Acute Oncology and Chemotherapy Clinical Network Group (CNG)

Acute Oncology and Chemotherapy Clinical Network Group (CNG) Annual Report 2013-2014 This Annual Report has been agreed by: Title Name Date Agreed AO/Chemotherapy CNG Chair Ernie Marshall 29.07.2014 CMSCN Cancer Clinical Lead Chris Warburton 29.07.2014 CWW Area Team Medical Director Kieran Murphy 29.07.2014 Agreed by the Acute Oncology & Chemotherapy CNG 29.07.2014 AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 1 of 9

Contents 1.0 Structure and function of the CNG... 3 2.0 Coordination of care/patient pathways... 4 3.0 Patient experience... 4 4.0 Clinical outcomes/indicators... 4 5.0 Good Practice... 5 6.0 Concerns... 5 Appendix 1.0: Chemotherapy Conference Agenda... 6 Appendix 2.0: CNG Attendance (2013 attendance reflects CNG arrangements prior to January 2014) 7 AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 2 of 9

1.0 Structure and function of the CNG This annual report for Cheshire & Merseyside Strategic Clinical Network (CMSCN) Acute Oncology (incorporating CUP) & Chemotherapy Clinical Network Group (CNG) relates to the operational period 1st April 2013 to 31st March 2014. This report describes the work carried out across the Network over the course of the year. The CNG supports the overall aims of the network by facilitating collaboration between providers and users of oncology cancer services in order to provide seamless care based on best practice. The Group is the main source of clinical advice to the CMSCN Cancer Steering Group & Oversight Group. Prior to January 2014, CMSCN supported two CNG s: Acute Oncology & CUP + Chemotherapy. The groups were merged in January given cross-cutting issues. 14-1E-101y/14-1E-101m/14-1E-101s network configuration remains unchanged as referenced in the CNG Constitution Appendix 3.0. 14-1E-102y/14-1E-102m/14-1E-102s - The CNG is a busy, productive multi-professional group with strong engagement from participating Trusts and MDTs. Group membership is fully compliant with peer review requirements. The CNG s Constitution is reviewed & updated on an annual basis. Content includes: Terms of Reference Communication requirements Key Responsibilities 14-1E-103y/14-1E-103m/14-1E-103s - the CNG meets triannually. Appendix 2.0 contains a summary record of meeting dates & attendance. 14-1E-104y/4-1E-104m/14-1E-104s - The CNG has produced a detailed work programme, which reflects the strategic ambitions of CMSCN. This has been agreed with the Network Cancer Clinical Lead & Medical Director of Cheshire, Wirral & Warrington Area Team. 14-1E-105s - Network Leadership - Dan Collins (network lead pharmacist) and Mike Varey (network lead chemotherapy nurse) remain in post & have agreed responsibilities/time to undertake role. This includes chairing the Network Pharmacist Group & Network Chemotherapy/Acute Oncology Nurses Group respectively. 14-1E-105y - the MSSCC Group met 16.08.13 to collaboratively review cases, timeliness of definitive treatment (14-1E-114y) and clinical outcomes (14-1E-115y). In addition the group review & updated network MSCC guidelines (14-1E-111y), including MSCC patient information (14-1E-112y). 14-1E-106s - Criteria for Acting as an Assessor of Competence - the network has an agreed competency framework. This will be subject to review in July 2014. 14-1E-106y the CNG has agreed the range of treatments and procedures for acute oncology which should be offered on site at The Clatterbridge Cancer Centre. This is subject to annual review as part of the CNG Constitution. AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 3 of 9

In addition, the CNG has agreed the following guidelines, which are subject to regular review. 14-1E-107y - Consultant Oncologist Telephone call service 14-1E-108y - Induction Training in the use of AO service 14-1E-109y - Assessors and training for MSCC Coordinators 2.0 Coordination of care/patient pathways 14-1E-105y - the MSSCC Group met 16.08.13 to collaboratively review cases, timeliness of definitive treatment (14-1E-114y) and clinical outcomes (14-1E-115y). In addition the group review & updated network MSCC guidelines (14-1E-111y), including MSCC patient information (14-1E-112y). In addition, the CNG has agreed the following guidelines, which are subject to regular review. 14-1E-110y - Acute oncology Pathways 14-1C-105m - CUP Clinical Guidelines 14-1C-106m - Network CUP Guidelines and Algorithms on the Systemic Therapy of Treatable Syndromes 14-1C-107m - CUP Patient Pathways 14-1C-108m - CUP Patient Investigation and Management Policy 14-1E-107s - Policy for Preventing Regular Deviation from the Network Agreed Treatment Algorithms 3.0 Patient experience 14-1E-112y the network have agree to adopt Macmillan Cancer Support Malignant spinal cord compression patient information leaflet. This was updated in 2014. The network patient alert card was reviewed in 2013. A further review is planned in September 2014. 14-1C-109m - CUP Patient Experience, a network survey was agreed in 2013 & distributed in February 2014 via Acute Oncology Teams. Results were discussed by the CNG in May 2014 who acknowledged the difficulties in gaining feedback from this patient group and resulting poor response rates which makes benchmarking difficult. The action agreed was to revise survey, reducing number of questions & focus on experience rather than team contact. 14-1E-108s a 24 Hour Telephone Advice Service for Patients continues to be operated & delivered by The Clatterbridge Cancer Centre as per network specification. 4.0 Clinical outcomes/indicators The MSCC Group met 16.08.13 to collaboratively review cases, timeliness of definitive treatment (14-1E-114y) and clinical outcomes (14-1E-115y). An audit of timeliness of investigation is scheduled for 2014. AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 4 of 9

14-1C-110m - the CNG had agreed a minimum dataset for CUP which is coordinated by the SMDT. All MUO/CUP patients are registered for data completeness. Progress is reported at each CNG alongside any clinical trial updates - 14-1C-111m. Acute Oncology Performance Measures have also been agreed by the CNG as a standardised method of demonstrating service development and cost effectiveness. This is in addition to the network agreed minimum dataset for acute oncology. 14-1E-109s the CNG routinely reviews deviations from network treatment algorithms and network chemotherapy errors 14-1E-110s as per agreed Network Guidance for Ensuring Safety and Quality of Chemotherapy Services. 5.0 Good Practice Acute Oncology/CUP patient experience survey developed Acute Oncology Performance Measures have also been agreed Haematology algorithm template agreed Primary care engagement Annual multi-professional conference Appendix 1.0 Haematology dose banding pilot agreed Annual network-wide neutropenic sepsis audit Area team engagement Acute Oncology publications 6.0 Concerns Continued gaps in acute oncology workforce namely nursing cover and administrative support E-prescribing implementation AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 5 of 9

Appendix 1.0: Chemotherapy Conference Agenda Chemotherapy Conference Friday 12 th April 2013, Foresight Centre, Liverpool 2013 PROGRAMME 9.00 9.25 Registration / Tea and Coffee Session 1 - Anita Corrigan 9.25-9.30 Welcome 9:30 10.00 10.00 10.20 10.20-10.35 10.35 10.50 Ageing Matters Macmillan Older Peoples Pilot national findings Local Project Poly pharmacy in older people with cancer Age UK Partnership Hazel Brodie Kate Parker Ian Allen Jane Macaulay 10.50 11.00 Facilitated panel discussion with questions from the audience 11.00 11.30 Coffee / poster voting 11.30 11.50 Acute Oncology (Out of hours and admission avoidance) Ernie Marshall 11:50-12:05 12:05 12.20 Holistic Needs Assessment Network Approach Implementing in Clinical practice Jonnie Raynes Diane Dearden 12:20 12.50 Treatment of Systemic Mastocytosis Naumen Butt 12.50 13.00 Facilitated panel discussion with questions from the audience 13.00-14.00 Lunch / Poster Voting / Industry Session 2 Mike Varey 14.00 14:45 National Commissioning Board Peter Clarke New Structure & CDF/funding 14.45-15:30 Role of research in treatment of cancer Joe Sacco 15:30-15:40 Facilitated panel discussion with questions from the audience 15:40-15.50 Poster Prize presentations Mike Varey 15:50-16:00 Closing remarks: Mike Varey, Chair MCCN Chemotherapy Nurse Group AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 6 of 9

Acute Oncology / Chemotherapy CNG Attendance Appendix 2.0: CNG Attendance (2013 attendance reflects CNG arrangements prior to January 2014) Name Organisation Role 09.05.2013 26.07.2013 17.10.2013 15.11.2013 24.01.2014 Lynny Yung AUHT CCS Representative/Consultant Haematologist Vikram Singh AUHT CCS Representative/Consultant Haematologist AP Chan Ton AUHT AUH AO Lead/CUP MDT Lead Clinician CCC Medical Oncologist Paul Flynn AUHT CCS Representative/Pharmacist Wendy Unsworth AUHT AO CNS Graham Whyte AUHT Palliative Care Consultant Karen Selwood AH CCS Representative/Chemotherapy Nurse AP David Breen COCH CCS Representative/Oncology Pharmacist Laura Whittle COCH CCS Representative/Chemotherapy Nurse Shaker Abdallah COCH COCH AO Lead /CUP MDT Lead Clinician CCC Medical Oncologist Alison Taylor COCH AO CNS Carole Moseley IOM CCS Representative/Pharmacist R AP Ayman Madi RLBUHT RLBUHT AO Lead/CUP MDT Lead Clinician CCC Medical Oncologist Dan Collins RLBUHT CCS Representative/Oncology Pharmacist/NPG Chair Eddie Lawson RLBUHT CCS Representative/Chemotherapy Nurse Mike Varey 1 RLBUHT AO CNS/CUP MDT/NAOCNG Chair AP Tim Helliwell RLBUHT Histopathologist AP Helen Neville Webb S&O S&O AO Lead /CUP MDT Lead Clinician CCC Medical Oncologist R AP AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 7 of 9

Sarah Cox S&O AO CNS R AP AP Cathy Rimmer S&O CCS Representative/Pharmacist R Julie Marshall S&O CCS Representative/Chemotherapy Unit Manager Ernie Marshall STHK Acute Oncology & Chemotherapy CNG Chair STHK AO Lead /CUP MDT Lead Clinician CCC Medical Oncologist/CCS Representative Jeanette Ribton STHK CCS Representative/Chemotherapy Lead Nurse Amy Vercell STHK CCS Representative/Chemotherapy Nurse Maureen Scotton STHK AO CNS AP Chris Rhall STHK AO CNS AP Clare Littlewood STHK Palliative Care Consultant AP Alison Coackley STHK Palliative Care Consultant AP Peter Williams STHK Consultant Medical Physician AP AP Tracey Thornton STHK CCS Representative/Pharmacist Rosie Lord CCC Clinical Oncologist/NCG Chair Brian Haylock CCC Clinical Oncologist/NRG Chair AP AP AP Peter Robson CCC MSCC Senior Clinical Advisor (Clinical Oncology) AP AP AP Zaf Malik CCC Clinical Oncologist Michelle Bancroft CCC Physiotherapist Jayne Kelly CCC Pharmacist Bernie Wilson CCC CCS Representative/Lead Chemotherapy Nurse Zaid Sarsam WC MSCC Senior Clinical Advisor (Surgical) AP AP AP Adrian Moss WHH WHH AO Lead/CUP MDT Lead Clinician Shaker Abdullah WHH Acute Oncolgist Ann Chaffe WHH AO CNS AP Julie Street WHH CCS Representative/Pharmacist Barbara Hammer WUH CCS Representative/Consultant Haematologist AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 8 of 9

Richard Griffiths 2 WUH WUH/CCC CUP MDT Lead Clinician CCC Medical Oncologist/CCC CUP SMDT Lead Clinician Eliyaz Ahmed WUH Acute Oncologist AP Jessica Gilmore WUH AO CNS AP Stephanie James WUH AO CNS Amanda Goodier WUH CCS Representative/Haematology CNS Mark Buchanan WUH A&E Consultant David Agbamu WUH Consultant Histopathologist AP David Hughes WUH Consultant Radiologist Simon Purcell WUH CCS Representative/Pharmacist Sarah Griffiths CMSCN Network Assistant Jo Myler CMSCN Network Assistant Anita Corrigan CMSCN Network Manager AP Caroline Osborne CWW AH Area Team Cancer Pharmacist Lead Pharmacist Terry Mullin Knowsley CCG GP AP Tony Murphy N/A Patient Representative AP Ray Murphy N/A Patient Representative John Lawrence N/A Patient Representative AP AP KEY: = Attended AP = Apologies sent D = Deputy sent R = Remote Attendance (TC/VC) KEY: Chemotherapy CNG AO/CUP CNG AO & Chemotherapy CNG AO & Chemotherapy CNG Annual Report (Approved 29.07.2014) Page 9 of 9