INTERNAL VALIDATION REPORT (MULTI-DISCIPLINARY TEAM)

Transcription

1 INTERNAL VALIDATION REPORT (MULTI-DISCIPLINARY TEAM) Network Trust MDT MVCN EAST AND NORTH HERTFORDSHIRE Mount Vernon Cancer Centre Cancer Network MDT (11-2K-1) /12 Date Self Assessment Completed 24th November 2011 Date of IV Review 25th November 2011 Lead Clinician Dr Paul Mulholland Compliance CANCER NETWORK MDT Key Themes Structure and function of the service Self Assessment 80.8% (21/26) Internal Validation 61.5% (16/26) The role of the Cancer Network MDT is to coordinate the non surgical aspects of care quality holistic care for patients affected by Brain and Central Nervous System cancers. We work as a team offering a high quality, comprehensive service to the patient, their family and friends. A holistic approach has been adopted by all members of the team and the ability to video conference to all of the community palliative care teams across the Network results in better communication and ultimately better care for the patients. A Clinical Nurse Specialist has been newly appointed and is working across National Hospital for Neurology and Neurosurgery and Mount Vernon Cancer Centre to improve communication and to enable patients at diagnosis to meet with their key worker and ensure smooth transition of care through the patient pathway. Last year 107 patients were discussed by the Cancer Network MDT. All the core members are in place but cover has not been established for many. The Mount Vernon chemotherapy and radiotherapy treatment is carried out, compliant with waiting time standards for 62 day and 31 day targets. Coordination of care/patient pathways The CNMDT continues to work towards improving co-ordination of care for patients who are referred for treatment. The neurosurgical pathway for the patients has only been agreed in recent months and therefore the establishment of this pathway will take time to become embedded. INTERNAL VALIDATION REPORT for Mount Vernon Cancer Centre - Cancer Network MDT (published: 15th December 2011) Page: 1/5

2 There was a difficulty with transfer of electronic imaging from the network to National Hospital for Neurology and Neurosurgery which should now be resolved with the introduction of CIMAR. The oncology pathway is being addressed at present and this will be of great benefit to the Network MDT and the patients as more information will be available for discussion at the MDT. Patient experience The patient Information prescription has been updated within the last month to be more specific to the patients needs. Mount Vernon patients were not included in the recent National Inpatient Survey as they were not recorded on the Trust PAS system at the time of data collection; therefore we were unable to use this data to ascertain patients' experiences within our in patient facility. This has now been rectified and Mount Vernon patient will be included in the next National inpatient survey in December 2011, the team look forward to the results of this survey. Patient information is available for all stages and types of treatment in easy to read leaflets whilst all patients have access to a Macmillan information centre. Mount Vernon has been the pilot site for patient information prescription which is now being rolled out nationally. Clinical outcomes/indicators Top 5 priorities for team - Establishment of neuro surgical pathway - Repatriation of oncology treatment back to Mount Vernon Cancer Centre - Implementation of CIMAR - IT system for transfer of images to and from the neuro-surgical centre - Patient survey - Addressing the Core membership of the MDT,attendance rates and the provision of cover - Addressing the transfer of information to and from the CNMDT and back to the GP/Referring team Good Practice Good Practice/Significant Achievements - Macmillan sponsored Clinical Nurse Specialist application successful and post holder employed September Commenced MDT with involvement of clinicians both from Mount Vernon Cancer Centre, National Hospital for Neurology and Neurosurgery and Community Palliative Care teams across the network - Specialist neuro rehabilitation pathways have been mapped across the network - Implementation of Information prescriptions with the Linda Jackson Centre - Close working relationships with NHNN - Patient access to trials with a designated medical oncologist Concerns INTERNAL VALIDATION REPORT for Mount Vernon Cancer Centre - Cancer Network MDT (published: 15th December 2011) Page: 2/5

3 Immediate Risks Serious Concerns 1. The fact that the clinical oncologist designated as a member of the core MDT has not attended any meetings was highlighted as a serious concern by the panel. During the discussion the panel were assured by the team that this clinical oncologist is expected to attend in the future. 2. The appointment of a neuro-oncology CNS has made a significant difference to the way in which patients can be managed both locally and in developing relationships with the National Hospital for Neurology and Neurosurgery, Queen's Square. The role involves attending MDTs, providing clinical support to patients in the locality areas and undertaking clinical work at the Mount Vernon Cancer Centre. However the lack of formal cover arrangements for MDT or clinical work was highlighted as a serious concern by the panel. They recognise that work is underway to identify suitable arrangements for cover, and the discussion highlighted that there have been difficulties encountered due to the different sub specialisms of the CNS' working at Queen's Square. However the panel strongly recommend that robust arrangements are put into place as soon as possible for both local and CMDT cover. Concerns 1. The panel highlighted that the Clinical Oncologist is the only member of the core MDT not to have attended the advanced communications course. They were assured by the team that this was being addressed and that a place on a future course has been arranged. 2. The lack of a locally produced MDT leaflet containing information on local services was highlighted as a concern. The panel recommend that one is produced as soon as possible and that it includes cover arrangements for the CNS once these are in place. 3. The panel was interested to hear about the communications plan which is currently being put together and implemented across the pathway. However, the panel is concerned that this is a theoretical plan rather than one which is fully operational. While systems appear in place to communicate outcomes of the MDT to GPs, a robust system for communicating with local trust clinical leads is still in development. The review panel strongly suggests that the systems and processes of this plan are implemented throughout the network especially within local Trusts and into community neuro-rehabilitation services. INTERNAL VALIDATION REPORT for Mount Vernon Cancer Centre - Cancer Network MDT (published: 15th December 2011) Page: 3/5

4 General Comments The panel noted the immense amount of work that has gone into developing the CNMDT and in building the relevant systems and processes across the pathway of care. The panel would like to highlight the following areas of good practice; the excellent, strong clinical leadership, both medical and nursing has been a key factor in the achievement of outcomes so far. The team's focus on patient centred care should be recognised and commended. Patients are able to benefit from being included in national clinical trials something that is of particular value to patients within the network. It was noted however that the cover arrangements for the core MDT are not yet in place; the team is therefore urged to review this position. It was also noted that the extended MDT does not include a dietician or radiologist as identified within the peer review measures. While the workplace contained some of the areas which required development by the MDT, this was not a complete record of all actions which are required to be completed. The panel strongly recommends that the workplan is further developed. Summary of validation process The IV panel met on Friday 25th November in order to the review the Network Board, Locality and Cancer Network MDT measures. The panel members included: MVCN Programme Manager- Quality Macmillan Nursing Services Manager Cancer & Palliative Care Commissioning Manager- Acute, Cancer, Palliative and End of Life Care User Representative The panel met privately for two hours to look over the evidence that the group had provided and then after this they met with members of the Brain & CNS IOG and MDT groups face to face in order to consolidate their findings and ask any further questions that they had. When the panel was satisfied that all key topics had been discussed and all queries addressed then they reconvened in order to write up their report. Glossary of Terms: AHP: Allied Health Professional CNMDT: Cancer Network Multi Disciplinary Team CNS: Clinical Nurse Specialist IOG: Improving Outcomes Guidance NDSG: Neuro-Oncology Disease Site Group NHNN: National Hospital for Neurology and Neurosurgery NSMDT: Neurosciences Multi Disciplinary Team SCG: Specialist Commissioning Group UCLH: University College London Hospital UCLP: University College London Partners INTERNAL VALIDATION REPORT for Mount Vernon Cancer Centre - Cancer Network MDT (published: 15th December 2011) Page: 4/5

5 Organisational Statement I, Julie Juliff (Validation Chair) on behalf of EAST AND NORTH HERTFORDSHIRE agree this is an honest and accurate assessment of the Cancer Network MDT. Agreed by Barbara Gill (Chief Executive) on 13th Dec INTERNAL VALIDATION REPORT for Mount Vernon Cancer Centre - Cancer Network MDT (published: 15th December 2011) Page: 5/5