Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services. Gynae-Oncology Network Site Specific Group (NSSG) Annual Report 2016/17

Transcription

1 Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services Gynae-Oncology Network Site Specific Group (NSSG) Annual Report 2016/17 Version 1.0 1

2 This Annual Report was prepared by: Philip Rolland, Chair of the SWAG Gynae-Oncology NSSG, Consultant Gynaecological, Gloucestershire Royal Hospitals NHS Foundation Trust Helen Dunderdale, SWAG Cancer Network NSSG Support Manager Gynae-Oncology Contents Section Contents Page 1 Overview, achievements and challenges Overview of report Overview of service Achievements and key service improvements over the past 15 months Challenges for the NSSG 5 2 The Network Group Meeting and 6 Membership 2.1 Chair of the NSSG Network Group Membership Attendance Spreadsheet Associate Members of the NSSG 12 3 Chemotherapy Treatment Algorithms 4 Clinical Trials and Research Activity Discussion of Clinical Trials Recruitment Action Plan Current Clinical Trials Activity Recruitment of Teenagers and Young Adults (TYA) Version 1.0 2

3 1. Overview, achievements and challenges 1.1 Overview of report This report reflects the period of activity for the NSSG from 1 st January 2016 to 31 st March It contains a summary of the activity of the Gynae-Oncology NSSG for this period measured against several key performance indicators that have been outlined in the National Cancer Peer Review Programme. The report should be reviewed alongside three other key documents for the NSSG: the Constitution, Clinical Guidelines and the Work Programme. The Gynae-Oncology NSSG Constitution provides an overview of how the NSSG operates, outlining the general working processes of the NSSG, the patient referral pathways and the guidelines to which the NSSG adheres. The Clinical Guidelines outline the diagnostic and treatment processes agreed by the network group. The Work Programme summarises the key areas for growth, development and improvement of the NSSG over the next financial year (and beyond where appropriate). All four documents should be reviewed together to give a full overview of the NSSG, its performance and its future plans. 1.2 Overview of service The Gynae-Oncology site-specific group aims to oversee, support and bring together the viewpoints of all the multi-disciplinary teams working within Gynae-Oncology cancer services across the Network. The group also aims to ensure the same standard of care and treatment with this type of cancer across the Network. The NSSG works to ensure implementation of NICE guidelines for investigation and treatment of Gynaecological cancers and to provide guidelines for supportive care. It supports a programme of education on key developments in the field of Gynaecological cancer. It also aims to continue and expand the clinical trials programmes available within individual trusts. 1.3 Achievements and key service improvements over the past 15 months The following are noted as key achievements and service improvements of the Gynae-Oncology NSSG over the past 15 months (during 2016/17): Clinical opinion on network issues Inaugural meeting of the South West Academic Gynae-oncology Group for Education and Research (SWAGGER), attended by representatives from each MDT across the SWAG and Peninsula region Improved efficiency of the MDT by division of CNS roles. Clinical guidelines Educational update on the role of BRCA testing in patients with ovarian cancer Review of non-surgical treatment for endometrial cancer Educational update on the role of histopathology in identifying genetic conditions associated with gynaecological malignancies, with special attention to pathological manifestations of Lynch syndrome Agreement of the list of chemotherapy protocols to be developed. Version 1.0 3

4 Coordination of patient care pathways Provision of advice on development of the South West suspected cancer referral proforma Royal United Hospitals Bath onco-genetic pathway review Development of Gynae-oncology and Sarcoma Shared Care Pathway. Patient experience User Representative input on What is Important to a Patient and Their Family/Carers and What Would They Want to Know When Confronting a Complex or Major Surgical Intervention, Particularly at the End of Life? Living With and Beyond Cancer (Survivorship) In, the recovery package had been fully implemented with assistance from Survivorship Lead Catherine Neck Quality indicators, audits and data collection Results and recommendations from the following audits were shared: Management of endometrial cancer audit Audit of patient outcomes following definitive treatment of inoperable carcinoma of the cervix, treated with concurrent chemo-radiotherapy and image guided brachytherapy Vulval cancer surgical audit. Potential future projects from the gynae-oncology database have been identified. Research Three clinical trials update Improved recruitment via cross referrals Review of a regional feasibility study of hysterectomy after chemo-radiotherapy for patients with Stage 1b2 / IIb cervical cancer Review of a regional feasibility study: The use of cell salvage in ovarian cancer (PB-PG : Trial of intraoperative cell salvage vs. transfusion in ovarian cancer (TIC TOC)) Proposal for prospective study of patients with high risk endometrial cancer, treated either by node dissection plus selective ERBT or no node dissection and ERBT. Endpoints are morbidity and cost. Quality Surveillance Programme Introduction of the 5 year forward Cancer Strategy, the formation of Cancer Alliances and replacement of Peer Review Guidelines with the Quality Surveillance Programme. Version 1.0 4

5 1.4 Challenges for the NSSG The key challenges for the Gynae-Oncology NSSG moving forward are highlighted below: Clinical guidelines Development of local clinical guidelines in 2015/16 was postponed due to revision of national clinical guidelines. Coordination of patient care pathways Improving diagnostic capacity Development of melanoma shared care pathway. Patient experience Development of regional patient feedback process by the Clinical Nurse s Streamlining patient pathways to improve the patient experience. Living With and Beyond Cancer (Survivorship) Provision of IT and other support to the Gloucestershire team before it will be possible to fully implement the recovery package. Quality indicators, audits and data collection Streamlining data collection processes by development of the Somerset Cancer Register and possible link to the Gynae-Oncology bespoke database Ensuring that all Trusts in the Network regularly contribute to the educational and audit programmes. Research Continuing to expand and support the clinical trials programme. Service development Incorporating the requirements of the Genomic Medicine Centre into practice Development of a genetic testing service. Version 1.0 5

6 2. The Network Group Meeting and Membership 2.1 Chair of the NSSG Mr John Murdoch was Chair of the Gynae-Oncology NSSG from 2015 to June 2016, including Chairing the inaugural South West Academic Gynae-Oncology Group for Education and Research (SWAGGER). Mr Philip Rolland undertook the role of NSSG Chair after this point and Ms Claire Newton agreed to Chair SWAGGER following a SWAGGER planning meeting in March A list of responsibilities for the NSSG, for the Chair, and for other members of the NSSG, plus the NSSG terms of reference, can be found in the paper Recurrent Arrangements for Cancer Network Clinical Groups and Responsibilities for Peer Review, as proposed by the South West Strategic Clinical Network (SWSCN) Cancer Network Manager, Jonathan Miller (14 th July 2014): Recurrent-Arrangements-v5-Final.pdf The NSSG meetings are also conducted in line with the Manual for Cancer Services, Gynae-Oncology Measures, Version Network Group Membership The Gynae-Oncology NSSG and SWAGGER meetings convene on an annual basis, six months apart as an alternative to biannual NSSG meetings, as agreed with the SWAG and Peninsula Cancer Managers. In 2016/17, meetings were held on the 15 th January 2016, the 17 th June 2016, and the 17 th March Attendance Spreadsheet The table below shows the core members of the NSSG and their attendance. All participants at MDTs are welcome to attend the NSSG meetings. Table 1.0 Gynae-Oncology NSSG core members and attendance 2016/17 Trust Name Position PH Ahmed Talaat Consultant Gynaecological Amit Patel Consultant Gynaecological Claire Newton Consultant Gynaecological NBT Feras Naaisa Consultant Gynaecological PH Geoff Hughes Consultant Gynaecological Version 1.0 6

7 TST Jo Morrison Consultant Gynaecological RDE Katharine Edey Consultant Gynaecological RCH Khadra Galaal Consultant Gynaecological RUH Nick Johnson Consultant Gynaecological Jo Bailey Consultant Gynaecological John Murdoch Consultant Gynaecological GLOS Kathryn Hillaby Consultant Gynaecological RDE Mike Hannemann Consultant Gynaecological RCH Nagindra Das Consultant Gynaecological GLOS Philip Rolland Consultant Gynaecological GLOS Rob Gornall Consultant Gynaecological UHB Sarah Platt Subspecialty Fellow GLOS Audrey Cook Consultant Clinical Hoda Booz Consultant Clinical RDE Jenny Forrest Consultant Clinical RUH Penny Kehagioglou Consultant Clinical TST Petra Jankowska Consultant Clinical GLOS Radhika Counsell Consultant Clinical Waheeda Owadally Consultant Clinical Axel Walther Consultant Medical Version 1.0 7

8 TST Emma Cattell Consultant Medical RDE Kate Scatchard Consultant Medical RUH Rebecca Bowen Consultant Medical GLOS Emma Gilbert Consultant RCH John McGrane Consultant RDE John Renninson Consultant Gynaecologist YDH Lydia Karamura Consultant Gynaecologist SDHT Morven Leggott Consultant Gynaecologist WAHT Colin Bevan Consultant Obstetrician & Gynaecologist ND Stephen Bennett Consultant Obstetrician & Gynaecologist NBT Tracy-Louise Appleyard Rachel McCoubrie Consultant Obstetrician & Gynaecologist Consultant in Palliative Care Vivek Nama Consultant Senior Lecturer ND Mary Alexander Consultant Histopathologist RUH Pinias Mukonoweshuro Consultant Histopathologist RDE Trupti Mandalia Consultant Histopathologist RDE Nichola Cope Consultant Histo/Cytopathologist Joya Pawade Consultant Pathologist GLOS Linmarie Ludeman Consultant Pathologist RUH Sarah Johnson Consultant Pathologist GLOS Louise Jelly Consultant Radiologist John Hughes Consultant Radiologist GLOS Richard Hopkins Consultant Radiologist Version 1.0 8

9 TST Sue Slater Consultant Pathologist TST Surabhi Agrawal Consultant Pathologist TST Paul Burn Consultant Radiologist Pauline Humphrey Therapy Radiographer RDE Carole Brewer Consultant Geneticist Samantha Cole Clinical Psychologist Sarah Platt Senior Registrar GLOS Jonathan Frost Clinical Research Fellow Kristelle Von Brockdorff SPR Oncology GLOS Georgina Lewis Trainee Surgical Care Practitioner GLOS Becky Hutchinson Gynae Oncology Advanced Nurse Practitioner GLOS Alta Viljoen Gynae Oncology Clinical Nurse SDHT Debbie Fitzgerald Gynae Oncology Clinical Nurse Donna Beckett Gynae Oncology Clinical Nurse RDE Gail Webb Gynae Oncology Clinical Nurse RDE Jacky Stewart Gynae Oncology Clinical Nurse RUH Jane O'Mahoney Gynae Oncology Clinical Nurse Jayne Alexander Gynae Oncology Clinical Nurse ND Jo Gordon Gynae Oncology Clinical Nurse GLOS Karen Easton Gynae Oncology Clinical Nurse Version 1.0 9

10 Katy Horton- Fawkes Gynae Oncology Clinical Nurse TST Kristy Coomber Gynae Oncology Clinical Nurse GLOS Lisa Peck Gynae Oncology Clinical Nurse PH Liz Ridgway Gynae Oncology Clinical Nurse GLOS Louise Jones Gynae Oncology Clinical Nurse GLOS Margareta Chibane Gynae Oncology Clinical Nurse YDH Sally Keates- Porter Gynae Oncology Clinical Nurse TST Sue Golby Gynae Oncology Clinical Nurse RUH Tracie Miles Gynae Oncology Clinical Nurse SDHT Tracy Hill Gynae Oncology Clinical Nurse GLOS Alison O'Connor Lymphoedema Clinical Nurse RUH Kerry Sant Lymphoedema Clinical Nurse GLOS Kim Wilcox Lymphoedema Clinical Nurse N/A Christine Teller User Representative Sally Hawkins MDT Co-ordinator TST Ann England Medical Sec/CPGON Administrator Administration Helen Dunderdale Cancer Network SSG Support Manager Administration Asha Sahni Cancer Network Administrative Coordinator Version

11 Administration Kaitlyn Hamilton Cancer Network Administrative Coordinator 2.4 Associate Members of the NSSG The table below notes the Associate membership of the NSSG during 2016/17 and their attendance at the meetings. Table 1.1 Associate NSSG members and guest attendance 2016/17. Organisation Name Position Macmillan Catherine Neck Macmillan AHP & Survivorship Lead WAHT Emma Pugh Cancer Manager Peninsula CRN Julie Cunningham Senior Research Delivery Manager Birmingham Women's Hospital Raji Ganesan Consultant Histopathologist WoE CRN Richard Mundy Portfolio Facilitator Table 1.2 Attendance by Trust TRUSTS/OTHER SWAGGER Attendance Gynae NSSG Attendance SWAGGER Attendance Glos NBT 1 1 ND 3 PH 3 1 RCH 3 RDE 10 4 RUH 4 1 SDHT 3 TST WAHT 1 YDH 2 Administration Associate Membership 1 1 Version

12 Guests 1 2 User Representatives 1 Total Attendance SWAGGER Attendance Glos NBT ND PH RCH RDE RUH SDHT TST WAHT YDH Administration Gynae NSSG Attendance Glos NBT RUH WAHT Administration Associate Membership Guests User Representatives Version

13 SWAGGER Attendance Glos NBT ND PH RCH RDE RUH SDHT TST WAHT YDH Administration Associate Membership 3. Chemotherapy Treatment Algorithms An agreed list of acceptable chemotherapy treatment algorithms is reviewed bi-annually and is available to view on the SWSCN website here. Any treatment algorithms that require updating are to be listed in the NSSG work programme. 4. Clinical Trials and Research Activity 4.1 Discussion of Clinical Trials Members of the NSSG discuss each MDT s report on clinical research trials within every NSSG meeting. A list of open trials on the Gynae-Oncology National Institute for Health Research (NIHR) portfolio, and any potential new trials, is supplied for each NSSG meeting by the West of England Clinical Research Network (CRN) Cancer Research Delivery Manager. Due to the CRN s mapping with the Academic Health Science Networks, Taunton and Yeovil are in South West Peninsula CRN. The Cancer Research Delivery Manager from the Peninsula CRN will provide the NSSG with the data for these Trusts. Potential new trials to open and actions to improve recruitment will be documented in the NSSG work programme. The NHS staff member nominated as the research lead for the NSSG is Rebecca Bowen. Version

14 The studies currently open across the network were reported as recruiting well. Any small rare cancer trials should be opened in one of the hospitals within the region to ensure that patients do not have to travel to London. There is a dearth of new trials at present. 4.2 Recruitment Action Plan The trials available in each Trust will be updated on the South West Strategic Clinical Network website at regular intervals so that the NSSG members can ensure, wherever possible, that clinical research trials are accessible to all eligible Gynae-Oncology cancer patients. NSSG members can view potential clinical trials to set up via the following link: Current Clinical Trials Activity A summary of the clinical trial recruitment into National Institute of Health Research trials during 2016/17 can be found on the SWCN website here. 4.4 Recruitment of Teenagers and Young Adults (TYA) There were no TYA patients recruited to Gynae-Oncology studies in 2016/17. -END- Version