Haematology Clinical Network Group (CNG)

Transcription

1 Haematology Clinical Network Group (CNG) Constitution Version 1.0 This Constitution 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 Constitution 2014 Page 1 of 18

2 Version Control This is a controlled document please destroy all previous versions on receipt of a new version. Date Approved: July 2014 Review Date: April 2015 Version Date Issued Review Date Brief Summary of Change 1.0 July 2014 April 2015 Approved Haematology CNG Constitution 2014 Page 2 of 18

3 Table of Contents Section 1.0: Structure and Function Introduction Network Configuration C-101h Membership C-102h CNG Chair C-102h Terms of Reference C-102h Communication Key Responsibilities Strategic Development Meeting Frequency C-103h Work Programme & Annual Report C-104h... 8 Section 2.0: Co-ordination of Care/Patient Pathways Network HODS Investigational Guidelines C-105h Clinical Guidelines C-107h Chemotherapy Treatment Algorithms C-108h Clinical Diagnostic Pathways C-109h Patient Pathways C-110h Section 3.0: Patient Experience C-111h Section 4.0: Clinical Outcomes/Indicators C-112h Performance Indicators CNG Audits C-112h Clinical Trials C-113h Appendix 1.0: Core & Extended Haematology CNG Membership Appendix 2.0: Haematology CNG Guideline Summary Appendix 3.0: Network Oncology Provision Haematology CNG Constitution 2014 Page 3 of 18

4 Section 1.0: Structure and Function 1.1 Introduction Cheshire & Merseyside Strategic Clinical Networks (CMSCN) are based in the North West of England & cover a population in excess of 2.4 million. The healthcare system covers a mix of rural and urban populations with high levels of deprivation and poor physical and mental health. The work of the SCN is facilitated by a support team hosted by Cheshire, Warrington and Wirral Area Team. The network comprises a number of stakeholders including: Patients, carers/families and members of the public 12 Clinical Commissioning Groups 2 NHS England Local Area Teams 9 Acute Hospital Providers (8 with A&E provision) 5 Specialist Hospital Providers 2 Mental Health Trusts 4 Vertically Integrated Community Trusts 3 Community Trusts 10 Hospices 9 Local Authorities 9 Health and Wellbeing Boards 9 Local Healthwatch organisations 2 Academic Health Science Networks 1 Ambulance Trust This document outlines the Constitution and Terms of Reference for the Haematology Clinical Network Group (CNG) and will be reviewed on an annual basis. 1.2 Network Configuration C-101h The implementation milestones to meet the requirements of the NICE IOG for Haemato-oncology have been met. The identity and location of the different levels of haematology services with the identified catchment populations are included in the tables below. Aintree/Southport & Ormskirk MDT Hospital Trust Aintree University Hospital NHS Foundation Trust Southport and Ormskirk Hospital NHS Trust Level of Service 2b 2a Referring CCG s MDT Catchment Population 1 Knowsley CCG South Sefton CCG Liverpool CCG Southport & Formby CCG West Lancs CCG Southport & Formby CCG South Sefton CCG 40, , ,491 24, ,842 99,223 15,350 Total 553,139 Haematology CNG Constitution 2014 Page 4 of 18

5 Royal Liverpool & Broadgreen MDT Hospital Trust Royal Liverpool & Broadgreen University Hospital NHS Trust Level of Service 2b Referring CCG s MDT Catchment Population 1 Knowsley CCG Liverpool CCG 32, ,473 Total 402,692 Hospital Trust Royal Liverpool & Broadgreen University Hospital NHS Trust Level of Service Referring MDT s MDT Catchment Population 1 3/4 AUH/S&OH 2,152,273 STHK/WHH WUH/COCH St Helens & Knowsley/Warrington & Halton MDT Hospital Trust St Helens & Knowsley Teaching Hospitals NHS Trust Warrington & Halton Hospitals NHS Foundation Trust Level of Service 2b 2a Referring CCG s MDT Catchment Population 1 Halton CCG St Helens CCG Knowsley CCG Halton CCG Warrington CCG, St Helens CCG 64, ,553 80,548 64, ,117 38,638 Total 611,120 Wirral/Countess of Chester MDT Hospital Trust Wirral University Teaching Hospital NHS Foundation Trust Countess of Chester NHS Foundation Trust Level of Service 2b Referring CCG s Wirral CCG West Cheshire CCG MDT Catchment Population 331,216 25,411 2a West Cheshire CCG 228,695 Total 585,322 Royal Liverpool & Broadgreen University Hospital NHS Trust provides: Higher Intensity Chemotherapy - tertiary referral services including Bone marrow Transplant services Cellular Therapy Services Haematology CNG Constitution 2014 Page 5 of 18

6 Specialist Integrated Haematological Malignancy Diagnostic Service locally referred to as Haematological Oncology Diagnostic Service (HODS) The designated Principal Treatment Centre for Teenagers and Young Adults (TYA) is the Clatterbridge Cancer Centre NHS Foundation Trust. As CCC does not provide haemato-oncology services, the network configuration for TYA includes Royal Liverpool and Broadgreen University Hospitals NHS Trust (RLBUHT) as the TYA centre for haematological cancer. There are also close links with Alder Hey Children s NHS Foundation Trust (children s PTC) which provides solid tumour and haematological oncology services for patients up to their 20 th birthday. Radiotherapy and chemotherapy for solid tumours is provided by The Clatterbridge Cancer Centre. Paediatric haemato-oncology is provided by Alder Hey Children's NHS Foundation Trust The Network Haematological Oncology Diagnostic Service (HODS) provides the following investigational modalities and techniques; morphology and cytopathology of bone marrow aspirates, trephine biopsies and tissue biopsies flow cytometry immunocytochemistry molecular techniques for detection of clonality, chromosomal translocations and mutations cytogenetics and FISH. The Service has agreed pathology diagnostic pathways with the laboratories in the network catchment. The pathways specify that specimens taken for a suspected diagnosis of haematological malignancy, and specimens found to be suspicious of a haematological malignancy at any stage during the laboratory investigation, should be transferred immediately for all further investigation, to the HODS. The service will provide appropriate representation to all Haematology MDTs (4 in total) within CMSCN. 1.3 Membership C-102h Within CMSCN there is a single Haematology Clinical Network Group (CNG). Core membership consists of: the MDT lead clinician from each of the Haematology MDT s at least one nurse core MDT member a named chair who should be a core MDT member two user representatives an NHS employed member of the CNG nominated as having specific responsibility for users' issues and information for patients and carers a member of the CNG nominated as responsible for ensuring that recruitment into clinical trials and other well designed studies is integrated into the function of the CNG named secretarial/administrative support a haematologist a clinical oncologist a pathologist Haematology CNG Constitution 2014 Page 6 of 18

7 a radiologist Please see Appendix 1 for full membership list. 1.3 CNG Chair C-102h The chair of the Haematology CNG is Dr Nagesh Kalakonda, Consultant Haematologist, Royal Liverpool & Broadgreen University Hospital NHS Trust (RLBUHT). The term of the Chair s role should be reviewed after three years. The Chair will have an annual review with the Network Cancer Clinical Lead. Members of the haemato-oncology community who express interest in chairing the CNG will be invited to a meeting with the Cancer Clinical Lead who will decide the Chair based on agreed skills and competencies. A key part of the role will be to ensure effective engagement of constituent members and communication with stakeholders. 1.4 Terms of Reference C-102h The Haematology CNG is the main source of clinical advice to the CMCSN Cancer Steering Group & Oversight Group on all matters relating to its area of expertise. The role of the CNG is to ensure coordination of the cancer pathway, consistency of clinical practice and to achieve the best possible outcomes and experience for patients, irrespective of where their treatment and care is provided. The role of the CNG includes: Service planning Service improvement Service monitoring including clinical performance and outcomes Workforce development Research and development The CNG has a key role in the development of plans to implement national guidance and to monitor implementation. These will subsequently form part of the Network s Service Delivery Plan. It will ensure that concerns and areas of risk are raised with the Taskforce via agreed governance agreements. The NCG should have active engagement of all chemotherapy teams in the network. 1.5 Communication The Chair will provide feedback to the Cancer Steering Group including presenting key areas of work e.g. service priorities. The Chair will represent the Network appropriately, including at a regional and national level. Members should ensure that all decisions are fed back and become integrated into constituent organisational structures and processes. The Chair will ensure that all CNG peer review evidence is updated annually. 1.6 Key Responsibilities The responsibilities of the CNG are to: Review latest national guidelines/standards published by NICE, Department of Health, Royal Colleges and other professional bodies/committees agreeing best practice recommendations. Haematology CNG Constitution 2014 Page 7 of 18

8 Coordinate the consistent implementation of national guidance/recommendations across the network. To work closely with other network groups to develop clinical and referral guidelines that reflect best practice Identify local population needs and gaps in service and advise on approaches to address these. To provide expert advice to commissioners on the commissioning of cost effective anticancer therapies, best service models, pathways of care and emerging technologies Develop workforce recommendations in response to service developments, recruitment difficulties and emergent technologies. Annually monitor progress regarding compliance against cancer measures, participating fully in the peer review process and ensuring any remedial action plans following peer review are implemented. Stimulate and lead areas for service improvement and innovation within the network. Analysis of national minimum data sets for variations in clinical practice/patient outcomes Review approved clinical trials, other research and development initiatives and encourage patient entry Undertake network wide audits and provide a forum for the wider discussion of local audits as part of its role in education and development. Ensure there is a process for obtaining patient and carer advice and involvement in service issues and in the development of plans related to the CNG. 1.7 Strategic Development The CNG will ensure engagement and communication with stakeholders with regard to service plans and developments. This will include triennial identification of investment requirements necessary to meet quality standards and outcomes which will serve to influence strategic commissioning plans. This will be agreed and monitored as part of the CNG work programme. In line with its terms of reference the CNG will ensure that service planning; considers the whole patient pathway promotes high quality care and equal access to services takes account of the views of patients and carers considers opportunities for workforce and service redesign 1.8 Meeting Frequency C-103h CNG meetings will be held triannually with additional meetings as required for short term task and finish projects. The meeting will be quorate when 50% of the units are represented at the meeting. Meeting attendance will be recoded and reported annually. 1.9 Work Programme & Annual Report C-104h The CNG will review and update its constitution annually. An annual report and work programme will be complied by the group. The three key documents will be ratified by the CNG at the first meeting following 1 st April each year. Haematology CNG Constitution 2014 Page 8 of 18

9 Section 2.0: Co-ordination of Care/Patient Pathways 2.1 Network HODS Investigational Guidelines C-105h The CNG, in consultation with the service lead of the HODS have agreed both laboratory investigational algorithms and protocols for prognostication and minimal disease monitoring, based on the following principles: they are aimed both at categories of suspected disease and relevant clinical/haematological presenting problems they stipulate multiple investigational modalities to confirm a given patient's diagnosis, so that the results of one modality may be used to corroborate those of another they incorporate allowable options for choices between investigations and specify how the investigational pathway may be redirected at any point in the process, depending on results up to that point. Choices of investigation and decisions to redirect the pathway should be allowable at the behest of the investigating laboratory alone in consultation with referring clinician agreed time limits for the production of reports and methods of sample handling and transport when sending samples in from laboratories outside the SIHMDS These will be reviewed annually. 2.2 Clinical Guidelines C-107h The CNG is responsible for ensuring coordination and consistency across the network. This is supported by a number of CNG agreed guidelines. These detail how a given patient should be clinically managed i.e. guidelines on imaging, and management by which modality of treatment and in the case of chemotherapy, at which intensity, including BMT. Designated MDT s/cng members will be identified by the CNG to lead on specific guidelines. The CNG will ratify the guidelines and individual MDTs will agree to abide by them. The CNG will subsequently review, agree and update these guidelines on a regular basis and will audit the implementation of these guidelines, making sure they are kept up to date. See Appendix 2 for full list of CNG agreed polices/guidelines. 2.3 Chemotherapy Treatment Algorithms C-108h The CNG, in consultation with the Acute Oncology & Chemotherapy CNG will agree a list of acceptable chemotherapy treatment algorithms. The list will be updated bi-annually. 2.3 Clinical Diagnostic Pathways C-109h The CNG in consultation with its constituent MDTs and pathology laboratories has agreed and produced a clinical diagnostic pathway which 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 HODS rather than the local pathology services for diagnosis. These will be reviewed biennially. Haematology CNG Constitution 2014 Page 9 of 18

10 2.4 Patient Pathways C-110h The CNG has agreed a generic patient supportive care pathway & tasked each unit with developing & maintaining service directories identifying the named contact points for local service. In addition, the CNG has agreed the following pathways: TYA pathways for initial management and for follow up on completion of first line treatment. Carcinoma of unknown primary pathway. Section 3.0: Patient Experience C-111h The CNG will annually review patient feedback of participant MDT s and any actions implemented. The CNG will agree any actions required on a network foot print & allocate responsibility for delivery to an appropriate group. CMSCN is committed to user involvement in, and representation on, all Clinical Network Groups. Within the CNG, there are two appointed user representatives who are invited to participate in all discussions at the group and associated events with a standing opportunity for user issues to be raised at every CNG meeting for user feedback and input into the group s work programme. In addition, CMSCN use a range of different methods and mechanisms to maximise patient and public involvement in order to allow people to be involved as much or as little as they choose. Fundamental to this approach is the development of the People s Voice. This largely virtual assembly will consist of patient, carer, public and community representatives; its purpose is to support the participation and engagement of patients, carers and members of the public on changes and improvements to health and wellbeing services, policies or strategies. In addition, Nagesh Kalakonda has been nominated as having specific responsibility for users issues and information for patients and carers. Section 4.0: Clinical Outcomes/Indicators C-112h 4.1 Performance Indicators 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. The CNG has agreed that collection of the MDS and associated checks on quality, quantity and validity is the responsibility of Trust Cancer Teams and ultimately is the responsibility of the named Executive Lead for Cancer in each Trust. Haematology CNG Constitution 2014 Page 10 of 18

11 All teams should collect the data relevant to the care they have provided. Where a patient is referred between teams for specialist investigations or treatment, then it is the responsibility of the specialist MDT to transfer the relevant dataset that they collect during the care of their patients back to the referring MDT. The Somerset Cancer Register (SCR) is accepted as the primary data collection system used to collect cancer data across CMSCN. Each Trust will ensure that data capture systems are organised to ensure that data is collected in a timely manner and in accordance with Caldicott and data protection policies. 4.2 CNG Audits C-112h In line with the agreed terms of reference, the CNG will agree a network audit project and review progress/completion on an annual basis. 4.3 Clinical Trials C-113h The CNG will: Support local equity of access for all patients across CMSCN Support the development of the North West Coast Clinical Research Network (NWC CRN) portfolio of cancer studies Identify service configuration requirements to deliver local and national trials portfolio and develop plans for implementation Receive annual recruitment report from each MDT and agree any remedial actions. Haematology CNG Constitution 2014 Page 11 of 18

12 Appendix 1.0: Core & Extended Haematology CNG Membership Core Haematology CNG Membership Name Organisation Role Dr Lynny Yung Aintree University Hospital NHS Foundation Trust AUH/S&O MDT Lead Clinician Consultant Haematologist Rachel Chidley Aintree University Hospital NHS Foundation Trust AUH/S&O MDT Nursing Representative Haematology CNS Philip Jones Aintree University Hospital NHS Foundation Trust Radiologist Mark Aintree University Hospital NHS Foundation Trust Radiologist Dr Nauman Butt Royal Liverpool & Broadgreen University Hospital NHS Trust RLBUHT MDT Lead Clinician Consultant Haematologist Dr Nagesh Kalakonda 1 Royal Liverpool & Broadgreen University Hospital NHS Trust RLBUHT MDT Lead Clinician Haematology CNG Chair Consultant Haematologist TBC Royal Liverpool & Broadgreen University Hospital NHS Trust RLBUHT MDT Nursing Representative Dr Geetha Menon Royal Liverpool & Broadgreen University Hospital NHS Trust Pathologist Dr Toby Nicholson St Helens & Knowsley Teaching Hospitals NHS Trust STHK/WHH MDT Lead Clinician Consultant Haematologist Dr Mohammed Saipillai The Clatterbridge Cancer Centre NHS Foundation Trust Clinical Oncologist Lorraine Derbyshire Warrington & Halton Hospitals NHS Foundation Trust WHH MDT Nursing Representative Haematology CNS Dr David Galvani Wirral University Teaching Hospital NHS Foundation Trust WUHT/COC MDT Lead Clinician Consultant Haematologist Haematology CNG Constitution 2014 Page 12 of 18

13 Amanda Goodier Wirral University Teaching Hospital NHS Foundation Trust WUHT/COC MDT Nursing Representative Haematology CNS Jeff Engel N/A User Representative Barbara Paulus N/A User Representative Leigh Pauls 2 Aintree University Hospital NHS Foundation Trust Research Practitioner Jo Myler Cheshire & Merseyside Strategic Clinical Networks Administrative Support 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 Extended Haematology CNG Membership Name Organisation Role Dr Jeff Smith Aintree University Hospital NHS Foundation Trust Consultant Haematologist Dr Vikram Singh Aintree University Hospital NHS Foundation Trust Consultant Haematologist Julie Curran Aintree University Hospital NHS Foundation Trust Haematology CNS Ian Hincks Aintree University Hospital NHS Foundation Trust Haematology CNS Mark Caswell Alder Hey Children's NHS Foundation Trust Paediatric Oncologist Dr Salaheddin Tueger Countess of Chester NHS Foundation Trust Consultant Haematologist Dr Hilary Leggat Countess of Chester NHS Foundation Trust Consultant Haematologist Dr Gillian Brearton Countess of Chester NHS Foundation Trust Consultant Haematologist Dee Forbes Countess of Chester NHS Foundation Trust Haematology CNS Laura Whittle Countess of Chester NHS Foundation Trust Haematology CNS Dr Angela Douglas Liverpool Women's NHS Foundation Trust Consultant Clinical Cytogeneticist : Scientific Director, Cheshire and Merseyside Regional Genetics Laboratory Haematology CNG Constitution 2014 Page 13 of 18

14 Dr Rak Salim Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant Haematologist Professor Richard Clark Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant Haematologist Professor Andy Pettitt Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant Haematologist Dr Stephen Hawkins Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant Haematologist Director of HODS Dr Arvind Arumainathan Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant Haematologist Dr Sarah Coupland Royal Liverpool & Broadgreen University Hospital NHS Trust Consultant Histopathologist Dan Collins Royal Liverpool & Broadgreen University Hospital NHS Trust Pharmacist Linda Boyne Royal Liverpool & Broadgreen University Hospital NHS Trust Counsellor Elizabeth Dale Royal Liverpool & Broadgreen University Hospital NHS Trust Research Practitioner Dr David O Brien Southport and Ormskirk Hospital NHS Trust Consultant Haematologist Lynn Sugden Southport and Ormskirk Hospital NHS Trust Haematology CNS Mi Mi Khine Southport and Ormskirk Hospital NHS Trust Haematology SAS Dr John Tappin St Helens & Knowsley Teaching Hospitals NHS Trust Consultant Haematologist Dr Maged Gharib St Helens & Knowsley Teaching Hospitals NHS Trust Consultant Haematologist Ruth Jackson St Helens & Knowsley Teaching Hospitals NHS Trust Haematology CNS Dave Keegan St Helens & Knowsley Teaching Hospitals NHS Trust Haematology CNS Dr Mohamed Kaleel-Rahman Warrington & Halton Hospitals NHS Foundation Trust Consultant Haematologist Dr Ranjit Dasgupta Wirral University Teaching Hospital NHS Foundation Trust Consultant Haematologist Dr Barbara Hammer Wirral University Teaching Hospital NHS Foundation Trust Consultant Haematologist Maria Chapman Wirral University Teaching Hospital NHS Foundation Trust Haematology CNS Pat Gillis North West Coast Clinical Research Network Research Delivery Manager Anita Corrigan Cheshire & Merseyside Strategic Clinical Networks Network Manager Caroline Osborne CWW Area Team Cancer Pharmacist Chris Ward Royal Liverpool & Broadgreen University Hospital NHS Trust Haematology CNS Haematology CNG Constitution 2014 Page 14 of 18

15 Appendix 2.0: Haematology CNG Guideline Summary REFERRAL/DIAGNSOTIC GUIDELINES CNG LEAD ISSUE DATE REVIEW DATE CMSCN HODS Diagnostic Pathways S. Hawkins July 2013 August 2014 Initial Management Pathway for TYA Patients MCCN Tumour Type: Leukaemia L. Elder October 2013 August 2015 Initial Management Pathway for TYA Patients MCCN Tumour Type: Lymphoma L. Elder October 2013 August 2015 CMSCN Neck Lump Pathway A. Dingle September 2013 April 2015 CMSCN CUP Pathway R. Griffiths November 2012 July 2014 Primary central nervous system lymphoma pathway J. Smith October 2011 April 2013 Fertility preservation at the Liverpool Women s- guidance note for clinicians A. Drackley July 2014 July 2016 PET-CT N. Kalakonda July 2014 July 2016 LEUKAEMIA GUIDELINES CNG LEAD ISSUE DATE REVIEW DATE Clinical guidelines for the management of Acute Myeloid Leukemia (AML) Version 3 S. Tueger April 2012 April 2013 Acute Lymphoblastic Leukemia TBD TBD TBD CMSCN Recommendations for the Management of Chronic Myeloid Leukemia R. Clark August 2012 August 2013 Treatment guidelines - Chronic Lymphocytic Leukaemia A. Pettitt November 2011 November 2012 BSCH Guidelines on the diagnosis, investigation and management of Chronic Lymphocytic Leukaemia BSCH July 2013 Current LYMPHOMA GUIDELINES CNG LEAD ISSUE DATE REVIEW DATE CMSCN Treatment guideline and algorithm for Advanced Stage Follicular and Nodal A. Pettit February 2013 April 2015 Marginal Zone* Lymphomas A. Arumainathan CMSCN Clinical Guidelines and Treatment Algorithm for Mantle Cell Lymphoma A. Arumainathan May 2013 May 2016 Haematology CNG Constitution 2014 Page 15 of 18

16 BCSH Guidelines for the investigation and management of mantle cell lymphoma BCSH September 2012 Current Waldenstrom s Macroglobulinemia/LPL N. Kalakonda July 2014 July 2016 BCSH Guidelines on the diagnosis and management of Waldenstrom s BCSH February 2014 Current macroglobulinaemia CMSCN Guideline for the treatment of Burkitts Lymphoma J. Smith January 2014 January 2016 CMSCN Clinical Guidelines and Treatment Algorithm for Mantle Cell Lymphoma A. Arumainathan May 2013 May 2016 CMSCN Clinical Guidelines and Treatment Algorithm for Primary Central Nervous J. Smith September 2013 September 2016 System Lymphoma (PCNSL) and Primary Intraocular lymphoma (PIOL) CMSCN Treatment guidelines Limited stage Gastric Marginal Zone Lymphoma A. Arumainathan January 2013 April 2015 Clinical Guidelines for Treatment of Hodgkin s lymphoma N. Kalakonda February 2012 February 2014 Guidelines for the Treatment of Diffuse Large B Cell Lymphoma (DLBCL) N. Kalakonda January 2012 January 2014 BCSH Guidelines for the Management of Mature T-cell and NK-cell Neoplasms BCSH June 2013 Current BCSH Guideline on the management of primary resistant and relapsed classical BCSH October 2013 Current Hodgkin lymphoma BCSH Guidelines for the first line management of classical Hodgkin lymphoma BCSH February 2014 Current Position Statement on the Role of Cytogenetic Testing for Myeloma & Paraproteinaemia S. Hawkins A. Douglas July 2010 July 2012 MDS GUIDELINES CNG LEAD ISSUE DATE REVIEW DATE CMSCN Guidelines for diagnosis and management of adult myeloproliferative neoplasms (PV, ET, PMF and hypereosinophilic syndromes) BCSH Guidelines for the diagnosis and management of adult myelodysplastic syndromes CMSCN Myelodysplastic Syndromes (MDS) Guidelines - Version 2 N. Butt February 2013 December 2013 BCSH December 2013 Current T. Nicholson R. Dasgupta April 2011 April 2012 Haematology CNG Constitution 2014 Page 16 of 18

17 MYELOMA GUIDELINES CNG LEAD ISSUE DATE REVIEW DATE CMSCN Myeloma guideline S. Hawkins January 2014 January 2014 CMSCN Treatment guideline and algorithm Symptomatic Multiple Myeloma P. Chu February 2012 February 2013 BCSH Guidelines for the diagnosis and management of multiple myeloma BCSH February 2014 Current AFTERCARE/FOLLOW-UP GUIDELINES CNG LEAD ISSUE DATE REVIEW DATE CMSCN TYA pathways for follow up on completion of first line treatment: Leukaemia L. Elder October 2013 August 2015 CMSCN TYA pathways for follow up on completion of first line treatment: Lymphoma L. Elder October 2013 August 2015 CMSCN Suggested follow-up intervals for haemato-oncology patients TBC February 2012 February 2013 CMSCN Haematology Pathway Guideline TBC July 2014 July 2016 CMSCN Haematology Rehabilitation Pathway TBC February 2011 No review date Prevention and Treatment of Tumour Lysis TBC April 2010 April 2013 BMT Pathway R. Salim TBC TBC Radiotherapy Referral Pathway M. Saipillai TBC TBC CCC Chemotherapy Protocols (Solid Tumours) E. Marshall TBC TBC CCC Radiotherapy Protocols B. Haylock TBC TBC Haematology CNG Constitution 2014 Page 17 of 18

18 Appendix 3.0: Network Oncology Provision CMSCN Oncology Configuration Trust Radiotherapy A&E/Acute Medicine In-patient Haematology Aintree University Hospitals NHS Foundation Trust CCC x x x Alder Hey Children's NHS Foundation Trust * x N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Liverpool Heart and Chest Hospital NHS Foundation Trust x x x x x x x x x x x x Countess of Chester Hospital NHS Foundation Trust x x x x The Clatterbridge Cancer Centre NHS Foundation Trust x x x x N/A x Liverpool Women's NHS Foundation Trust x x x x x x x x x x x Warrington and Halton Hospitals NHS Foundation Trust x x x x x Royal Liverpool and Broadgreen University Hospitals NHS Trust** x In-patient Oncology OPD Haematology Chemotherapy OPD Oncology Chemotherapy Onsite Haematologist Onsite Oncologist Visiting Oncologist Haemato-oncology Pharmacy x x x Southport & Ormskirk Hospital NHS Trust x x x x St Helens & Knowsley Teaching Hospitals NHS Trust x x x x The Walton Centre NHS Foundation Trust** x x x x x x x x x x x x Oncology Pharmacy Acute Oncology Service CUP MDT Specialist Childrens Hospital* MSCC Treatment Centres** Haematology CNG Constitution 2014 Page 18 of 18