SCAN Colorectal Group

Transcription

1 DRAFT SCAN Colorectal Group Friday 6 th December pm Oncology Seminar Room, WGH with videolink to Victoria Hospital, Kirkcaldy. Present Ibrahim Amin Angie Balfour Sarah Buchan Paul Fineron Stephen Glancy Christina Lilley Maureen Lamb Christine Dodds Sheena Mackenzie (Chair) Maureen Morgan Mark Potter Chinna Reddy Beth Simpson Ali Stewart Graeme Wilson Apologies Domenyk Brown Patrick Collins Martin Keith Kate Macdonald Hamish Phillips Lynn Smith Isobel Williams MINUTES Consultant Surgeon, NHS Fife ERAS Nurse Practitioner, NHS Lothian SCAN Audit Facilitator Consultant Histopathologist, NHS Lothian Consultant Radiologist, NHS Lothian SCAN Modernisation Manager Cancer Audit Facilitator, NHS Fife Senior Cancer Audit Facilitator, SCAN SCAN Groups and Communications Co-ordinator Consultant Colorectal Surgeon, NHS Lothian CNS, NHS Fife Consultant Surgeon, NHS Borders ERAS Nurse Specialist, NHS Lothian Colorectal Cancer Co-ordinator, NHS Lothian Consultant Radiologist, NHS Lothian Consultant Colorectal Surgeon, NHS Dumfries & Galloway Senior Cancer Information Officer, NHS Dumfries & Galloway Network Manager, SCAN Clinical Oncologist, Edinburgh Cancer Centre Cancer Audit Facilitator, NHS Borders Consultant Colorectal Surgeon, NHS Dumfries & Galloway Colorectal CNS, NHS Dumfries & Galloway Consultant Surgeon, NHS Fife A full membership list is available on HUwww.scan.scot.nhs.ukU Item 1BAction 1 0BIntroductions, apologies, minutes The minutes of the meeting on 9 th August 2013 were approved. Follow-up protocols It had been noted at the previous meeting that patients in Fife who undergo curative resection for colorectal cancer are followed up for 5 years, compared with 3 or 4 years in Lothian. No Fife clinicians were present at the August meeting to provide their rationale for a 5-year follow-up period. It was agreed that board Leads should provide information about their current practice in relation to colorectal SCAN Office, Pentland House, 47 Robb s Loan, Edinburgh EH14 1TY Tel: E: sheena.mackenzie@nhslothian.scot.nhs.uk W: Page 1 of 5

2 follow up for patients undergoing curative resection for colorectal cancer. Mark Potter said that one of his students was in the process of examining the evidence in this area but that it would take some time for the results of this work to be available. Action: Board Colorectal Leads to send information about their current practice in relation to follow up for patients undergoing curative resection for colorectal cancer to Sheena Mackenzie by 31 st January SCAN Issues Christina Lilley gave an update on regional and national developments. Radiotherapy SCAN presented regional data at a national radiotherapy workforce event held on 17 th Sept. The South East and West of Scotland Cancer Networks are currently providing support to the North of Scotland, where there are specific radiotherapy staffing issues. In response to national pressures, the National Planning Forum has commissioned a short-life working group to review the issues and develop an action plan by February Access to New Medicines The Scottish Government has announced that the Individual Patient Treatment Request (IPTR) process is to be replaced by a new peer Approved Clinical System (PACS). While changes are put in place, clinicians are advised to follow IPTR processes. Transforming Care After Treatment (TCAT) SCAN submitted 6 proposals, out of a total of 18, in the first phase of the TCAT programme. Feedback on the proposals has been positive and Macmillan are expected to announce their decision on 13th December. Detect Cancer Early SCAN held a regional meeting on 7th November to share experiences and identified the following areas for possible regional collaboration: - Public health initiatives (eg to tackle inequalities, hard-to-reach groups, prevention, improve symptom awareness, education, communication and increase uptake of screening) - Better co-ordination of planned capital bids. Edinburgh Cancer Centre Reprovision NHS Lothian s Strategic Planning Department is leading work to plan the future accommodation requirements for the Cancer Centre. A scoping meeting has been arranged for 16 th December and regional boards will be involved in the planning process. Visit from Sean Duffy, National Clinical Director for Cancer Services The managers of the 3 Scottish cancer networks will meet Sean Duffy on 17 th December to discuss good practice in and challenges for cancer services in Scotland. Any suggestions for issues to be raised should be communicated to Kate Macdonald (kate.macdonald@nhslothian.scot.nhs.uk / ) before 17 th Dec. Page 2 of 5

3 Draft SCAN ehealth Workplan Group members identified systems to support information sharing as a key clinical priority. 3 Workplan Draft Pathway for SCAN Patients with Colorectal Cancer who have Complex Pelvic Primary Disease or Recurrence The Group discussed the draft pathway developed by and agreed that: - patients should be referred to the Edinburgh Colorectal MDT (rather than to a named consultant) - the purpose of the referral to the MDT should be clearly stated (eg for advice or for specialist treatment in Edinburgh) - the MDT summary should include the name of the Consultant taking on the case - if the referring clinician has any concerns about delays, they should contact the named Consultant in Edinburgh. Audit Comparative Report Sarah Buchan said that the 2012 report was complete apart from the commentary from. Action: to provide commentary for 2012 comparative audit report. It was agreed that the future comparative audit reports should cover financial years, in line with new Scottish and UK-wide reporting schedules. UK Bowel Cancer Audit Sarah Buchan reported that SCAN had submitted data for the 2012/13 report. She said that Maureen Lamb had identified an issue for boards using ecase in relation to submitting data on whether patients have been seen by a CNS, as this is not covered by the QPI dataset. It was agreed that should write to Jim Docherty to support a request that ecase be amended to collect the required data. The Group agreed that, if ecase could not be amended, consideration should be given to other options for collecting this information or submitting data to the UK audit without this particular item. Recurrence data Christina Lilley said that the National Cancer Quality Steering Group had posed a query about the current extent of data collection on recurrence. Group members agreed that they would support the introduction of routine data collection on recurrence and survival. It was suggested that local recurrence at 3 years and 5-year survival might be appropriate measures and that national consistency in data collection was an important consideration. Mode of referral Christine Dodds informed the Group that mode of referral, necessary to identify screening patients, was not included in national datasets. Sarah Buchan had added a field to her Access database to capture Page 3 of 5

4 this information and said that he would make a request to Jim Docherty to enable this information to be collected via ecase. Action: to write to Jim Docherty to request that ecase be amended to collect data on a) whether patients have been seen by a CNS and b) mode of referral. Education Day 2014 suggested that, in view of the limited response from Primary Care to the idea of having a colorectal education day, the Spring 2014 event might focus on quality improvement, with input from all disciplines and all sites. Action: to develop a draft programme for the Spring 2014 Colorectal Education Day for circulation. Joint Surgery with Gynae Surgeons It was noted that a complex pelvic surgery MDM had been established on alternate Friday mornings, with input from Colorectal, Gynaecology and Urology and that it was possible have videolinks to this from other sites. It was noted that joint surgery, with colorectal and gynae surgeons, was beginning to be available in Lothian and that some joint cases had also been undertaken in Fife. It was agreed that the Co-ordinator for the Complex Pelvic Surgery MDM should be asked to send information about referring patients to colleagues in Fife, Borders and Dumfries & Galloway. Action: Sheena Mackenzie to ask Dawn Cole to send information about referring patients to the Complex Pelvic Surgery MDM to the Colorectal Leads in Fife, Borders and Dumfries & Galloway. Sheena Mackenzie reported that he had attended part of a recent SCAN Gynae Education Day where radical intra abdominal ovarian debulking had been discussed and said that he expected the demand for this type of surgery would increase. Mr Mander also observed that Hyperthermic Intraperitoneal Chemotherapy (HIPEC), although not currently available in the SCAN region, was a development on the horizon which it would be useful to learn more about. 4 2BFor information CRUK Primary Care Facilitator Engagement Pilot Sheena Mackenzie advised Group members that Cancer Research UK (CRUK) was funding a pilot in NHS Greater Glasgow and Clyde of employing a Primary Care Facilitator to help practices increase participation in bowel screening. [Editorial note: NHS Lothian is also undertaking pilot work with GP practices to increase the uptake of bowel screening.] Revised primary care referral guidelines for colorectal cancer said that the main changes in the revised guidelines Page 4 of 5

5 were that the timescale for transient symptoms had been reduced from 6 weeks to 4 weeks and that the guidance stated that the carcinogenic embryonic antigen (CEA) test should not be used as a screening tool. The need to update local GP information systems to reflect the revised guidelines was noted and offered to liaise with John Donald about replacing the current page on NHS Lothian s Ref Help system. Action: to liaise with John Donald about replacing the current page about colorectal referrals from primary care on NHS Lothian s Ref Help system. 5 2BAny other business Audit of colonoscopies It was agreed that the Group should review data on new colonoscopies and new CT colonoscopies at the June meeting. Actions: Board reps. to provide local audit data on colonoscopies for by 30 th May. (Note: Lothian data attached.) Stephen Glancy It was noted that Mark Potter and Stephen Glancy had contributed to guidelines for NHS Lothian for imaging of the colon and agreed that these should be circulated with the minutes (copy attached). 6 3BDates of future meetings Date of Colorectal Education Day TBC Friday 6 th June 2014 Friday 5 th Sept 2014 Friday 5 th Dec 2014 All meetings pm in the Telepresence Suite at the Western General Hospital, Edinburgh with videolinks to Dumfries and VHK. (Borders colleagues will book local v/c room if required.) Page 5 of 5