ESSEX AND EAST SUFFOLK GYNAECOLOGICAL CANCER NETWORK SITE SPECIFIC GROUP Friday, 14 th December 2012 at 2.00pm -4.00pm TA Centre Chelmsford MINUTES Present: Mr Barnaby Rufford (Chair) BR Consultant Gynae Oncologist, Ipswich Mr Khalil Razvi KR Consultant Gynae Oncologist, SUHFT Michael Scanes MS User Involvement Facilitator Mr Jonathan Evans-Jones JEJ Consultant Gynae Oncologist, CHUFT Marilyn Lewis ML CNS Gynae Oncology, Basildon Alison Miller AM CNS, Southend Mr Anders Linder AL Consultant Gynae Oncologist, Ipswich Mr C K Partington CP Consultant Gynae Oncologist, MEHT Emma Azeem EA CNS Gynae Oncology, Southend Jane Torble JT CNS, MEHT Amanda Green AGr CNS,CHUFT Julie Gormer JG MDT, Co-Ordinator, CHUFT Alison Garnham AG CNS, Ipswich Dr Kishor Padki KP Public Health Consultant ECN Dr Fani Toneva FT Consultant Gynae Oncologist, SUHFT 1. Welcome and Introductions As Mr Razvi was delayed in traffic, Mr Rufford agreed to open the meeting. 2. Apologies Alan Lamont, Rachael West, Anita Bruce, Kate Simon, Wendy Davies, Rachael Keenan, Dr Madhavi Venumbaka, Wendy Ella, Deborah Woods, Thomas Jenkins 3. Previous Minutes 7 th September 2012 The minutes accepted as a true record. 4. Patient and Carer Issues Patient Transport: The issue of poor provision of patient transport across the Network was discussed briefly and it was agreed that this was not an issue that this group could resolve and that it was for the commissioners to resolve. The item should not be included in future agendas. Page 1 of 6
5. Matters Arising 5.1 Commissioning MS explained that the commissioning of any cancer which is discussed at a Specialist MDT will be commissioned by the regional Specialist Commissioning Group which for this area will be based in Cambridge. The proposals are out for consultation until middle of January 2013. Details can be found at the following web site: http://www.engage.commissioningboard.nhs.uk/consultation/ssc-area-b/ Clinical Reference Groups have been established for each Cancer Type. The information can be found via the following web site and following the links to Site Specific Clinical Reference Groups and Gynaecology. http://www.ncin.org.uk/cancer_type_and_topic_specific_work MS added that they would be commissioning from IOG compliant services and that the population in the East Suffolk and Essex Network was marginally less than the 2 million which would be required for two specialist centres. BR said that the population base for Ipswich was over the 1 million figure and the number of procedures was well over the minimum requirements. KR said that the population for Southend Centre was probably less than 1 million. 5.2 Enhanced Recovery AG said that Ipswich were moving slowly towards implementing ER. They have a new Ward Matron who is keen to start. They have a position statement document to which they are working. KR suggested that the group audit the progress across the Network. He will circulate a proforma early in January so that all trusts are collecting the same data. KR 5.3 UKGOSOC AL will present the results at the next audit meeting. The topic should be removed from the agendas of future meetings. Page 2 of 6
5.4 Peer Review AG said that there were no issues at Ipswich. KR said that the Network and Southend were only involved in a Self-assessment only. MEHT had a Self-assessment and Internal Validation. CHUFT was the only Trust to have a Peer Review visit. JEJ reported that the report was positive with a couple of small concerns raised: - Lack of cover for the CNS - Access to Primary Care Ultrasound. 5.5 Use of CA125 (for follow up after Chemotherapy) Still waiting for Alan Lamont to write a protocol on the topic and produce a patient leaflet. Alan Lamont BR said that regular CA125 does not improve outcomes. It is better to wait for symptoms. The issue is slowly fading away as new patients are unaware of the practice. BR will write protocol letter confirming the use of other tumour markers, which while in the Network guidelines are being ignored. BR 5.6 Workforce Strategy Southend Changes: Dr Desiree Kolomainen has been appointed as Consultant Gynaecological Oncologist at Southend Hospital and will be starting in Feb 2013. Dr Fani Toneva will be leaving in Feb 2013.Dr Jan Prejbisz will be covering the Medical Oncology with Dr Hafiz Algurafi. Ipswich: No change. They are still hoping to recruit a third Consultant Gynae- Oncologist to the team, but until the financial situation shows an improvement they will struggle on with 2. Colchester: The single CNS needs cover when she is on leave, and to assist with the growing work load. Broomfield: No change Page 3 of 6
5.7 Network Research Nobody from the Research Network was present. BR said that there was little change in Ipswich with some recruitment to Oncology Trials. There were no surgical trials available. KR said that in Southend they have a Research Co-ordinator who attends the MDT with the result that they are recruiting more. KR will circulate the procedure to the other teams. KR 5.8 CNS Report The CNSs had not met recently and EA said that it was difficult due to clinical commitments. It was agreed that they would keep in touch via email and that they would formally meet on the Audit day as was the previous practice: some time during the day the NSSG would split into two groups: CNSs and Clinicians where topics specific to the separate groups can be discussed 5.9 Audit 2013 - Audit Chemotherapy Pathways for Endometrial Cancer and then revisit the Guidelines. - Audit of Enhanced Recovery: KR - UKGOSOC: AL - Interval debulking surgery for Ovarian Cancer: AL - Late Effects Survey across the Network: EA 6. Any Other Business 6.1 NAEDI: Ovarian Cancer Awareness Campaign KP gave the group an update on the plans for an Ovarian Cancer Awareness Campaign : Our Network is hosting the DH led media and PR (no TV) campaign on Ovarian Cancer from mid-january till mid-march 2013. The key message of the posters, press and radio adverts with the Be Clear on Cancer banner will be Feeling bloated, most days, for 3 weeks, could be a sign of ovarian cancer Chances are it`s nothing to worry about, but finding it early makes it more treatable. So if you can`t get rid of that bloated feeling, tell your doctor Page 4 of 6
The NAEDI team are involved in clinical engagement to ensure that all practices and secondary care (Gynae NSSG) are informed of this campaign and ready to respond to any additional activity. We will be promoting an e-learning module for ovarian cancer to all practices. We have distributed briefing sheets to GPs, practice teams and pharmacies on the preparedness for the campaign. We are also planning an educational session for GPs and Nurse practitioners on early diagnosis of ovarian cancer in February 2013. 6.2 Laparoscopic Surgery EA reported that at a Peer Review visit she had made to another Trust outside the Network, the subject of Laparoscopic surgery for Hysterectomies for Endometrial Cancer had been raised and she wondered what the situation was in this Network. BR said that the Norfolk & Norwich Hospital had gone from zero to around 95% in a short period of time. Ipswich need the equipment to do this procedure. Southend and Broomfield are doing some laparoscopic work. CHUFT have the infrastructure in place but need the qualified surgeon to attend Gynae lists. BR will forward a paper on this procedure to MS for circulation to the group. BR It was agreed to add this item to future agendas so that progress could be monitored. 6.3 Transition Update MS reported that the current situation was that on 1 st April 2013, the Essex Cancer Network would cease to exist in its present form. It will be replaced by a Strategic Clinical Network covering the East of England (Norfolk, Suffolk, Cambridge, Hertfordshire, Bedfordshire and Essex) and would cover Cancer, Cardiovascular, Mental Health, Neurological Conditions., Maternity and Children s Services. The Director of the Network has a perinatal background. The Patient Groups in Essex are unhappy that their voice will be lost in this bigger Network and are lobbying MPs, Acute Trust Chief Executives and Clinical Commissioning Groups Chief Executives to support and provide resources for a Provider Network in Essex. KR asked what they could do to help as it was essential that there was support for NSSGs going forward. MS said that if each Cancer Clinician could write to their CE supporting a Provider Network it could only help. He added that perhaps Ipswich might consider becoming part of this Network as two groups of patients (Gynae and Upper GI) were part of a Network including East Suffolk and Essex. Page 5 of 6
7. Confirmed Dates for 2013 Dates for 2013 all 2.00pm 4.00pm Friday 15 th February 2013 TA Centre, Springfield Friday 5 th July 2013 Audit and NSSG Full day Friday 18 th October 2013 Page 6 of 6