CLIC Sargent Eligibility Criteria

Transcription

1 1 Eligibility Criteria DOCUMENT GOVERNANCE: Eligibility criteria Produced by J. Hawkins & Grants Team Sponsored by Dara de Burca Version Approval by Executive Team 10 th June 2014 Board of Trustees 3 rd July 2014 Version V2.1 Version 2 start date 12th January 2015 Version amendments V Eligibility & Registration Criteria for Financial Support Susan George V2 v 2014 Review: Criteria updated & applicable across all services V2.1 March 2015 Minor amendment to Bone Marrow Failure Syndrome list page 7 following a researched appeal. Review Date January 2017

2 2 Eligibility Criteria Eligibility criteria: Children and young people are eligible for a grant and service if they are diagnosed with cancer before their 25 th birthday. The child or young person must be eligible for free NHS cancer treatment within the UK, including members of (or child of) HMS Armed Forces and diplomatic core/embassies. The child or young person is being treated and coded as cancer under the medical specialties of oncology, neuro-oncology, surgical oncology or malignant haematology, or have a bone marrow failure syndrome covered by the national CCLG guidelines. (In TYA services this may include a range of site specific cancer MDTs) Ineligible: Patients who have completed curative treatment for more than a period of 12 months. Patients who relapse or have a new cancer diagnosis after their 25 th birthday. Children or young people diagnosed with a condition which pre-disposes them to a cancer diagnosis. Such patients become eligible at the point of cancer diagnosis. Patients who have been diagnosed outside the UK and travel from their country of origin to the UK and are not eligible for free NHS treatment. International and private patients who are funded by their government/embassy/employer(s) or themselves. Appeals Process: Diagnosis may be uncertain or very rare and workers may be unsure if the child or young person fits the criteria. Go through the steps in appendix 1. Contact Jeanette Hawkins or Simon Morgan-Jones for advice as per the queries and appeals box.

3 3 Appendix I Easy Guide Is the child or young person less than 25 years old at diagnosis? or relapse? Is the child or young person eligible for free NHS treatment? Ineligible Is the child or young person being treated and coded as by cancer the NHS by the under NHS oncology, under neuro- oncology, neuro- surgicaloncology, or surgical- malignant oncology haematology? or malignant haematology? For additional guidance For refer additional to appendices guidance II refer (children) to appendices or III (young II (children) People) or III (young People) Does the child or young person have a bone marrow failure syndrome covered by the CCLG Guidelines? For additional guidance refer to appendix IV Is this; A rare tumour? A borderline tumour? Inoperable for histology Undefined point on a benign / malignant continuum? And the Consultant would like to appeal? Eligible Ask Queries Consultant & Appeals for supporting Ask Consultant evidence for and supporting discuss evidence with; and discuss with; Jeanette.hawkins@clicsar gent.or.uk Jeanette.hawkins@clicsarge Or nt.or.uk Simon.Morgan- Or Jones@clicsargent.org.uk Simon.Morgan- Jones@clicsargent.org.uk And cc. grants@clicsargent.org.uk

4 4 Appendix II Detailed lists for further guidance: Children Children with the following diagnoses are normally eligible for s support/services: Source WHO International Classification of childhood cancer ICD codes For more detailed subgroups of haematological malignancy see; Group 1 Leukaemias, myeloproliferative diseases, and myelodysplastic diseases Lymphoid leukaemias Acute myeloid leukaemias Chronic myeloproliferative diseases Myelodysplastic syndrome and other myeloproliferative diseases Unspecified and other specified leukaemias Group 4 Neuroblastoma and other peripheral nervous cell Neuroblastoma and ganglioneuroblastoma Other peripheral nervous cell Group 7 Hepatic Hepatolastoma Hepatic carcinomas (inc Hepatocellular carcinoma) Unspecified malignant hepatic Group 10 Germ cell, trophoblastic and of gonads Intracranial and intraspinal germ-cell Malignant extracranial and extragonadal germ cell Malignant gonadal germ-cell Gonadal carcinomas Other and unspecified malignant gonadal Group 13 Other Lymphoproliferative Langerhans Cell Histiocytosis LCH Haemophagacytic Lymphohistiocytosis HLH Group 2 Lymphomas and reticuloendothelial Hodgkin Lymphomas n-hodgkin lymphomas Burkitt Lymphoma Miscellaneous lymphoreticular Unspecified lymphomas Group 5 Retinoblastoma Retinoblastoma Group 8 Malignant Bone Tumours Osteosarcoma Chondrosarcoma Ewing s tumour and related sarcomas of bone Other specified malignant bone Group 11 Other malignant epithelial and malignant melanomas Adrenocortical carcinoma Thyroid carcinoma Nasopharyngeal carcinomas Malignant melanomas Skin carcinoma Other and unspecified carcinomas Group 3 CNS and miscellaneous intracranial and Ependymoma and choroid plexus tumour Astrocytoma Intracranial and intraspinal embryonal Other gliomas Other specified intracranial and Unspecified intracranial and Group 6 Renal Tumours Nephroblastoma and other nonepithelial renal (includes Wilm s) Renal carcinoma Unspecified malignant renal Group 9 Soft tissue and other extraosseous sarcomas Rhabdomyosarcoma Fibrosarcomas, peripheral nerve sheath and other fibrous Kaposi sarcoma Other specified soft tissue sarcomas Unspecified soft tissue sarcomas Group 12 Other and unspecified malignant Other specified malignant Other unspecified malignant

5 5 Appendix III Detailed lists for further guidance: Cancers in Adolescents and Young Adults Young People with the following diagnoses are normally eligible for s support/services: Source: British Journal of Cancer (2002) 87, NEC= t elsewhere classified Group 1 Leukaemias 1.1. Acute lymphoid leukaemia (ALL) 1.2. Acute myeloid leukaemia (AML) 1.3. Chronic myeloid leukaemia (CML) 1.4. Other and unspecified leukaemia (Other Leuk) Other and unspecified lymphoid leukaemias Other and unspecified myeloid leukaemias Other specified leukaemias, Unspecified leukaemia NEC Group 4 Osseous and chondromatous, Ewing s tumour and other of bone (bone ) 4.1. Osteosarcoma 4.2. Chondrosarcoma 4.3. Ewing s tumour 4.4. Other specified and unspecified bone (Other bone ) Other specified bone Unspecified bone Group 7 Melanoma and skin carcinoma 7.1. Melanoma 7.2. Skin carcinoma Group 2 Lymphomas 2.1. n-hodgkin s lymphoma (NHL) n-hodgkin s lymphoma, specified subtype n-hodgkin s lymphoma, subtype not specified 2.2. Hodgkin s disease (HD) Hodgkin s disease, specified subtype Hodgkin s disease, subtype not specified Group 5 Soft Tissue Sarcomas 5.1. Fibromatous (Fibrosarcoma) 5.2. Rhabdomyosarcoma 5.3. Other soft tissue sarcomas Other specified soft tissue sarcomas Unspecified soft tissue sarcomas Group 8 Carcinomas (except of skin) 8.1. Carcinoma of thyroid 8.2. Other carcinoma of head and neck Nasopharyngeal carcinoma Carcinoma of other sites in lip oral cavity and pharynx Carcinoma of nasal cavity, middle ear, sinuses, larynx and other ill-defined sites in head and neck 8.3. Carcinoma of trachea, bronchus, lung and pleura Group 3 CNS and other intracranial and 3.1. Astrocytoma Specified low grade astrocytoma Glioblastoma and anaplastic astrocytoma Astrocytoma not otherwise specified 3.2. Other gliomas 3.3. Ependymoma 3.4. Medulloblastoma and other primitive neuroectodermal 3.5. Other and unspecified malignant intracranial and (Other CNS) Other specified malignant intracranial and Unspecified malignant intracranial and 3.6. n-malignant intracranial and Specified non-malignant intracranial or Unspecified intracranial or Group 6 Germ cell and trophoblastic 6.1. Gonadal germ cell and trophoblastic 6.2. Germ cell and trophoblastic of non-gonadal sites Intracranial germ cell and trophoblastic Other non-gonadal germ cell and trophoblastic Group 9 Miscellaneous specified NEC 9.1. Embryonal NEC Wilms tumour Neuroblastoma Other embryonal NEC 9.2. Other rare miscellaneous specified Paraganglioma and glomus Other specified gonadal NEC Myeloma, mast cell and miscellaneous reticuloendothelial NEC

6 6 Group 10 Unspecified malignant NEC Unspecified NEC 8.4. Carcinoma of breast 8.5. Carcinoma of genito-urinary (GU) tract Carcinoma of kidney Carcinoma of bladder Carcinoma of ovary and testis Carcinoma of cervix and uterus Carcinoma of other and ill-defined sites in GU 8.6. Carcinoma of gastro-intestinal (GI) tract Carcinoma of colon and rectum Carcinoma of stomach Carcinoma of liver and illdefined sites in GI tract 8.7. Carcinomas of other and illdefined sites not elsewhere classified (NEC) Adrenocortical carcinoma Other carcinomas NEC Group 11 Other Lymphoproliferative Langerhans Cell Hystiocytosis LCH Haemophagacytic Lymphohistiocytosis HLH Other specified NEC

7 7 Appendix IV Bone Marrow Failure Disorders covered by CCLG guidelines Source: CCLG Children s Cancer & Leukaemia Group Aplastic Anaemia in Childhood: Treatment Guidelines V3.1 July 2013 and planned 2015 EBMT transplant guidance. Eligible from diagnosis: Bone Marrow Failure Syndromes Aplastic Anaemia Fanconi Anaemia Dyskeratosis Congenita (DKC) Shwachmann-Diamond Syndrome (SDS) Congenital Amegakaryocytic Thrombocytopenia (CAMT) Diamond-Blackfan Anaemia Congenital Neutropenia Please note that Appendix II, III & IV are not exhaustive lists and that there are many rare cancers that can affect children and young people, there are also a number of adult cancers that rarely affect children and young people. If you are in any doubt about a child or young person s eligibility for 's services on the basis of their diagnosis, please contact Jeanette Hawkins or Jeanette.hawkins@clicsargent.org.uk