Taking Action to Improve Outcomes which may be of interest ( Quality Performance Indicators (QPIs) Work to develop reporting and governance processes for QPIs is ongoing. The format of reports will be standardised, target dates for reporting will need to be aligned nationally and key individuals will need to be identified to progress actions. The QPI governance process is to be tested using breast cancer data. Following a request from the Deputy Chief Medical Officer, SCAN health boards have confirmed that processes are in place locally for QPI data collection. NHS Lothian plans to implement a TRAK-based MDM module for all tumour groups over the next 18 months. The generic patient experience QPIs are expected to be available for consultation shortly. A toolkit is being developed to help services carry out the annual patient experience work required by the patient experience QPIs. CEL (2012) 30: (Revised) Guidance for the Safe Administration of Cytotoxic Chemotherapy Health boards need to complete audits against the CEL by September In SCAN this work will be co-ordinated by the regional Chemotherapy Group and boards have already undertaken preliminary audits to identify key areas of risk. The CEL requires each board to identify a chemotherapy lead who will have the main responsibility for safe delivery of chemotherapy in their board. Page 2 of 5

3 New Chair for Regional Cancer Planning Group (RCPG) Tracey Gillies, Associate Divisional Medical Director for NHS Lothian, has been appointed RCPG Chair, replacing Dr Angus Cameron, Medical Director for NHS Dumfries & Galloway. New SCAN Modernisation Manager Christina Lilley has been appointed to provide support for SCAN projects and will be looking initially at radiotherapy capacity and chemotherapy repatriation. Individual Patient Treatment Requests (IPTRs) The Lothian Medicines Management Committee has developed an updated policy for IPTRs which includes contacts for all SCAN boards. Patient information will be developed to ensure informed consent. 24-hour Chemotherapy Helpline the service was launched as a pilot in Lothian on 10th June to give patients at risk of developing side effects from their cancer treatment 24/7 access to advice. Specially trained helpline advisers at NHS24 will use a validated triage tool to obtain relevant information about symptoms and decide whether the patient needs advice, follow up after 24 hours by the NHS24 Cancer Team or urgent hospital assessment. Hamish Phillips reported that, following the introduction of the helpline, there had been an increase in the number of patients seen but not in the number of patients admitted and that the service was being fine tuned. Radiotherapy developments The West of Scotland Cancer Network has submitted an outline business case for a satellite radiotherapy centre at Monklands Hospital in Lanarkshire. The Scottish Government s Capital Investment Group is due to make a decision on this by the end of August. SCAN has been undertaking demand and capacity work which will be fed into a national event on 17th September. Neuro and paediatric cancer patients from the north of Scotland are currently being treated in Edinburgh due to staff shortages in the north. 3 Workplan Pathway for Management of Complex Patients for Exenterative or Reoperative Surgery As requested by the Medical Director for NHS Fife, the Group discussed the pathway for patients from peripheral boards treated in Edinburgh. Group members felt that arrangements for referring patients to the Edinburgh MDM (multidisciplinary meeting) were satisfactory, but that it would be helpful to clarify who should be responsible for patients post treatment. James Mander offered to draft a written policy and circulate this to Stuart Whitelaw, Satheesh Yalamarthi, Karol Pal and Hamish Phillips for comments. Action: James Mander to draft a written policy to clarify who should be responsible for patients referred to Edinburgh for treatment and circulate this to Stuart Whitelaw, Satheesh Yalamarthi, Karol Pal and Hamish Phillips for comments. James Mander Audit James Mander said SCAN s performance compared well with that in Page 3 of 5

4 the rest of the UK, as reported in the UK Bowel Cancer Audit. One area of surprise in the report was that, although the AP rate in England and Wales was 28%, nearly 60% of patients had a stoma at one year (which was likely to be permanent). This data should be considered when decisions are being made around operative planning in elderly and co-morbid patients. Sarah Buchan reported that she had received 2012 data from all boards and was working to prepare a draft comparative report for the audit sub-group meeting on 6 th Sept. She said that the first full report on QPIs was not due to be submitted until April 2013 and that the comparative report would include a mixture of QIS standards and QPIs. Christina Lilley asked whether the data collected by boards following the introduction of QPIs would continue to allow comparisons with other parts of the UK to be made in future. Martin Keith said that Peigi Muir (previous Audit Facilitator for NHS Lothian) had been confident that this would be possible. In response to a query from Hamish Phillips, Lorna Bruce said that there was an intention to undertake an initial review of QPIs after 9 months. Workplan Group members noted that, as agreed at the December meeting, the audit sections of the workplan had been updated, The revised version was approved. Waiting Times The Group noted that all boards had, on occasion, failed to meet the 31-day or 62-day waiting times targets during Martin Keith said that in Dumfries & Galloway this was mainly a small numbers effect, as one patient breaching the target resulted in the board failing to meet the 95% threshold. Borders and Lothian were confident that there were no systemic issues underlying the occasional breaches. Karol Pal said that Borders would be interviewing for a replacement for Mohammad Hosny at the end of September or beginning of October and that a further retirement would require recruitment to a second post. James Mander said the Edinburgh Colorectal Unit would be happy to support the Borders if there were any areas of coloproctology that the new surgeon was unhappy to undertake. Education Day 2014 James Mander said that the education event in April had been very successful and suggested that the aim of the 2014 event might be to provide updates for GPs. It was agreed that Sheena Mackenzie should ask the SCAN Primary Care Group to consider this and what subjects they might like to see on the agenda. Action: Sheena Mackenzie to ask the SCAN Primary Care Group for their views on having a bowel cancer education event in Sheena Mackenzie Page 4 of 5

5 4 2BAny other business Audit of pathology Paul Fineron reported that Lothian and Borders had performed well in an audit of pathology reports carried out in Dundee. Fife s results were not quite as good. McKinsey Colorectal Cancer Improvement Network James Mander advised the group that a report on the colorectal work with McKinsey was due to be published in the autumn. 5 3BDates of future meetings 6 th Dec 2013: pm: Telepresence Suite, Western General Hospital, Edinburgh, with videolinks available from Dumfries and VHK. Page 5 of 5