DRAFT SCAN Skin Group Friday 24 th February 2012 Dermatology Seminar Room, Lauriston Building with videolink to Borders General Hospital MINUTES Present Alex Holme Daniel Kemmett Chair Simone Laube Kate Macdonald Sheena Mackenzie Marie Mathers Megan Mowbray Lisa Naysmith Jonathon Rees Gillian Smith Apologies Ewan Brown Kathy Burton Shirley Douglas-Keogh Sheena Dryden Val Doherty Alastair Law Pam Muir Cameron Raine Jackie Stevenson Audit Manager, SCAN Consultant Plastic Surgeon, NHS Lothian Consultant Dermatologist, NHS Borders Network Manager, SCAN SCAN Groups and Communications Co-ordinator Consultant Pathologist, NHS Lothian Consultant Dermatologist, NHS Fife Professor of Dermatology, University of Edinburgh Scottish Melanoma Group & SCAN Skin Cancer Audit Consultant Medical Oncologist, ECC Cancer Audit & Redesign Manager, NHS Fife Service Manager, Medical Division, NHS Lothian Nurse Specialist, NHS Lothian Consultant Oncologist, NHS Lothian SCAN MDM Co-ordinator/Patient Tracker Consultant Plastic Surgeon, NHS Lothian Cancer Audit Facilitator, NHS Fife A full membership list can be found on www.scan.scot.nhs.uk Item Action 1 Introductions / Minutes welcomed Dr Simone Laube to her first Skin Group meeting and said that Mr Cameron Raine had also accepted an invitation to join the Group. The Group noted the three requested amendments to the minutes of the meeting on 04/11/11 and approved the revised version. 2 SCAN Issues Quality Performance Indicators (QPIs) observed that the development of QPIs seemed to be progressing quickly and expressed the hope that the Scottish skin cancer networks would have the opportunity to develop QPIs for melanoma in 2013. SCAN Office, Pentland House, 47 Robb s Loan, Edinburgh EH14 1TY T: 0131 465 7682 W: www.scan.scot.nhs.uk Sheena.mackenzie@nhslothian.scot.nhs.uk Page 1 of 5
Detect Cancer Early advised the Group that the media campaign for the national Detect Cancer Early (DCI) initiative had started on 20 th February. He said that, although the initiative was initially focusing on breast, bowel and lung cancer, four of the eight signs/symptoms people were being advised to look out for were related to the skin and there could therefore be an increase in the workload for the skin service. He said that that some funding was attached to the DCI initiative but it was unclear how this would be allocated. It was agreed that information about the media campaign should be circulated (copy attached). Chemotherapy Electronic Prescribing and Administration System (CEPAS) Kate Macdonald reported that electronic prescribing was live in Lothian and Fife and would go live in Borders and Dumfries & Galloway by the end of March [Note: Launch now likely to be late April/early May]. Regional Review of Non-Surgical Oncology Kate Macdonald said that that the health boards were developing local workplans to take forward the programme of redesign recommended by the review. SCAN Website Kate Macdonald advised the Group that the SCAN website would be moving to a new IT platform in March. 3 Workplan CUTANEOUS ONCOLOGY SURGERY DEVELOPMENT Lisa Naysmith reported that Macmillan Cancer Support had been unable to match the 100k cancer modernisation funding from the Scottish Government. It had therefore been decided to proceed with building the Mohs lab and one biopsy room and to seek funding for the second biopsy room from the Edinburgh and Lothian Health Foundation and the Lothian Cancer Planning and Implementation Group. Subject to approval from NHS Lothian s Director of Finance, the first phase of the building work could start towards the end of March. The cancer modernisation funding was originally allocated on the basis that it would be spent by the end of the current financial year but an extension had been obtained. Lisa Naysmith said that, in the meantime, the Mohs service was being provided from temporary accommodation. She said there were plans to recruit to a surgical skin fellowship once the new facilities were completed. AUDIT Scottish Skin Cancer Networks Comparative Melanoma Audit Report 2010 reported that the approach taken to ensuring that everyone had an opportunity to comment on the audit report from the national skin cancer networks meeting in November 2011 appeared to have been successful, with comments being received after each circulation. She said that the third and final version of the report, which had been circulated, would be sent to all network RCPGs and Medical Directors and, following checks for disclosive information, published on the three cancer network websites. Alison said that an actions page had been introduced and she hoped that future meetings would include feedback on progress in addressing actions. Page 2 of 5
Megan Mowbray reported that a meeting had been held to discuss consistency of Pathology reporting and it had been agreed that the approach taken by Alan Evans would be followed. Alison suggested that the three network leads might discuss post triage urgency. Alex Holme noted that SCAN had audited this in 2010. Future of Gillian Smith s post said that numerous requests to NHS Lothian for funding had been unsuccessful. She said that ISD was restructuring its workforce and she hoped they would be willing to second Gillian to a 0.6 WTE SCAN post, which would allow collection of Lothian and Borders melanoma data to continue. Alison said that discussions with Lothian about the formal establishment of a post would continue. 2010 Comparative Melanoma Audit Report said that the 2010 comparative melanoma audit report had been signed off would be sent to board clinical governance departments and the SCAN RCPG. It would also be published on the SCAN website. She said that she hoped the ISD report on survival analysis, due to be published in April, would provide information relevant to the query about the higher proportion of thicker melanomas in Fife. WORKPLAN The Group reviewed the Skin Group workplan and suggested a number of amendments/additions. Protocols It was agreed that the regional skin cancer protocols should be reviewed. Action: Sheena Mackenzie and Gillian Smith to look for copies of previous protocols. Sheena Mac Gillian Smith Pathology - Marie Mathers said that she planned to audit a year s pathology reports to identify how many came from GPs (unsuspected melanoma diagnoses) and any delays in lab processes. She hoped to be in a position to report back to the June meeting. queried whether it would be possible for pathology results to be made available more quickly on TRAK. It was noted that clinicians could contact Lothian s IT helpdesk (x85050) to request access to SCI store. [Note: Access of reports through SCI allows slightly faster access to reports and is also an alternative to TRAK.] Alex Holme suggested that automatic notification for clinicians when pathology reports became available would be useful. A number of other proposed audits were noted: Waiting time between diagnosis and wide local excision (WLE) Melanoma in children Olivia Excision of skin cancer in primary care Alex Holme Completeness of excision of non-melanoma skin cancer in 2ndary care Lisa Naysmith Completeness of excision of non-melanoma skin cancer in 2ndary care and linking with pathology to feed back to operator Clare Page 3 of 5
Leitch asked if review of audit data would be included in the next Scottish Melanoma Group meeting. It was agreed that she should ask Megan Mowbray and Val Doherty about this. Action: to ask Megan Mowbray whether a review of audit data will be included in the next Scottish Melanoma Group meeting. Detect Cancer Early It was agreed that and Kate Macdonald should discuss data collection for the DCE initiative and that Alex Holme should consider a questionnaire survey for patients. Actions: and Kate Macdonald to discuss data collection for the DCE initiative. Alex Holme to consider a questionnaire survey for patients in relation to DCE. Kate Macdonald Alex Holme said that he would update the Skin Group workplan, following the above discussions, and that he would write to Sheena Dryden and Ewan Brown about any additional amendments. He asked Group members to contact him with any other suggestions about additions to the workplan. Action: to write to Sheena Dryden and Ewan Brown about any further additions/amendments to the Skin Group workplan. Group members to send suggestions about any further additions to the workplan to. to update the workplan for discussion at the June meeting. ALL FIFE MELANOMA PATHWAY Megan Mowbray reported on a meeting in January with Tayside plastics and Fife medical and surgical management. It had been agreed that, from April 2012, Mr Omar Quaba would be the plastics lead for skin cancer patients in Fife. Everyone had agreed that skin cancer in Fife would remain part of SCAN. All Fife patients would continue to go to Lothian for Oncology and that, as far as possible, patients requiring an overnight stay should stay in Fife. There was an outstanding issue about who should undertake SNLB (sentinel node biopsies) for Fife patients. Members of the Skin Group identified a number of issues to be considered, including the need for specific expertise within the nuclear medicine department, overnight care for plastics patients and whether there would be a sufficient volume of patients in Fife to maintain expertise. It was agreed that, in conjunction with, should write to the Cancer Lead in Fife about the issues in relation to melanoma services and SNLB. It was agreed that an invitation should be extended to Omar Quaba to Page 4 of 5
join the Skin Group. Marie Mathers suggested that pathology representation should be invited from Fife and Dumfries & Galloway. Actions: to contact Barry Powell and Jenny Geh from the Sentinel Node Special Interest Group about guidelines on SNLB work., in conjunction with, to write to Dr Clive Preston, Fife Cancer Lead, about issues in relation to melanoma services and SNLB. Sheena Mackenzie to invite Omar Quaba to join the Skin Group and to explore options for extending pathology representation on the Group. Sheena Mackenzie 4 For information The Group noted the report made by the SCAN Skin Group Chair to Regional Cancer Planning Group (RCPG) on 14/12/11. 5 Any other business Waiting times for routine biopsies It was noted that the waiting times for routine biopsies in Fife and Lothian continued to exceed the 18 weeks referral to treatment target. National MCN for skin cancer advised the Group that an application to establish a national MCN for skin cancer had been submitted to the National Services Advisory Group and a decision was expected in the next few weeks. Action: to liaise with Val Doherty about circulating a copy of the national skin MCN application to the Skin Group. Deputy Chair informed the Group that Marie Mathers had agreed to be the Group s Deputy Chair. Date of next meeting said that it might be necessary to change the date of the next meeting. Action: to liaise with Sheena Mackenzie about the date of the next Skin Group meeting. Sheena Mac 6 Dates of future meetings Fri 7 th September 2012: 08.00am: Venue TBC Note change of date! Fri 16 th Nov 2012: 08.00am: Dermatology Seminar Room, Lauriston Building (this date may need to be reviewed if it clashes with the national melanoma meeting) Page 5 of 5