London Cancer Pathway Board for Haematological Malignancies

Transcription

1 Pathway Board for Haematological Malignancies Date: Thursday, 16 th August 16:30-18:00 Venue: Boardroom, 3 rd Floor, UCLP, 170 Tottenham Court Road, London W1T 7HA Chair: Dr Kirit Ardeshna ACTION LOG Action Owner Date Agreed Status KA to invite Dr Maria Calaminici to form a histopathology working group To form a working group to improve earlier diagnosis and referrals by GPs KA to contact Simon Whitley to discuss referral pathways for suspected lymphoma neck lumps CN to survey the available patient information literature and develop up-todate information pack for patients with the support of a CNS forum To encourage their CNSes to contact CN for participation in CNS forum KAi to send KA the end of treatment summary template developed by NCSI To share with KA suggestions on clinical trials reporting that can be passed on to the NLCN and NELCRN teams To circulate a complete the draft of the annual work to all members for approval at the next meeting KA and Tim Burdey to revise the activity pro forma based on the input obtained from Board members To coordinate the completion of the BCSH audit on behalf of their trust To circulate draft pathways for haematological malignancies to the subspeciality groups for feedback To report on follow-up procedures and survivorship issues Kirit Ardeshna 16 th August 2012 Emma West 16 th August 2012 Kirit Ardeshna 16 th August 2012 Claire Nicholas 16 th August 2012 All members 16 th August 2012 Kim Ainsworth 16 th August 2012 All members 16 th August 2012 Kirit Ardeshna Tim Burdsey Kirit Ardeshna Tim Burdsey 16 th August rd September th August 2012 All members 16 th August 2012 Tim Burdsey 16 th August 2012 Victoria Grandage 16 th August th September

2 1. Welcome, apologies and minutes of the last meeting KA welcomed the Board and introductions were made. The Board heard the apologies that had been received. KA welcomed Claire Nicholas, CNS at as new member of the Board. The minutes of the last meeting (18 th June 2012) were accepted as an accurate record of proceedings. 2. Update on London Cancer ST informed the Board that the membership lists and meeting documentation of the pathway boards can now be viewed online at 3. Review on Objectives The present members reviewed the objectives as outlined in the draft annual work that was tabled at the meeting. The Board agreed the following objectives: Improve diagnostic reporting to enhance accuracy, consistency and speed of diagnosis Dr Maria Calaminici with the support of a histopathology working group To review the current state of the diagnoses of haematological malignancies across London Cancer To consider how a specialist integrated haematological malignancy diagnostic service(s) (SIHMDS) can be developed within London Cancer To promote speedy diagnosis and production of integrated reports in line with existing guidelines and peer review measures To develop solutions that enable the specialist histopathology workforce to cope with the increasing workload of providing services to both NCL and NEL Challenges: The Board discussed the issues surrounding poor compliance with current peer review measures on histopathology report production due to staffing and IT issues To set up a SIHMDS working group led by Dr Maria Calamanici. Membership should be open To produce a summary report on how current peer review measures for the production of integrated reports can be met To identify current challenges and workable solutions for the histopathology workforce (e.g. geographic distribution, workload, maintenance of skills) Improve early diagnosis by addressing issues in the GP setting Dr Emma West with the support of a working group To improve 2ww referrals forms to ensure that referrals are appropriate and processed in a speedy manner To increase GP s awareness of symptoms of lymphoma, myeloma and leukaemia 2

3 Challenges: The Board discussed the causes for inappropriate 2ww referrals for suspected haematological malignancies. KA announced that Jill Ireland, Deputy Director & NAEDI Programme Lead for the NCLWE Cancer Commissioning Network has been invited to present her work on earlier diagnosis to the Board on 17 th October To set up a GP referral working group led by Dr Emma West To produce a GP fact sheet ( Do s and Don ts for referrers ) To suggest improvements to existing 2ww referral forms in line with NICE guidelines Improve referral pathways to optimise diagnosis of neck lumps and enhance connectivity with the head and neck pathway TBC Challenges: To utilise and optimise the existing referral pathways for neck lumps To optimise the biopsy procedure for diagnostic and research purposes The Board heard that it is currently not systematically captured how soon after the identification of a suspicious lump a biopsy is performed. The Board agreed that referral pathways must not be restricted to neck lumps but also extended to lumps in the groin and other regions. KA to liaise with Simon Whitley, Pathway Director for Head and Neck cancer to discuss improvements to the referral pathway JG to refine biopsy protocols to allow samples to be integrated into current research projects Improve patient experience and patient information Claire Nicholas supported by a CNS forum Available support: To provide patients with up-to-date adequate patient information material at the appropriate time in their treatment journey To document the evidence for the importance of CNS s for patient experience The Board heard that Katherine Joel has been appointed as project manager for patient experience and user involvement for London Cancer. CN to convene a CNS forum for Haematological Malignancies CN to survey the available patient information literature and develop up-to-date information pack for patients All Board members to encourage their CNS to participate in the CNS forum, contact CN at Claire.nicholas@uclh.nhs.uk 3

4 Implement consistent approach to the provision of end of treatment summaries TBC Available support: Next steps To develop a template for a secondary care discharge report that informs GPs on the follow-up procedure needed for their patient KAi informed the Board that a first template has been developed by the National Cancer Survivorship Initiative (NCSI) to improve the communication between primary care and cancer services. KAi to send KA the end of treatment summary template developed by NCSI Improve performance in clinical trials TBC Available support Next steps To improve performance in clinical trials, i.e. the number of available trials that are open to recruitment and the numbers of patients recruited into those trials The Board heard that the NLCRN and NELCRN teams are working together to produce a unified reporting template for clinical trials in London Cancer. All Board members to share with KA suggestions on clinical trials reporting that can be passed on to the NLCN and NELCRN teams ACTION: KA and Tim Burdsey to complete and circulate the draft annual work to all Board members for approval at the next pathway board meeting. 4. Activity Data A preliminary pro forma outlining heamato-oncology services in London Cancer was tabled at the meeting. Data had been received from WXUH, PAH, and. Members of the Board suggested that to improve the quality of the data the pro forma should revised to include the following: - Number of indolent cases that require treatment - Specific ICD10 codes in use - New cases ( not including referrals from other sites within London Cancer) - Clinical trials activity - Average number of in-bed patient days The Board agreed that an audit should be designed that quantifies the delays in discharge due to social issues. ACTION: KA and Tim Burdsey to revise the activity pro forma based on the input obtained from Board members. 4

5 5. BCSH levels of care and transt activity KA asked all members to coordinate the completion of the audit of care and transt activity issued by the British Committee of Standards in Haematology on behalf of their trust. ACTION: All members to coordinate the completion of the BCSH audit on behalf of their trust. 6. Update from subspeciality groups KA reported that the lymphoma subspeciality group will complete the revision of the lymphoma guidelines for London Cancer in September. The Board heard that the myoproliferative pathway group will set up a system-wide MDT for its subspeciality. 7. Review of draft pathways Draft pathways for haematological malignancies were circulated for comment in advance of the meeting. Comments on the draft pathways will also be invited from the subspeciality groups. KAi suggested that as the follow-up procedures vary between the haematological conditions; the draft pathways should be extended to reflect the respective survivorship pathways. KA agreed that Victoria Grandage, the Board s Lead for Living With and Beyond Cancer will be able to report on these procedures at the next Board meeting. ACTION: Tim Burdsey to circulate the draft pathways for haematological malignancies to the subspeciality groups for feedback. ACTION: Victoria Grandage to report on follow-up procedures and survivorship issues in haematological malignancies at the next Board meeting 8. Research and audit This item was discussed as part of the Board s objective setting. 9. Any other business Cancer Drugs Fund: SC suggested that submissions to the Cancer Drugs Fund from trusts within London Cancer could be coordinated on the pathway board level to avoid duplication of efforts. He proposed that submission to the fund should be discussed by all pathway boards in advance of the submission deadline to synchronize efforts. 8. Times and dates of future meetings The next meeting of the Pathway Board for Haematological Malignancies will be on Wednesday, 12 th September at pm in the Boardroom, 3 rd Floor, 170 Tottenham Court Road, London W1T 7HA. 5

6 Attendees Name Charlotte Painter Chris McNamara Claire Nicholas Emma West Ian Grant John Gribben Kim Ainsworth KiritArdeshna Lucy Gladman Peter Wylie Simon Cheesman Sonja Tattermusch Trust/Organisation HUH City and Hackney BHRUT London Cancer BHRUT London Cancer Apologies Name Andres Virchis Anna Cassoni Faris Al-Refaie FarrukhSha Flora Dangwa Heather Oakervee Karl Peggs Kate Cwynarski Liz Kingdon Maria Calminici NaimAkhtar Neil Rabin Samir Agrawal Tim Burdsey Wendy Mills Trust/Organisation BCF/ PAH WH NMUH/ London Cancer 6