Haematology Clinical Network Group (CNG)

Transcription

1 Haematology Clinical Network Group (CNG) Annual Report This Annual Report has been agreed by: Title Name Date Agreed Haematology CNG Chair Nagesh Kalakonda CMSCN Cancer Clinical Lead Chris Warburton CWW Area Team Medical Director Kieran Murphy Agreed by the Haematology CNG Haematology CNG Annual Report (Approved ) Page 1 of 14

2 Contents 1.0 Structure and function of the CNG Coordination of care/patient pathways Patient experience Clinical outcomes/indicators Good Practice Concerns... 5 Appendix 1.0: Core & Extended Haematology CNG Attendance... 6 Appendix 2.0: CWT Data Appendix 3.0: Clinical Trials Data Haematology CNG Annual Report (Approved ) Page 2 of 14

3 1.0 Structure and function of the CNG This annual report for Cheshire & Merseyside Strategic Clinical Network (CMSCN) Haematology Clinical Network Group (CNG) relates to the operational period 1st April 2013 to 31st March This report describes the work carried out across the Network over the course of the year. The CNG supports the overall aims of the network by facilitating collaboration between providers and users of haemato-oncology services in order to provide seamless care based on best practice. The Group is the main source of clinical advice to the CMSCN Cancer Steering Group & Oversight Group. 13-1C-102h - The CNG is a busy, productive multi-professional group with strong engagement from participating Trusts and MDTs. Group membership is fully compliant with peer review requirements. The CNG s Constitution is reviewed & updated on an annual basis. Content includes: Terms of Reference Communication requirements Key Responsibilities 13-1C-103h The CNG meets triannually. Each MDT was represented at CNG meetings during this period. Appendix 1.0 contains a summary record of meeting dates & attendance. 13-1C-104h - The CNG has produced a detailed work programme, which reflects the strategic ambitions of CMSCN. This has been agreed with the Network Cancer Clinical Lead & Medical Director of Cheshire, Wirral & Warrington Area Team. 2.0 Coordination of care/patient pathways 13-1C-105h - Investigational Guidelines for prognostication and minimal disease monitoring have been agreed for the Haemato-Oncolgy Diagnostic Service (HODS) which are based on peer review principles. 13-1C-107h - The CNG has reviewed & updated its clinical guidelines during this reporting period. These reflect all relevant modalities, including: Acute leukaemia and other myeloid disorders Lymphoid diseases Plasma cell malignancies 13-1C-108h - The CNG in consultation with the AO/Chemotherapy CNG has agreed a list of acceptable chemotherapy treatment algorithms. This is updated bi-annually. 13-1C-108h - The CNG has reviewed & updated its clinical diagnostic pathway. This specifies that: where there is a clinical suspicion of a previously undiagnosed haematological malignancy, diagnostic tissue and blood specimens should be sent direct to the relevant named SIHMDS rather than the local pathology services for diagnosis. Haematology CNG Annual Report (Approved ) Page 3 of 14

4 13-1C-110h - The CNG continued to develop its supportive care pathway during this reporting period. The aim is for this to be signed off during Separately, Trust Lead Cancer Nurses and Macmillan Cancer Information & Support Centre Managers are developing local service directories to enable MDT members to signpost patients on to appropriate sources psychological support, social support and rehabilitation. The CNG has agreed pathways for: Teenage and young adults: covering initial management and follow up on completion of first line treatment Carcinoma of unknown primary Rehabilitation Pathways for radiotherapy and transplant will be developed in Patient experience 13-1C-111h - Results of the 2013 National Cancer Patient Experience Survey were released at the end of August Nationally 11,602 haematology patients responded to the survey of which CMSCN accounted for 2.6%. Nationally, 88% of patients reporting their care was either excellent or very good, with CMSCN patients reporting more positively network average 91.1%. The results were discussed at the CNG in January 2014 & while there are many questions reporting in the upper percentile, there are areas for improvement. MDTs will be presenting their remedial action plans to the CNG in July 2014, including any actions implemented. 4.0 Clinical outcomes/indicators 3-1C-112h The CNG has agreed that the following network minimum datasets: National Cancer Waiting Times Dataset (NCWTMDS) Systemic Anti-Cancer Therapy Dataset (SACT) Cancer Outcomes and Services Dataset (COSD) Cancer Waiting Times data is reported at each meeting & issues relating to pathway breaches investigated. Systemic Anti-Cancer Therapy Dataset (SACT) & Cancer Outcomes and Services Dataset (COSD) conformance is reported at each meeting to support 100% data compliance by January 2015 & resulting improved haemato-oncology outcomes using high quality data and intelligence. An audit of HODS reporting times has been undertaken in year demonstrating a clear link between the rising workload and longer turnaround times. The team are currently holding monthly meetings to monitor TATs and to implement measures to improve them. Examples include process mapping, revision of diagnostic algorithms to allow rationalisation, additional staffing and revision of technical processes. Haematology CNG Annual Report (Approved ) Page 4 of 14

5 Flow Cytometry Aspirate morphology 50 0 Jul-11 Oct-11 Jan-12 Apr-12 Jul-12 Oct-12 Jan-13 Apr-13 Jul-13 Oct-13 Jan-14 Apr C-113h - The network group discussed MDT's clinical trial reports at its meeting in April. Each Unit agreed to be more proactive in ensuring equity for patients wishing to go into trials. 5.0 Good Practice HODS Team fully in place Funding has been secured for another histopathologist and a business manager. Quarterly HODS quality meetings established Routine audit of HODS turnaround times Interface with Acute Oncology & Chemotherapy CNG Network-wide annual joint neutropenic sepsis audit Annual multi-professional chemotherapy conference Haematology algorithm template agreed Primary care engagement Haematology dose banding pilot agreed Annual network-wide neutropenic sepsis audit Area team engagement 6.0 Concerns E-prescribing implementation Haematology CNG Annual Report (Approved ) Page 5 of 14

6 Core Haematology CNG Membership Appendix 1.0: Core & Extended Haematology CNG Attendance Name Organisation Role Dr Lynny Yung AUHT AUH/S&O MDT Lead Clinician Consultant Haematologist D D AT AT Rachel Chidley AUHT AUH/S&O MDT Nursing Representative Haematology CNS Dr Nauman Butt RLBUHT RLBUHT MDT Lead Clinician Consultant Haematologist Dr Nagesh Kalakonda BLBUHT RLBUHT MDT Lead Clinician Haematology CNG Chair Consultant Haematologist Chris Ward RLBUHT RLBUHT MDT Nursing Representative Haematology CNS Dr David Galvani WUHT WUHT/COC MDT Lead Clinician Consultant Haematologist Amanda Goodier WUHT WUHT/COC MDT Nursing Representative Haematology CNS Laura Whittle 1 COCH WUHT/COC MDT Nursing Representative Haematology CNS Dr Toby Nicholson STHK STHK/WHH MDT Lead Clinician Consultant Haematologist Lorraine Derbyshire WHH STHK/WHH MDT Nursing Representative Haematology CNS AT AT AT AT AT AT AT AT AP AT AP AP AT AP AP AT AT AT AT Sandra Hatton N/A User Representative AP AP AP Haematology CNG Annual Report (Approved ) Page 6 of 14

7 Jeff Engel N/A User Representative Barbara Palus N/A User Representative Leigh Pauls 2 MCCRN/AUHT Research Practitioner AT AT AT AP Sarah Griffiths CMSCN Administrative Support AT AT AT AT Mohamed Saipillai CCC Clinical Oncologist AP Dr Geetha Menon RLBUHT Pathologist AT AT AP AP Philip Jones UHA Radiologist AP AP AP AP 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 KEY: AT = Attended AP = Apologies sent D = Deputy sent R = Remote Attendance (TC/VC) Haematology CNG Annual Report (Approved ) Page 7 of 14

8 Extended Haematology CNG Membership Name Organisation Role Dr Jeff Smith AUHT Consultant Haematologist AT AT AT AT Dr Vikram Singh AUHT Consultant Haematologist Julie Curran AUHT Haematology CNS Ian Hincks AUHT Haematology CNS Mark Caswell AH Paediatric Oncologist AP Dr Salaheddin Tueger COCH Consultant Haematologist Dr Edwin Lee COCH Consultant Haematologist Dr Hilary Leggat COCH Consultant Haematologist Dr Gillian Brearton COCH Consultant Haematologist AT AT AT AT Dee Forbes COCH Haematology CNS Dr Angela Douglas LWH Consultant Clinical Cytogeneticist : Scientific Director, Cheshire and Merseyside Regional Genetics Laboratory AT D D Julia Kenyon LWH Clinical Scientist AT AT Magada Ainscough LWH Principal Scientist AT AT Dr Rak Salim RLBUHT Consultant Haematologist Dr Arpad Toth RLBUHT Consultant Haematologist AP AP Professor Richard Clark RLBUHT Consultant Haematologist AP Professor Andy Pettitt RLBUHT Consultant Haematologist AP AP Dr Stephen Hawkins RLBUHT Consultant Haematologist Director of HODS AT AT AT AT Dr Arvind Arumainathan RLBUHT Consultant Haematologist AT AP AT AT Dr Sarah Coupland RLBUHT Consultant Histopathologist AP Cathy Marsden RLBUHT Nurse Consultant AP AP AP AP Haematology CNG Annual Report (Approved ) Page 8 of 14

9 Dan Collins RLBUHT Pharmacist AT AT AT AT Linda Boyne RLBUHT Counsellor AP AP AP AP Elizabeth Dale RLBUHT Research Practitioner Dr David O Brien S&O Consultant Haematologist Lynn Sugden S&O Haematology CNS Dr John Tappin STHK Consultant Haematologist Dr Maged Gharib STHK Consultant Haematologist Ruth Jackson STHK Haematology CNS AP AP Dave Keegan STHK Haematology CNS Dr Chandramouli Nagarajan WHH Consultant Haematologist AP AP AT AT Dr Mohamed Kaleel-Rahman WHH Consultant Haematologist AT Ruth Glenn WHH Haematology CNS Dr Ranjit Dasgupta WUHT Consultant Haematologist Dr Barbara Hammer WUHT Consultant Haematologist Maria Chapman WUHT Haematology CNS Pat Gillis NWC CRN Research Delivery Manager AP AT AP AP Anita Corrigan CMSCN Network Manager AT AT AT AP Caroline Osborne CWW AT Cancer Pharmacist AT AT D AP David Barber CWW AT Cancer Pharmacist AT Haematology CNG Annual Report (Approved ) Page 9 of 14

10 Appendix 2.0: CWT Data Haematology 2 Week Waits Q1 Q2 Q3 Q4 All Trusts Suspected Haematological Malignancies (Excluding Acute Leukaemia) 96.0% 96.8% 95.5% 97.2% All Trusts Suspected Acute Leukaemia 100.0% 100.0% 100.0% 100.0% Haematology 31 Day First Definitive Treatment Q1 Q2 Q3 Q4 All Trusts Haematological Admitted Care 100.0% 98.6% 100.0% 98.9% All Trusts Haematological Non Admitted Care 95.7% 98.9% 99.1% 99.0% Haematology 31 Day Subsequent Treatment Q1 Q2 Q3 Q4 All Trusts Haematological Admitted Care 100.0% 98.4% 100.0% 100.0% All Trusts Haematological Non Admitted Care 97.7% 97.8% 99.1% 98.2% Haematology 62 Day Treatment Q1 Q2 Q3 Q4 All Trusts Haematological Admitted Care 61.9% 76.6% 66.7% 74.4% All Trusts Haematological Non Admitted Care 84.8% 71.9% 82.2% 78.8% Haematology CNG Annual Report (Approved ) Page 10 of 14

11 Haematology 62 Day Consultant Updgrades Q1 Q2 Q3 Q4 All Trusts Haematological Non Admitted Care 84.6% 71.4% 100.0% 100.0% Haematology CNG Annual Report (Approved ) Page 11 of 14

12 Appendix 3.0: Clinical Trials Data 100 MCCRN Haematology Recruitment Activity by Randomisation Type Non RCT RCT 0 RLBUH WUTH S&O CoC UHA STHK WHH CCC Trust RCT Non RCT Total RLBUH WUTH S&O CoC UHA STHK WHH Alder Hey CCC Total Haematology CNG Annual Report (Approved ) Page 12 of 14

13 Haematology Study not open at this site MCCRN Recruitment by Study and Trust - 1 st Apr st Mar 14 Trial Title RLBUH WUTH S&O CoC UHA WHH STHK AH Study Total ALLR3 1 1 AML AML 18 Pilot 1 1 ChOICES 0 0 CHOP-OR 0 0 CLEAR: CLL 0 0 CLL COSMIC 0 0 DESTINY GILEAD 0117 Phase 3 Extension 2 2 InCiTE PIC 0 Site - LenD (Lenalidomide in CLL) 3 3 LI MAJIC MYELOMA XI NCRN 264 VALOR (VOS- AML-301) 2 2 NCRN NCRN421: GS-1101 in Combination with Bendamustine & Rituximab for Previously Treated CLL 2 2 NCRN440: Ibrutinib versus ofatumumab in relapsed/refractory CLL or SLL 2 2 NCRN443 PREAMBLE 1 1 NCRN448: EPIC 5 5 NCRN480 STRATUS 1 1 NCRN554 Ibrutinib in CLL/Small Lymphocytic Lymphoma 1 1 NCRN NCRN Study closed to recruitment PICLLe 0 0 RAvVA 4 4 RIAltO TEAMM UKALL UKALL Total Haematology CNG Annual Report (Approved ) Page 13 of 14

14 Lymphoma MCCRN Recruitment by Study and Trust - 1 st Apr st Aug 13 Study not open at this site Study closed to recruitment Trial Title RLBUH WUTH S&O CoC UHA STHK CCC Study Total CHEMO-T IELSG Intestinal t-cell trial (ITCL) 0 0 NCRN069 ORCHARRD - Ofatumumab vs Rituximab followed by ASCT in DLBCL 1 1 NCRN316 - Rixutimab in non- Hodgkin's lymphoma 7 7 NCRN394 RAY - Ibrutinib vs Temsirolimus in mantle cell lymphoma 2 2 NCRN414 LUMIERE - Alisertib vs investigators choice in relapsed or refractory peripheral T-cell lymp 0 0 NCRN439: BAY in indolent NHL 0 0 NCRN483 DAWN 1 1 NCRN487:A+AVD vs ABVD in first line advanced Hodgkin Lymphoma 3 3 NSHLG PACIFICO REMoDLB Total Haematology CNG Annual Report (Approved ) Page 14 of 14