Haematology Regional Group Meeting Monday 18 th October 2010, Antrim Hospital

Transcription

1 Haematology Regional Group Meeting Monday 18 th October 2010, Antrim Hospital In attendance: Dr Anne Kyle Clinical Lead Ms Sarah Taggart Ms Caroline McCaughey Ms Margaret Michael Dr Robert Cuthbert Ms Joanne Ogborn Dr Paul Kettle Mr John Curran Dr Lakshmi Venkatraman Dr Feargal McNicholl Ms Sylvia Cole Dr Jeremy Hamilton Ms Ms Meabh Cassidy Mr Moulod El-Agnaf Ms Lisa McGurgan Dr Lisa Rannigan Mr John McGrath Ms Janis McCulla Dr Mary Drake Dr Eligiusz Marszalek Apologies: Dr Mary-Francis McMullin Dr Don Hull Ms Sarah Williamson Ms Gillian Traub Ms Margaret Bowers Ms Jackie Quinn Dr Kathryn Boyd Ms Sandra Irvine

2 Summary of key points / outcomes/ action Identified Party & date Welcome and Introductions Dr Kyle extended a welcome to the new patient representative, John McGrath, a new pharmacy representative from SE Trust, Meabh Cassidy, and to who is acting as clinical co-ordinator until Lisa returns from maternity leave. 1. Minutes of the Previous Meeting & Matters Arising The minutes of the last meeting were agreed as a true and accurate reflection. Dr Kyle indicated that everything had been picked up from the previous minutes on this meetings agenda apart from the work plan and annual report. Action: Davinia to send out final versions of annual report and work plan to group Haematology Workforce Dr Kyle gave an overview of a regional scoping meeting held on 20 th July to discuss issues around Haematology workforce and workload in the region. The meeting was attended by Haematologist, managerial and nursing representatives from all Trusts in the region and several actions arose from the meeting, one of which was an audit of referral patterns and how referrals are actioned throughout the region. The issues raised at the meeting were also highlighted to the NICaN board in September who asked for a letter to be drafted to the RHSCB outlining details of the problem. Dr Kyle also outlined issues raised with the GP referral guidelines and asked the group whether these need reviewed. The consensus was that they would need reviewed at some stage but not currently. Dr Kyle then queried whether the regional issues in Haematology warranted a request for a review of Haematology services. After discussion on the merits of this approach it was decided to reconvene a meeting of the group from 20 th July following the results of the regional referral audit to discuss workload issues and the way forward. It was also decided to send out the letter that has been drafted to commissioners on workforce issues to the group for comment. Actions Reconvene manpower planning group following results of the regional audit to look at way forward. Send out draft letter outlined Haematology issues to group for comment. Dr Anne Kyle/ Update re Molecular Haematology Diagnostic Service Dr Cuthbert provided an update in relation to this. Dr Venkatraman outlined issues with the turnaround time in molecular pathology and that the issues are not being sorted or addressed. To fix the issues would require massive investment in molecular pathology and the development of a regional service. Dr Venkatraman is working with a small group to set up a diagnostic review panel which they are still working on. They also have diagnostic guidelines out for consultation which they hope to finalise soon. They are still hoping to push forward the issue of the molecular service and the need for it to be preferably single site.

3 Actions Dr Venkatraman to discuss these issues are the meeting of the next pathology group, feedback to Anne Kyle who will take forward the issue through the regional group. Dr Lakshmi Venkatraman, Dr Anne Kyle 2. NICaN Regional Drugs and Therapeutics Process Velcade and Renal Failure Dr Mary Drake gave an update on Velcade. It needs a business case which she was hoping to do. She ed Diedre Quinn who said she should sue a cost per case basis on the meantime but Dr Drake replied and stated that this would cause an unacceptable delay for patients. There followed a discussion on the difficulties experience by group members in trying to get drugs approved on a cost per case basis. Dr Paul Kettle outlined that he has received a letter from CMO stating that all cost per case needs to be signed off by finance. Action: Dr Mary Drake to complete business case for Velcade Dr Kettle to send a copy of the letter to Dr Kyle. Davinia to ask Bridget Tourish for clarification on this matter. Dr Mary Drake, Dr Paul Kettle, 3. Update from Haematology CNS Forum Ms Joanne Ogbourne provided an update. The group are working on regional bone marrow biopsy leaflets one pre procedure, one post procedure and one for H/C professionals. A process for approval of leaflets was agreed. Joanne should send the leaflets to Davinia who will send out to everyone for comment. It was agreed to delay looking at the peer review measures relating to patient experience until we get confirmation of what is happening with peer review. Action: Joanne to talk to Danny Sinclair/ re the use of a readers panel and the pt info sub-group to help with the leaflets. Joanne also to seek Haematologist input to the leaflets. Joanne Ogbourne 4. PPI and patient information update PPI and Pt Information Lead Network and MDT level Ms Janis McCulla outlined the need for a patient information and PPI lead for the group. It was agreed that the group should have two leads to provide cross cover, 1 Haematologist and 1 nurse. Feargal McNicholl was nominated as a PPI and Pt information lead and also deputy chair for the Haematology regional group. Action - It was agreed to out to the rest of the Haematology nurse representatives on the group to get expressions of interest for the other lead position. 5. Transforming cancer follow up Davinia gave a short presentation on the forthcoming survivorship workshop and opportunities for funding via Macmillan Survivorship programme. See attached presentation for more information. Action: Davinia to circulate more information on the workshop and pilots carried out elsewhere

4 6. Regional Audit The audit titles in year were agreed: 1. Uptake of drugs and therapies against approved business cases Davinia outlined that D&T will request info on rituximab maintenance and Dasatinib for this year and that it is usually the responsibility of the lead author to ensure the audit is carried out in conjunction with pharmacy. 2. Evaluation of the clinical utility of routine bone marrow karyotyping in chronic myeloproliferative disorders This audit has been completed 3. Regional referral audit looking at catchment areas, GP referral patterns and how referrals are actioned this is due to finish at end of November. Dr Lisa Ranaghan stated that the cancer registry GAIN audit could also be included on the in year audit list. Results will be available at the end of March. Dr Cuthbert outlined audit data he has on referrals for flow cytometry. Dr Venkatraman also outlined information available on pathology core biopsies which she will send to Dr Kyle and present on. Davinia to speak to Bridget for guidance on what info will be required from D&T business cases 7. Update from sub-groups Myeloma Guidelines National Guidelines have not been published as yet but Dr Kyle is expected a copy in the near future. Lymphoma Guidelines Dr McNicholl informed the group that the guidelines should be completed by the end of November and will be available for the next group meeting. Acute Leukaemia sub-group Davinia to speak to Dr McMullin re Acute Leukemia guidelines. A pathway has been drawn up but it was previously agreed that CMGs were also needed. Radiology sub-group There has been no progress with the radiology sub-group. Dr McNicholl outlined that he would pick up on the work of this group once the Lymphoma guidelines were completed. PET provision there has still been no response as yet from the letter to Bernie Owens in Belfast Trust. Pathology sub-group Update was provided earlier in meeting Actions Dr McNicholl to circulate draft guidelines to group on completion. Davinia to speak to Dr McMullin re Acute Leukemia guidelines, resend drafted pathway and reconvene meeting of subgroup to look at CMG development. Dr Feargal McNicholl,

5 8. Clinical Trials update Davinia gave quick overview of the role of clinical trials lead. Dr Cuthbert highlighted that clinical trials issues need to be looked at regionally and there were no open trials for lymphoma patients at Belfast Trust. There were still no nominations for clinical trials lead. The group felt that this needed to be looked at regionally to improve clinical trials before someone would take this on. Dr Kyle to write letter on this with PPI involvement and will get a steer from Dermot on how to take issues forward. Dr Anne Kyle 9. CaPPs Dr Lisa Ranaghan outlined the need to agree the best process for running regional queries. There are suggestions that PMSID or the cancer registry could perform this function. The group raised concerns as to how comprehensive the information entered is and also how valid it is. Dr McNicholl raised a query regarding input of data. Actions: Dr Ranaghan agreed to look at issues offline with Haematologists as to how they use the system and give advice on data input. She will look at how the Haematologists are using the CaPPs system and will report back at the next meeting. Dr Ranaghan Date of Next Meeting: Tuesday 18 th January 2011, 2pm