SCAN Lung Group Friday 16 th November pm

Transcription

1 SCAN Lung Group Friday 16 th November pm Oncology Seminar Room, Western General Hospital, Edinburgh with videolink to Dumfries MINUTES Present Diana Borthwick Martin Keith Kate Macdonald Sheena Mackenzie Eilidh MacRae Julie Mencnarowski Heather Preston Vipin Zamvar In attendance Val Doherty Jill Thomas Apologies Sandra Bagnall Jane Lawson Felicity Little Janice Logan John Murchison Allan Price Paul Rafferty Kris Skwarski William Wallace CNS, NHS Lothian Respiratory Consultant, NHS Borders Senior Cancer Information Officer, NHS D&G SCAN Manager SCAN Groups and Communications Co-ordinator CNS, NHS Fife Lung CNS, NHS Lothian SCAN Cancer Audit Facilitator, NHS Lothian Lung CNS, NHS Fife Consultant Respiratory Physician, NHS Fife Consultant Surgeon, NHS Lothian SCAN Clinical Lead Cancer Modernisation Manager / DCE Programme, NHS Borders SCAN Patient Involvement Manager Advanced Nurse Practitioner, NHS Lothian Consultant Oncologist, ECC CNS, NHS Borders Consultant Radiologist, NHS Lothian Consultant Oncologist, ECC Respiratory Consultant, NHS D&G Consultant Respiratory Physician, NHS Lothian Consultant Pathologist, NHS Lothian Full list of members on Item 1 Introductions, minutes Action The minutes of the meeting on 28/09/12 were approved. 2 SCAN Issues Kate Macdonald updated Group members about regional and national initiatives including: SCAN Office, Pentland House, 47 Robb s Loan, Edinburgh EH14 1TY Tel: Mob (meeting days only): E: sheena.mackenzie@nhslothian.scot.nhs.uk W: Page 1 of 6

2 progress in the implementation across the region of a chemotherapy electronic prescribing and administration system the establishment of a short-life regional group on acute oncology regional pilot of telehealth to support remote consultations LINAC (linear accelerator) replacement programme for the Edinburgh Cancer Centre cancer modernisation funding forthcoming pilot of a national 24/7 chemotherapy helpline Kate said that a Projects Update Paper was in preparation which would provide more information about these developments. 3 Lung Cancer Issues EBUS In the absence of Kris Skwarski, this item was deferred. NATIONAL LUNG CANCER NETWORKS MEETING: 9 TH NOV 2012 gave a brief report on the national lung cancer networks meeting which had been organised by SCAN. He said that feedback on the event had been positive and that was compiling a report on the audit/survival items. It was agreed that Sheena Mackenzie should liaise with speakers about sharing their presentations. Action: Sheena Mackenzie to liaise with speakers about sharing their presentations from the National Lung Cancer Networks Meeting on 9 th Nov. Sheena Mac AUDIT QPI Development Group meeting: 31 st Oct 2012 The Group discuss the notes and actions from the QPI Development Group meeting on 31 st October. QPI 1: Pathological diagnosis The Lung Group agreed that, from 1 st April 2013, patients with non-definitive pathology who go on to be treated for lung cancer should be recorded at the MDM as having a pathological diagnosis. Action: Relay decision to record at MDM, from 1 st April 2013, patients with non-definitive pathology as having a pathological diagnosis to local audit colleagues. QPI 3: Investigation of mediastinal malignancy at the meeting on 31 st October it had been suggested that PET recording guidelines should be distributed to all PET Radiologists to ensure consistency in recording across the three cancer networks to ensure that information is readily accessible to audit. It was agreed that Kate Macdonald should ask Rachael Dunk to refer the question of how this might be taken forward to the national Radiotherapy Short-Life Working Group. Action: Kate Macdonald to ask Rachael Dunk to refer the question of how the required recording of positive mediastinal nodes might be taken forward to the national Radiotherapy Short-Life Working Group. Kate Macdonald Page 2 of 6

3 QPI 5: Lymph node assessment Lung Group members suggested that the data required by audit to report on this QPI might be included on pathology reports and that William Wallace should be asked to advise on this. Action: to liaise with William Wallace about including the data required by audit to report on QPI 5 on pathology reports. William Wallace It was noted that there were issues in obtaining audit data for SCAN patients treated at the Golden Jubilee Hospital due to lack of access to the relevant SCI Store. Alison Allen offered to investigate whether the Clinical Portal might offer a solution. Action: Alison Allen to investigate whether the Clinical Portal might offer a solution to issues in obtaining audit data for SCAN patients treated at the Golden Jubilee Hospital. Alison Allen advised the Group that a revised draft of the lung cancer QPIs had been produced and it was agreed that she should check with Iona Scott whether this could be circulated to the SCAN Lung Group. [Note: Ailsa liaised with Iona Scott and unfortunately the document is not for wider circulation at this stage. However, if there are any particular issues, these can be discussed with colleagues in order to get feedback.] It was noted that the draft palliative care QPIs had been published for national consultation - erience/palliative_care/palliative_care_indicators.aspx (closing date for comments: 21/12/12). European Lung Cancer (EuLuCa) Audit The Group noted the paper comparing Scottish data on patients diagnosed with lung cancer in July 2011 with data from other European countries. Comparative report 2011 The minutes of a meeting held on 13 th November to discuss the draft lung comparative audit report for 2011 had been circulated prior to the Lung Group meeting. CNS contact/referral said that, for the purposes of the comparative report, copying a CNS into letters counted as CNS contact/referral and Group members were asked to ensure that their secretaries copied CNSs into correspondence, including discharge summaries. Actions: Clinicians to ensure their secretaries copy CNSs into correspondence, including discharge summaries. Clinicians In view of the lower ratio of CNSs to patients diagnosed with lung cancer in Lothian compared with other SCAN boards, it was agreed that Ailsa Patrizio should liaise with Diana Borthwick about carrying out a benchmarking exercise against other areas. Action: to liaise with Diana Borthwick about Page 3 of 6

4 benchmarking CNS numbers in Lothian against other areas. Diana Borthwick Pathology type In anticipation of QPI implementation in 2013, it was agreed that all NSCLC (NOS) diagnoses should be reviewed. Ailsa Patrizio advised the Group that William Wallace had confirmed that he would review diagnoses for Lothian and Borders. and Martin Keith agreed to liaise with Pathologists locally. It was noted that Borders had reported a higher level of NSCLC (NOS) than other SCAN boards and offered to review this with Lynn Smith. Actions:, and Martin Keith to liaise with Pathologists re reviewing NSCLC (NOS) diagnoses. and Lynn Smith to review cases recorded as NSCLC in Borders. Martin Keith Surgical resection rates It had been suggested at the meeting on 13 th Nov that MDM minutes should record the specific reasons why early stage NSCLC patients are not suitable for surgery. suggested that it was important to collect data on the reasons why patients referred for surgery are turned down. offered to MDM Chairs about this. Action: to MDM Chairs about recording reasons why early stage NSCLC patients are not considered suitable for surgery. REGIONAL REVIEW OF NON-SURGICAL ONCOLOGY: ACTIONS FROM LUNG WORKSHIP The Group reviewed progress in relation to the recommendations of the lung workshop held on 12 th August Diagnostics pathway It was noted that work on reviewing the lung diagnostics pathway had been put on hold pending the outcome of the review of the SIGN lung cancer guideline. MDMs It was noted that the review of lung MDMs was an item in the Group s workplan (next review due Spring 2013) said that he would like to visit the lung MDMs in each of the SCAN boards. Jakki Faccenda confirmed that Borders reviewed its lung MDM on an annual basis. Martin Keith reported that Dumfries and Galloway was looking at ways of streamlining all its MDMs. Kate Macdonald suggested that Clare Gorman might be asked to share relevant information from Lothian s review of MDMs. Actions: to visit the lung MDMs in each of the SCAN boards. Kate Macdonald to ask Clare Gorman to share any relevant information from Lothian s review of MDMs with the lung group. Kate Macdonald Page 4 of 6

5 PET-CT AUDIT Kate Macdonald advised the Group that the national PET Group had asked the West of Scotland Cancer Surveillance Unit to lead on an audit of CT-PET. She said that the initial proposals for the audit would have required unrealistic levels of resource to carry out and would be reviewed at the next meeting of the national PET Group. Diana Borthwick emphasised the importance of timeliness (eg referral to PET scan and PET scan to report) and reminded the Group about the timeline audit which she and Julie Mencnarowski had carried out. Jakki Faccenda offered to ask John Reid about the outcome of a study on incidental findings of PET scans and whether these could be shared with the Lung Group and national PET Group. Action: to ask John Reid whether the outcome of a study on incidental findings of PET scans could be shared with the Lung Group and national PET Group. FUTURE MEETINGS PROTOCOLS Massive haemoptysis The Group agreed that Section 9 of the protocol (Actions in event of massive haemoptysis) should allow for patients being given Midazolam and/or Morphine and that the protocol should be signed off for use in SCAN. Inpatient referrals asked Group members to review the Inpatient Referral Protocol (copy attached) and contact him if they wished to suggest any updates. Action: Group members to send any comments on the Inpatient Referral Protocol to by 12 th Dec. ALL EBUS It was noted that Kris Skwarski had confirmed that no updates were required to the EBUS section of the Lung Clinical Management Protocols. Thoracic surgery Vipin Zamvar reported that he was discussing updates to the thoracic surgery protocols and hoped to have a revised draft in time for the next meeting. Management of small pulmonary nodules relayed a message from John Murchison that the protocol for the management of small pulmonary nodules was being used in Lothian and that Radiologists in Fife, Borders and Central region had asked for copies to use. It was suggested that the system of reviewing nodules at weekly Respiratory Radiology Meetings was one that worked well but that it was up to each health board to decide what approach to adopt. Actions: Ron Fergusson to confirm arrangements for reviewing small pulmonary nodules at the Western General Hospital and Colin Selby to liaise with Mark Jones about arrangements in Fife. Ron Fergusson Page 5 of 6

6 4 Any Other Business Review of referral guidelines for lung cancer The Group agreed that and Diana Borthwick should be nominated to represent SCAN on the national review group. Workforce pressures The Group noted that attempts to recruit a replacement for Ron Fergusson had not been successful and that the post would be readvertised. The Group also noted that an application had been made to use Detect Cancer Early funding to appoint additional Consultant/CNS/Admin support to relieve pressures on Kris Skwarski at the RIE. Pressures on CNSs in Lothian were discussed earlier in the meeting. PET referral process It was agreed that PET referral processes should be reviewed and documented at the next meeting. EGFR testing Diana Borthwick asked whether EGFR testing could be automatically carried out for adenomas (not small cell or squamous) and offered to liaise with William Wallace and Pathology colleagues in Fife about this. Action: to liaise with William Wallace and Pathology colleagues in Fife about automatic EGFR testing for cases of adenoma. 5 Dates of Future Meetings It was agreed that future Lung Group meetings should alternate between Wed and Fri afternoons and that the first meeting of 2013 would be held on Wed 6 th March: pm in the Western General Hospital Telepresence Room with videolinks to Dumfries and the RIE. Page 6 of 6