Work Programme/Service Delivery Plan 2010/2013

Transcription

1 Essex and East Suffolk Gynaecological Cancer Network Site Specific Group Work Programme/Service Delivery Plan 2010/2013 Version Number 1.2 Author Members of the NSSG Date Written June 2010 Reviewed May 2011 Next Review May

2 GYNAECOLOGY NSSG Work Programme/Service Delivery Plan AGREEMENT COVER SHEET This has been agreed by: Position Name Chair of Essex Cancer Network Board Pam Court Organisation Chief Executive NHS South West Essex Date Agreed September 2010 Position Name Organisation Chair of Gynae NSSG Mr Anders Linder Consultant Gynae-oncologist at Ipswich Hospitals Foundation NHS Trust Date Agreed June 2010 Position Name Organisation Research Clinical Lead for remedial actions for research (08-1C-108e) Dr Naveed Sarwar Consultant Medical Oncologist, South Essex Date Agreed June 2010 Position NSSG Members Agreed the Work Programme Date Agreed Reviewed June 2010 May 2011 Work Programme Review Date May

3 Essex and East Suffolk Gynaecological Cancer Network Site-Specific Group Work Programme/Service Delivery Plan Action Lead Timescale Critical Success 1. Service Planning Continue to work in partnership to link all gynae cancer referring and specialist centres serving Essex Cancer Network, to maximise collaboration and sharing of expertise though the single NSSG arrangement. NSSG will need to ensure sub-group arrangements remain robust to lead on for example audit, SI Tom Carr Single Gynae NSSG for Essex and East Suffolk meeting regularly and encompassing all requirements of the group as set out in Terms of Reference NSSG to consider publicity and marketing of the Gynae Cancer Network. Finalise the press release about the Network. This is becoming clearly more important considering the ever growing emphasis on Choose & Book Final the plans for the future provision of Gynae Brachytherapy December 2010 Dr Alan Lamont March Service Improvement, Service Development and QIPP NSSG to formally consider and agree Service Improvement priorities for 2010/2013 This will include e.g. Streamlined pathways, communication arrangements between centres, LMDT and SMDT interfaces; Waiting Times, Patient Information, Inpatient care, Psychosexual Support NSSG to identify and agree work groups to take Agree Service Improvement topics and workgroups by December 2010 Demonstrate in annual report Service Improvement achievements 2010/11 3

4 Service Improvement work streams forward Supervised by Anders Linder and Khalil Razvi. Introduction of an Enhanced Recovery Programme for Gynaecological cancer patients across the Network. This will include the assessment of features already in place, parts that are not, and differentiating between what would be useful and what would not. A strategy for this analysis and creating the plan will require local leads and a Network wide steering group to report to NSSG chair. Steering Group to be established Gradual implementation with completion by August 2013 To demonstrate protocols and local logistics implementing the components of Enhanced Recovery. Monitor inpatient times. Produce an agreed protocol and written information on the use of CA125 for follow ups of Ovarian Cancer across the Network.,, Dr Madhavan, Dr Lamont and Alison Garnham June 2011 Production of the protocol. CNS have agreed to meet every 4 months, including a journal club Alison Garnham, Emma Azeem and their CNS colleagues Co-ordination regarding local support groups Emma Azeem, Alison Garnham, Marilyn Lewis Developing and formalising arrangements for key worker Emma Azeem, Alison Garnham Complete All patients given the Network Key Worker Card CNSs planning to improve their knowledge of and improving post op wound care for vulvectomy patients Emma Azeem, Alison Garnham 3. SERVICE DELIVERY NSSG will keep its agreed constitution under review and update annually, ensuring it Review Complete Up to date agreed Clinical Guidelines for management of 4

5 incorporates key Peer Review requirements including MDS, Clinical Trials list, chemotherapy regimens etc. September 2010 Gynae cancer Essex Cancer Network and East Suffolk The implementation of the Somerset data collection system for the Essex based part of the NSSG and connecting it up with the Infoflex system used in Ipswich. August 2011 Up to date agreed Clinical Guidelines for the management of Gynae cancer in the network NSSG to formally consider the key commissioning questions for Gynae Cancer (Cancer Commissioning Guide 2008) and provide response and evidence that addresses these questions. These included in Appendix 1: Annual Audit Event in Spring Answers to Key Commissioning Questions will be presented at Annual Audit Event Review rehabilitation services including access to specialist cancer rehabilitation, palliative and end of life care services across all 4 localities against local rehabilitation pathways ECN Macmillan AHP Lead November 2011 To present service report and completed local rehabilitation pathway to the NSSG 4. SERVICE QUALITY, MONITORING AND EVALUATION Commit to Network-wide Gynae Cancer Audit and presentation of results at annual event. Endometrial cancer audit MRI prior to endometrial cancer 2010 Post surgery to commencing RT Impact on 2WW of the NICE guidance National Patient Satisfaction Audit Compliance against recommended RT fractions. Patient Satisfaction Audit Audit of the percentage of gynaecological oncology surgery performed outside of specialist centres (Key Commissioning Gynae lead clinicians Presentation in: Spring 2012 Gynae NSSG to present local and agreed network-wide audit results at Audit meetings. 5

6 Question) 5. EDUCATION & WORKFORCE Discuss and develop gynae cancer network workforce strategy to inform network annual service delivery plans, this includes consultants (for example getting in place the long planned for second Gynae Oncologist Consultant in Southend and writing up of business case for a third Gynae onc Consultant in Ipswich), middle grade (for example a clinical fellow), nurse specialists ( for example a second Nurse Specialist in Southend), MDT support staff, research and data collection All Group members Network Commissioning Priorities clearly setting out workforce requirements as they relate to Gynae cancer and the filling all required posts. Drawing up of a spread sheet of all core members, to facilitate planning pending retirement and succession planning 6. RESEARCH Ensure Network-wide commitment to Gynae cancer clinical trials maximising recruitment. All Gynae MDT clinicians Evidence that Gynae cancer teams actively recruiting to trials activity data being presented to NSSG and network audit event Review and agree list of approved trials for network and receive reports on recruitment levels. Spring 2011 Identify core members as locality leads with responsibility for recruiting into studies. Written reasons / constraints to be provided where the site has not become involved in a particular study. Development of improvement plans where required. (Analyse the additional Dr N Sarwar, Dr K Madhavan, Clinical Lead Research Network, Local Lead Clinicians and the Essex Cancer Research Network, including September 2011 Written response from MDT to approved list and reasons for not participating 6

7 time required in clinics for recruiting patients into studies.) Encourage intra and cross network referrals for access studies that are not being undertaken at local sites discussions with the Anglia East Cancer Research Network. Discuss at Network level how to incorporate research into the Work Plan Research Portfolio: Ovary: CHORUS (Chemotherapy vs Upfront Surgery): Prospective randomised controlled study comparing conventional follow up with Nurse led follow up for Epithelial ovarian cancer after completion of primary treatment (awaiting Ethics approval) in collaboration with UCL UKOPS Risk Prediction and Early Detection of Ovarian Cancer meoc- trial of open label carboplatin and paclitaxel +/- bevacizumabas first line chemotherapy in patients with mucinous epithelial ovarian cancer. Endometrium: PORTEC 3 Ovary: CA125 doubling time use of changes in CA125 doubling time to detect activity of cytostatic agents in women with relapsing ovarian carcinoma Proteomic profiling study for biomarkers for ovarian cancer DNA Methylation study Endometrium: NSECG- National study of Endometrial Cancer Genetics 7. WORK PROGRAMME AND ANNUAL REPORT Generate an annual report for submission to Network Board May 2011 Submission of Annual Report to Network Board May

8 Taken from Cancer Commissioning Guidance (2008) - Gynaecological cancers Appendix 1 The Improving Outcomes in Gynaecological Cancers guidance was published in 1999 and led to the centralising of treatment planning and most of the cancer surgery at a network level (with an assumption of 800,000 to 1 million population, this allows up to two specialist teams in the largest networks). The implementation of this guidance should now be complete. There is, however, some evidence that local teams are continuing to operate on a wider range of cancers than is approved in the guidance. Locally delivered surgery which must first be approved by a specialist team should be restricted to very early stage cancers of the uterus, and should amount to no more than 15 20% of the total of gynaecological cancer resections. The guidance covers cancers of the body of the uterus (endometrium), the uterine neck (cervix) and ovary, and rarer cancers of the vulva and vagina. When children s and young people s services have been reconfigured (by December 2010), germ cell tumours should normally be managed by specialist gynaecology teams linked to the children s and young people s services. Ovarian cancer is a difficult disease to treat and has a rather poor prognosis. Exemplary surgery and active non-surgical management should be expected. The following are suggested issues that could be addressed by commissioners when looking for a high-quality service. Key commissioning questions for gynaecological cancers Where to find the answers Team working What is the percentage of gynaecological oncology surgery performed HES outside a specialist team centre? (A figure of over 20% suggests that not enough of the surgery has been centralised.) Is any non-uterine gynaecological cancer surgery performed outside a HES specialist team centre? (The particular area of concern is ovarian cancer presenting as an emergency or unexpected finding.) Does every surgeon in the specialist MDT who manages gynaecological Local provider cancer spend at least 50% of their direct clinical care time on the management of cancer cases? Treatment What is the percentage of ovarian cancer resection performed as an emergency procedure? (Although occasional cases are probably unavoidable, the diagnosis should normally be suspected prior to surgery, and referred to the specialist team for discussion and possible surgery.) HES 8