National Peer Review Report: Sarcoma Cancer Services Report 2012/2013

Transcription

1 National Peer Review Programme National Peer Review Report: Sarcoma Cancer Services Report 2012/2013

2 Sarcoma MDT Overall Performance All 15 services reviewed against the 36 measures were on the Peer Review cycle. No services were selected for a cancer peer review visit in 2013/2014. The table below shows the outcomes against the measures for the 15 services reviewed in 2012/2013; Compliance PR 100% % % % % % % % 0 Median 69% Range 44-94% Interquartile Range 59-82% 2

3 100% Overall Compliance Ranges Sarcoma MDTs (11/12 and 12/13) 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Sarcoma MDT Sarcoma MDT Red vertical lines: complete range Blue box: inter-quartile range Orange horizontal line: median value Team below 50% (If more than one team, number in brackets) Immediate Risks and Serious Concerns with IRs (SA) with IRs (IV/EV) with IRs (PR) Total with IRs Percentage of with IRs (SA) (IV/EV) (PR) Total No of Percentage of % % The main focus of these were: The referral population base is not adequate to provide sufficient numbers to be an IOG compliant-namely 100 new cases per year. Lack of cover for CNS, this compromises the support for patients in times of annual leave and sickness. Lack of attendance at the MDT by core members including the radiologist and histopathologist. Patients therefore do not benefit from the full MDT discussion when decisions are made regarding diagnosis and treatment. Poor data collection. Retroperitoneal sarcoma pathways are not clearly defined and formalised. Insufficient oncology capacity available to Sarcoma service which results in a risk to the service in terms of the correct and safely managed administration of high dose chemotherapy and the management of side effects associated with the treatment. Good Practice There were many examples of good practice. These particularly focused on: Development of outreach clinics, reducing travelling times for patients and ensuring care closer to home. Rapid access to diagnostic tests, including one stop investigational pathways with timely turnaround of histopathology and imaging reporting. 3

4 Primary care educational awareness programmes on diagnosis and management of sarcomas Establishment of patient support groups and development of patient information across the country. Number of appointments to the MDT co-ordinator and Clinical Nurse Specialist roles across the country. Inter-relationships between other site specific MDTs and patient pathway development. Measures with below 50% compliance: Measure Number and Short Title PR (15 teams) 11-2L Lead Clinician and Core Team Membership 47% 11-2L Support for Level 2 Practitioners 47% 11-2L Core Members (or cover) Present for At Least 2/3 of Meetings 33% 11-2L Oncology Core Members Practice 47% 11-2L Attendance at National Advanced Communications Training Programme 11-2L Agreed List of Approved Trials 40% 7% 4

5 NETWORK 100% Sarcoma Advisory Group % 80% 70% 60% 50% 40% 30% 20% 10% SA PR 0% 5

6 Appendix 1 OVERALL PERCENTAGE COMPLIANCE AGAINST THE MDT PEER REVIEW MEASURES Sarcoma MDTs Measure Number and Short Title SA (0 teams) IV (0 team) PR (15 team) 11-2L Lead Clinician and Core Team Membership 47% 11-2L Level 2 Practitioners for Psychological Support 67% 11-2L Support for Level 2 Practitioners 47% 11-2L Attendance at Sarcoma Advisory Group Meetings 11-2L MDT Meetings 87% 11-2L MDT Agreed Cover Arrangements 53% 11-2L Core Members (or cover) Present for At Least 2/3 of Meetings 11-2L Annual Meeting to Discuss Operational Policy 87% 11-2L Policy for all Patients to be Reviewed by MDT 80% 11-2L Policy for Communication of Diagnosis to GP 53% 11-2L Operational Policy for Named Key Worker 93% 11-2L Surgical Core Members Practice 53% 11-2L Oncology Core Members Practice 47% 11-2L Core Histopathology Member Taking Part in an EQA scheme 11-2L Core Nurse Members Completed Specialist Study 11-2L Agreed List of Responsibilities for Core Nurse Members 11-2L Attendance at National Advanced Communications Training Programme 11-2L Extended Team Membership 73% 11-2L Patients' Permanent Consultation Record 73% 11-2L Patients' Experience Exercise 53% 11-2L Patient Written Information 53% 11-2L Treatment Planning Decision 93% 11-2L The Presentation Pathway for Soft Tissue Sarcomas of the Limbs and Trunk Wall 100% 33% 80% 87% 100% 11-2L The Presentation Pathway: Bone Sarcomas 100% 11-2L The Diagnostic Pathway for Soft Tissue Sarcomas Referred to the Sarcoma Service 11-2L The Diagnostic Pathway for Bone Sarcomas 100% 11-2L The Treatment Pathway for Soft Tissue Sarcomas Referred to the Sarcoma Service 11-2L The Treatment Pathway for Bone Sarcomas 100% 11-2L The Follow Up Pathway for Soft Tissue Sarcoma Referred to the Sarcoma Service 11-2L The Follow Up Pathway for Bone Sarcomas 88% 7% 86% 87% 87% 93% 6

7 11-2L Shared Care Pathways for Soft Tissue Sarcomas Presenting to Site Specialised MDTs 11-2L Agreed Collection of Minimum Dataset 80% 11-2L Area Audit 73% 11-2L Agreed List of Approved Trials 40% 11-2L MDT Case Numbers for Discussion 67% 11-2L Joint Treatment Planning for TYAs 67% 60% 7

8 Appendix 2 RADIOTHERAPY GENERIC SERVICES: IMMEDIATE RISKS, SERIOUS CONCERNS AND OVERALL COMPLIANCE Team Network % Stage IR SC MDT - University College London Hospitals NCLWECCN - North Central London and West Essex CCN 94 PR MDT - Royal Marsden - Chelsea SWLCN - South West London 89 PR SC MDT - Sheffield NTCN - North Trent 84 PR MDT - Royal Orthopaedic Hospital PBCN - Pan-Birmingham 83 PR MDT - Nottingham University Hospitals NHS Trust EMCN - East Midlands 81 PR SC MDT - Nuffield Orthopaedic Centre TVCN - Thames Valley 81 PR SC MDT - University Hospitals Birmingham Foundation Trust PBCN - Pan-Birmingham 74 PR MDT - Central Manchester & Manchester Childrens GMCCN - Greater Manchester & Cheshire 69 PR SC MDT - Leeds Teaching YCN - Yorkshire 66 PR MDT - Newcastle NECN - North of England 64 PR SC MDT - Plymouth PCN - Peninsula 59 PR SC MDT - North Bristol ASWCN - Avon, Somerset & Wiltshire 58 PR SC MDT - Royal Devon & Exeter PCN - Peninsula 56 PR SC MDT - Hull And East Yorkshire Hospitals NEYHCA - North East Yorkshire and Humber Clinical Alliance 50 PR IR MDT - Royal Liverpool & Broadgreen MCCN - Merseyside & Cheshire 44 PR SC MDT - RSCH SWSHCN - Surrey, West Sussex & Hampshire 96 SA MDT - South Tees NECN - North of England 96 SA MDT - Clatterbridge Centre MCCN - Merseyside & Cheshire 92 SA MDT - Clatterbridge@ Aintree MCCN - Merseyside & Cheshire 92 SA MDT - Ipswich AngCN - Anglia 92 SA MDT - Lincoln County Hospital EMCN - East Midlands 92 SA MDT - Royal Devon & Exeter PCN - Peninsula 92 SA MDT - Royal Free Hampstead NHS Trust NCLWECCN - North Central London and West Essex CCN 92 SA MDT - Sheffield NTCN - North Trent 92 SA MDT - Southend ECN - Essex 92 SA MDT - UHB ASWCN - Avon, Somerset & Wiltshire 92 SA MDT - Portsmouth CSCCN - Central South Coast 90 SA MDT - Lancashire Teaching Hospitals LSCCN - Lancashire & South Cumbria 89 SA MDT - Maidstone Hospital KMCN - Kent & Medway 89 SA * = Resolved 8

9