Head & Neck Cancer Clinical Network Group (CNG)

Transcription

1 Head & Neck Cancer Clinical Network Group (CNG) Constitution Version 1.0 This Constitution has been agreed by: Title Name Date Agreed Head & Neck Cancer CNG Chair Ann Dingle CMSCN Cancer Clinical Lead Chris Warburton CWW Area Team Medical Director Kieran Murphy Agreed by the Head & Neck Cancer CNG Head & Neck Cancer CNG Constitution 2014 Page 1 of 15

2 Version Control This is a controlled document please destroy all previous versions on receipt of a new version. Date Approved: August 2014 Review Date: April 2015 Version Date Issued Review Date Brief Summary of Change 1.0 August 2014 April 2015 Approved Head & Neck Cancer CNG Constitution 2014 Page 2 of 15

3 Table of Contents Section 1.0: Structure and Function Structure & Function Network Configuration C-101i/14-1C-102i/ Distribution and role of Local Support Team C-103i Membership- 14-1C-104i CNG Chair Terms of Reference Communication Key Responsibilities Strategic Development Meeting Frequency C-105i Work Programme & Annual Report C-106i Named Surgeons to perform lymph node resections C-107i... 8 Section 2.0: Co-ordination of Care/Patient Pathways Clinical Guidelines C-108i/14-1C-109i Chemotherapy Treatment Algorithms C-110i Patient Pathways C-111i/14-1C-112i Network Referral Proforma C-113i Section 3.0: Patient Experience C-114i Section 4.0: Clinical Outcomes/Indicators -14-1C-115i Performance Indicators CNG Audits Clinical Trials C-116i Appendix 1.0: Head & Neck Cancer Core CNG Membership Appendix 1.1: Head & Neck Cancer Extended CNG Membership Appendix 2.0: Clinical Guidelines Head & Neck Cancer CNG Constitution 2014 Page 3 of 15

4 Section 1.0: Structure and Function 1.0 Structure & Function Cheshire & Merseyside Strategic Clinical Networks (CMSCN) are based in the North West of England & cover a population in excess of 2.4 million. The healthcare system covers a mix of rural and urban populations with high levels of deprivation and poor physical and mental health. The work of the SCN is facilitated by a support team hosted by Cheshire, Warrington and Wirral Area Team. The network comprises a number of stakeholders including: Patients, carers/families and members of the public 12 Clinical Commissioning Groups 2 NHS England Local Area Teams 9 Acute Hospital Providers (8 with A&E provision) 5 Specialist Hospital Providers 2 Mental Health Trusts 4 Vertically Integrated Community Trusts 3 Community Trusts 10 Hospices 9 Local Authorities 9 Health and Wellbeing Boards 9 Local Healthwatch organisations 2 Academic Health Science Networks 1 Ambulance Trust This document outlines the Constitution and Terms of Reference for the Head & Neck Cancer Clinical Network Group (CNG) and will be reviewed on an annual basis. 1.1 Network Configuration C-101i/14-1C-102i/ Within CMSCN there is a single Head and Neck Clinical Network Group (CNG) that deals with upperaero digestive tract (UAT) cancer and thyroid cancer. Within Merseyside and Cheshire Cancer Network there is an established Head and Neck MDT hosted by Aintree University Hospitals NHS. The MDT deals with all cases of upper-aero digestive tract cancer, salivary gland tumours, UAT cancer involving the skull base and thyroid cancer. The MDT serves a network population of 2.3 million. All surgery for patients with UAT cancer, other than excision biopsy, is undertaken at Aintree University Hospital and all patients are managed on a designated head and neck ward. Hemithyroidectomy, total thyroidectomy and level 6 dissection is undertaken outside Aintree for well differentiated thyroid cancer following agreement by the SMDT. Complex thyroid cancer including medullary cancer and those well differentiated cancers that may have local invasion or lymph nodes outside level 6 are undertaken at Aintree. Diagnosis and assessment of patients with head and neck cancer symptoms takes place in designated hospitals. The current network configuration is detailed below. Head & Neck Cancer CNG Constitution 2014 Page 4 of 15

5 Designated Hospital Name of Trust Designated Head & Neck Clinicians Aintree Hospital Royal Liverpool University Hospital Whiston Hospital Warrington Hospital Aintree University Hospital NHS Royal Liverpool & Broadgreen University Hospital NHS Trust St Helens & Knowsley Teaching Hospitals NHS Trust Warrington & Halton Hospitals NHS Foundation Trust N Roland S Jackson T Jones J Lancaster S Tandon J Brown R Shaw F Bekiroglu S Rogers S Jackson A Panarese R Shaw T Jones M Dodd V Nandapalan S Hampal J Brown Designated Thyroid Clinicians S Jackson N Roland J Lancaster S Tandon R Hardy A Waghorn A Panarese S Shore Neck Lump Clinic Specialist Thyroid Clinic V Nandapalan Integrated with neck lump clinic B Taylor N Sarfraz J Hobson Countess of Chester Hospital Countess of Chester NHS J Tahery K Fleming J Tahery C Harding McKean Arrowe Park Hospital Wirral University Teaching Hospital NHS Foundation Trust S Jackson D C Jones V Srinivasan G O Sullivan I Sherman V Srinivasan S Blair Integrated with neck lump clinic Ormskirk Hospital Southport & Ormskirk Hospitals NHS Trust T Lesser M Boyle N Roland N Roland Integrated with neck lump clinic Leighton Hospital Mid Cheshire Hospital NHS A Dingle F Bekiroglu A Dingle A Guy Integrated with neck lump clinic 1.2 Distribution and role of Local Support Team C-103i In order to provide aftercare and rehabilitation to patients following treatment, local support teams have been established by each designated hospital. Protocols have been developed that outline the Head & Neck Cancer CNG Constitution 2014 Page 5 of 15

6 role of the specialist team at Aintree, Clatterbridge Centre for Oncology and that of the local support teams in each of the above localities. These protocols (see clinical guidelines) are supported by a number of key principles that define the role of the local support teams as follows: To manage the aftercare and rehabilitation of head and neck cancer patients within the relevant locality To work closely with the Head and Neck MDT and other health professionals involved in the care of patients To co-ordinate local provision of services for each individual across different agencies and disciplines To ensure that appropriate levels of service are achieved and that gaps in service are highlighted to Locality Groups for resolution To work to agreed network protocols and ensure liaison with the MDT when specialist input/advice is required. The agreed configuration of local support teams is detailed below: Local Support Team Designated Hospital Locality Aintree Aintree Hospital Sefton Southport & Ormskirk Ormskirk Hospital Sefton Liverpool Royal Liverpool University Hospital Liverpool St Helens Whiston Hospital Eastern Sector Knowsley Whiston Hospital Eastern Sector Warrington & Halton Warrington Hospital Eastern Sector Wirral Arrowe Park Hospital Wirral Chester Countess of Chester Hospital Western Cheshire Mid Cheshire Leighton Hospital Central Cheshire 1.4 Membership- 14-1C-104i Core membership consists of: the MDT lead clinician from each of Head & Neck Cancer MDTs at least one nurse core MDT member a Head & Neck Cancer surgeon a clinical oncologist a medical oncologist a radiologist a histopathologist a consultant representing the radioactive iodine treatment modality two user representatives a named chair who should be a core MDT member an NHS employed member of the CNG nominated as having specific responsibility for users' issues and information for patients and carers a member of the CNG nominated as responsible for ensuring that recruitment into clinical trials and other well designed studies is integrated into the function of the CNG named secretarial/administrative support Head & Neck Cancer CNG Constitution 2014 Page 6 of 15

7 Please see Appendix 1.0 for full membership list. 1.3 CNG Chair The chair of the Head & Neck Cancer CNG is Ann Dingle, Consultant Ear, Nose & Throat Surgeon, Mid Cheshire Hospitals NHS Trust. The term of the Chair s role should be reviewed after three years. The Chair will have an annual review with the Network Cancer Clinical Lead. Members of the Head & Neck Cancer community who express interest in chairing the CNG will be invited to a meeting with the Cancer Clinical Lead who will decide the Chair based on agreed skills and competencies. A key part of the role will be to ensure effective engagement of constituent members and communication with stakeholders. 1.4 Terms of Reference The Head & Neck Cancer CNG is the main source of clinical advice to the CMCSN Cancer Steering Group & Oversight Group on all matters relating to its area of expertise. The role of the CNG is to ensure co-ordination of the cancer pathway, consistency of clinical practice and to achieve the best possible outcomes and experience for patients, irrespective of where their treatment and care is provided. The role of the CNG includes: Service planning Service improvement Service monitoring including clinical performance and outcomes Workforce development Research and development The CNG has a key role in the development of plans to implement national guidance and to monitor implementation. These will subsequently form part of the Network s Service Delivery Plan. It will ensure that concerns and areas of risk are raised with the Taskforce via agreed governance agreements. The NCG should have active engagement of all chemotherapy teams in the network. 1.5 Communication The Chair will provide feedback to the Cancer Steering Group including presenting key areas of work e.g. service priorities. The Chair will represent the Network appropriately, including at a regional and national level. Members should ensure that all decisions are fed back and become integrated into constituent organisational structures and processes. The Chair will ensure that all CNG peer review evidence is updated annually. 1.6 Key Responsibilities The responsibilities of the CNG are to: Review latest national guidelines/standards published by NICE, Department of Health, Royal Colleges and other professional bodies/committees agreeing best practice recommendations. Coordinate the consistent implementation of national guidance/recommendations across the network. Head & Neck Cancer CNG Constitution 2014 Page 7 of 15

8 To work closely with other network groups to develop clinical and referral guidelines that reflect best practice Identify local population needs and gaps in service and advise on approaches to address these. To provide expert advice to commissioners on the commissioning of cost effective anticancer therapies, best service models, pathways of care and emerging technologies Develop workforce recommendations in response to service developments, recruitment difficulties and emergent technologies. Annually monitor progress regarding compliance against cancer measures, participating fully in the peer review process and ensuring any remedial action plans following peer review are implemented. Stimulate and lead areas for service improvement and innovation within the network. Analysis of national minimum data sets for variations in clinical practice/patient outcomes Review approved clinical trials, other research and development initiatives and encourage patient entry Undertake network wide audit and provide a forum for the wider discussion of local audits as part of its role in education and development. Ensure there is a process for obtaining patient and carer advice and involvement in service issues and in the development of plans related to the CNG. 1.7 Strategic Development The CNG will ensure engagement and communication with stakeholders with regard to service plans and developments. This will include triennial identification of investment requirements necessary to meet quality standards and outcomes which will serve to influence strategic commissioning plans. This will be agreed and monitored as part of the CNG work programme. In line with its terms of reference the CNG will ensure that service planning; considers the whole patient pathway promotes high quality care and equal access to services takes account of the views of patients and carers considers opportunities for workforce and service redesign 1.8 Meeting Frequency C-105i CNG meetings will be held triannually with additional meetings as required for short term task and finish projects. The meeting will be quorate when 50% of the units are represented at the meeting. Meeting attendance will be recoded and reported annually. 1.9 Work Programme & Annual Report C-106i The CNG will review and update its constitution annually. An annual report and work programme will be complied by the group. The three key documents will be ratified by the CNG at the first meeting following 1 st April each year. 1.9 Named Surgeons to perform lymph node resections C-107i Hemi-thyroidectomy, total thyroidectomy and level 6 dissection is undertaken outside Aintree for well differentiated thyroid cancer following agreement by the SMDT. Complex thyroid cancer including medullary cancer and those well differentiated cancers that may have local invasion or lymph nodes outside level 6 are undertaken at Aintree. Head & Neck Cancer CNG Constitution 2014 Page 8 of 15

9 The following list provides details of the named surgeons authorised to perform lymph node resection on thyroid cancer patients. Patients who have undiagnosed and unsuspected lymphadenopathy at Level 6 should undergo a clearance at the time of thyroidectomy. The policy pertains to pre-diagnosed cervical lymphadenopathy secondary to thyroid cancer. Each member is a core member of the Head and Neck MDT. Name Title Trust Mr N J Roland Consultant ENT/Head & Neck Surgeon Aintree University Hospital NHS Mr S Jackson Consultant ENT/Head & Neck Surgeon Aintree University Hospital NHS Mr T Jones Professor of Head and Neck Surgery Aintree University Hospital NHS Mr J Lancaster Consultant ENT/Head & Neck Surgeon Aintree University Hospital NHS Mr S Tandon Consultant ENT/Head & Neck Surgeon Aintree University Hospital NHS Section 2.0: Co-ordination of Care/Patient Pathways 2.1 Clinical Guidelines C-108i/14-1C-109i The CNG is responsible for ensuring coordination and consistency across the network. This is supported by a number of CNG agreed guidelines for both UAT and Thyroid cancers. These detail how a given patient should be clinically managed i.e. the level of which modalities of imaging and pathology investigation and which modalities of treatment are indicated. Designated CNG members will be identified by the CNG to lead on specific guidelines. The CNG will ratify the guidelines and individual MDTs will agree to abide by them. The CNG will subsequently review, agree and update these guidelines on a regular basis and will audit the implementation of these guidelines, making sure they are kept up to date implementation is required, a network guideline will be developed. See Appendix 2.0 for full list of CNG agreed polices/guidelines. 2.2 Chemotherapy Treatment Algorithms C-110i The network group, in consultation with the Acute Oncology & Chemotherapy CNG will agree a list of acceptable chemotherapy treatment algorithms. The list will be updated bi-annually. 2.3 Patient Pathways C-111i/14-1C-112i The CNG has agreed a generic patient supportive care pathway & tasked each unit with developing & maintaining service directories identifying the named contact points for local service. Primary care and MDT management pathways are included in the CNG Clinical Guidelines & subject to biennial review. Head & Neck Cancer CNG Constitution 2014 Page 9 of 15

10 In addition, the CNG has agreed the following pathways: TYA pathways for initial management and for follow up on completion of first line treatment Carcinoma of Unknown Primary Pathway Sarcoma Pathway Rehabilitation Pathway See Appendix Network Referral Proforma C-113i The CNG has agreed a referral proforma for patients with UAT symptoms which are out the urgent suspicion of cancer definition. See Appendix 2.0 Section 3.0: Patient Experience C-114i The CNG will annually review patient feedback of their associated MDT s and any actions implemented. The CNG will agree any actions required on a network foot print & allocate responsibility for delivery to an appropriate group. CMSCN is committed to user involvement in, and representation on, all Clinical Network Groups. Within the CNG, there are two appointed user representatives who are invited to participate in all discussions at the group and associated events with a standing opportunity for user issues to be raised at every CNG meeting for user feedback and input into the group s work programme. In addition, CMSCN use a range of different methods and mechanisms to maximise patient and public involvement in order to allow people to be involved as much or as little as they choose. Fundamental to this approach is the development of the People s Voice. This largely virtual assembly will consist of patient, carer, public and community representatives; its purpose is to support the participation and engagement of patients, carers and members of the public on changes and improvements to health and wellbeing services, policies or strategies. In addition, Sally Lane has been nominated as having specific responsibility for users issues and information for patients and carers. Section 4.0: Clinical Outcomes/Indicators -14-1C-115i 4.1 Performance Indicators The CNG has agreed that the following network minimum datasets: National Cancer Waiting Times Dataset (NCWTMDS) COSD Data for Head and Neck Oncology (DAHNO) Cancer Waiting Times data is reported at each meeting & issues relating to pathway breaches investigated. Cancer Outcomes and Services Dataset (COSD) conformance is reported at each meeting to support 100% data compliance by January 2015 & resulting improved head & neck outcomes using high quality data and intelligence. Head & Neck Cancer CNG Constitution 2014 Page 10 of 15

11 DAHNO data will be reviewed annually by the CNG following publication of Annual Report to enable review of Trust and SCN data & allow comparisons to improve the quality of care and survival of patients with head & neck cancer. The CNG has agreed that collection of the MDS and associated checks on quality, quantity and validity is the responsibility of Trust Cancer Teams and ultimately is the responsibility of the named Executive Lead for Cancer in each Trust. All teams should collect the data relevant to the care they have provided. Where a patient is referred between teams for specialist investigations or treatment, then it is the responsibility of the specialist MDT to transfer the relevant dataset that they collect during the care of their patients back to the referring MDT. The Somerset Cancer Register (SCR) is accepted as the primary data collection system used to collect cancer data across CMSCN. Each Trust will ensure that data capture systems are organised to ensure that data is collected in a timely manner and in accordance with Caldicott and data protection policies. 4.2 CNG Audits In line with the agreed terms of reference, the CNG will agree a network audit project and review progress/completion on an annual basis. 4.3 Clinical Trials C-116i The CNG will: Support local equity of access for all patients across CMSCN Support the development of the North West Coast Clinical Research Network (NWC CRN) portfolio of cancer studies Identify service configuration requirements to deliver local and national trials portfolio and develop plans for implementation Receive annual recruitment report from each MDT and agree any remedial actions. Head & Neck Cancer CNG Constitution 2014 Page 11 of 15

12 Core Head & Neck Cancer CG Membership Appendix 1.0: Head & Neck Cancer Core CNG Membership Name Organisation Role Jeff Lancaster Aintree University Hospitals AUH MDT Lead, Consultant ENT Surgeon Huw Lewis-Jones Aintree University Hospitals Radiologist Professor Richard Shaw 1 Aintree University Hospitals North West Cancer Research Centre Consultant ENT Surgeo Shirley Pringle 1 Aintree University Hospitals Research Practitioner Sally Lane 2 Aintree University Hospitals Clinical Nurse Specialist Ann Dingle Mid Cheshire Hospitals NHS CNG Chair, Consultant ENT Surgeon, AUH MDT Member Tim Helliwell Royal Liverpool and Broadgreen University Hospital NHS Trust Consultant Histopathologist Linda Smith Royal Liverpool and Broadgreen University Hospital NHS Trust Consultant in Nuclear Medicine Network Thyroid Lead David Husband The Clatterbridge Cancer Centre Clinical Oncologist Vacant The Clatterbridge Cancer Centre Medical Oncologist Barbara Rouse N/A Patient Representative Geoff Hodge N/A Patient Representative Debbie McEllenborough Cheshire & Merseyside Strategic Cancer Network Network Assistant 1 CNG Lead for users issues and information for patients and carers 2 CNG Lead for ensuring recruitment into clinical trials and other well designed studies Head & Neck Cancer CNG Constitution 2014 Page 12 of 15

13 Extended Head & Neck C Membership Appendix 1.1: Head & Neck Cancer Extended CNG Membership Name Organisation Role Catherine Beardshaw Aintree University Hospitals Chief Executive Shaun Jackson Aintree University Hospitals NHS Consultant ENT Surgeon Nick Roland Aintree University Hospitals NHS Consultant ENT Surgeon Sankalap Tandon Aintree University Hospitals NHS Consultant ENT Surgeon Jon Sheard Aintree University Hospitals Consultant Hisptopathologist Terry Jones Aintree University Hospitals NHS Consultant ENT Surgeon James Brown Aintree University Hospitals NHS Consultant Maxillofacial Surgeon Simon Rogers Aintree University Hospitals NHS Consultant Maxillofacial Surgeon Faz Bekiroglu Aintree University Hospitals NHS Consultant Maxillofacial Surgeon Chris Butterworth Aintree University Hospitals NHS Consultant in Restorative Dentistry Lisa Houghton Aintree University Hospitals NHS Speech and Language Therapist Ruth Carpenter Aintree University Hospitals NHS Physiotherapist Kerry Nash Aintree University Hospitals NHS Cancer Data Manager Melanie Warwick Aintree University Hospitals NHS Cancer Manager Lesley Dempsey Aintree University Hospitals NHS Clinical Nurse Specialist Rachel Skelly Aintree University Hospitals NHS Dietician Paul Banks Aintree University Hospital Research Practitioner Kimberley Wilson Aintree University Hospital Dietitian Jawed Tahery Countess of Chester Hospital NHS Consultant ENT Surgeon Rebecca Hanlon Aintree University Hospital Consultant Radiologist Alison Waghorn Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant Breast and Endocrine Surgeon Linda Smith Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant in Nuclear Medicine Head & Neck Cancer CNG Constitution 2014 Page 13 of 15

14 Alex Panarese Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant ENT Surgeon Andrew Kwasnicki Royal Liverpool & Broadgreen University Hospital NHS Trust Specialist in Special Care Dentistry Vel Nandapalan St Helens & Knowsley Teaching Hospitals NHS Trust Consultant ENT Surgeon Lorraine Soudani St Helens & Knowsley Teaching Hospitals NHS Trust Clinical Nurse Specialist Adi Shenoy The Clatterbridge Cancer Centre NHS Clinical Oncologist Anoop Haridass The Clatterbridge Cancer Centre NHS Clinical Oncologist Caroline Brammer The Clatterbridge Cancer Centre NHS Clinical Oncologist Kate Green The Clatterbridge Cancer Centre NHS Head and Neck Clinical Nurse Specialist Pam Young The Clatterbridge Cancer Centre NHS Speech and Language Therapist Liz Waters The Clatterbridge Cancer Centre NHS Dietician Kieran Woods The Clatterbridge Cancer Centre NHS Radiographer Alyson Constantine The Clatterbridge Cancer Centre NHS Head of Performance and Improvement Katie Gilkes The Walton Centre NHS Skull Base Lead Neurosurgeon Emma Chadwick The Walton Centre NHS Assistant Divisional General Manager Sucha Hampal Warrington & Halton Hospitals NHS Consultant ENT Surgeon Venkat Srinivasan Wirral University Teaching Hospital NHS Consultant ENT Surgeon Yasmine Maurice Wirral University Teaching Hospital NHS Consultant Histopathologist Clare Norman Wirral University Teaching Hospital NHS ENT Specialist Nurse Head & Neck Cancer CNG Constitution 2014 Page 14 of 15

15 Appendix 2.0: Clinical Guidelines CLINICAL GUIDELINES FOR THE MANAGEMENT OF HEAD AND NECK (INCORPORATING THYROID) V Final - Copy.pdf Head & Neck Cancer CNG Constitution 2014 Page 15 of 15