Download Meeting Notes - Midland Cancer Network

Meeting Notes
National Breast Cancer Working Group - Workshop
Novotel Auckland Airport, Auckland
Friday 29 June 2012 1pm to 4pm
Facilitators
Presentations
Ian Campbell, Breast and general surgeon , Waikato DHB and interim chair
National Breast Cancer Working Group (NBCWG)
Charles DeGroot, Clinical Oncologist, Waikato DHB and chair National
Lung Cancer Working Group
Jan Smith, Manager, Midland Cancer Network
Presentations by Ian Campbell, Charles De Groot, John Childs and Jan
Smith are available for viewing
Ian Campbell.ppt
Introductions
Specialties
represented by
workshop
participants
Workshop
purpose
Chair
Charles DeGroot.ppt
John Childs .ppt
Jan Smith.ppt
Project manager for National Breast Cancer Working Group (NBCWG) is
Loryn Scanlan (Midland Cancer Network)
[email protected]
Specialty
Number
Breast and general surgeons
12
Plastic surgeons
2
Medical oncologists
6
Radiation oncologists
6
Breast physicians
1
Radiologists
4
Pathologists
4
Clinical nurse specialist / nurse – breast
12
screening, breast care, oncology
Geneticists
2
Pharmacists
1
Consumer representatives
4
Maori perspective
2
Pacific perspective
Breast screening representatives
2
Regional cancer networks
4
Ministry of Health
2
Non-government organizations
2
There was no primary care physician at the workshop.
Some participants are listed under more than one specialty.
To discuss:

purpose of the national tumour stream working groups
o
developing national service standards
o
developing tumour pathway and service framework

composition of the National Breast Cancer Working Group

approach to maintain communication with the wider breast cancer
sector
Workshop attendees affirmed Ian Campbell to take the role of chair of
NBCWG
Page 1 of 6
Composition of
NBCWG
Suggested membership that was presented to workshop:

breast surgeons (2)

breast physician (1)

radiation oncologist (2)

medical oncologist (2)

radiologist (2)

pathologist (2)

clinical nurse specialist / nurse (2)

primary care physician (1)

breast screening representative (1)

consumer representatives (2)

Maori perspective (1)

Pacific perspective (1)
With the inclusion of a Breast SIG representative and chairs of existing
regional breast work groups (who can also be one of the specialties listed).
Note: Only the Northern and Midland regional cancer networks have
established breast cancer work groups.
At the workshop it was agreed that the following disciplines be added to the
membership:

plastic surgeon

data specialist

palliative care

public health specialist / researcher
Other disciplines that were suggested to be included in the membership as
necessary:

genetics

psychology

social work

MRT

physiotherapy

psychiatry
 pharmacy.
Key discussion points
 There will be a core membership of the working group. Where there are
specific areas of work that require specialist expertise, then experts
would be co-opted to those meetings when required.

radiologist members should have wide knowledge of medical imaging
procedures including mammography, ultrasound, MRI and PET-CT

clinicians with broad knowledge or who are dual trained could
potentially cover more than one discipline

it was felt that Ian Campbell and others had enough knowledge of
current breast cancer data to avoid need for additional specific data
Page 2 of 6
person at this stage

need to ensure geographical coverage

working group so members are required to contribute time
Interested
persons and
possible
membership
candidates
List of persons unable to attend workshop but interested in working group
and persons nominated for possible membership by attendees at workshop
is attached in Appendix 1.
Next steps
Interested in being a member
Send completed expression of interest form and bio (not to exceed one
page) to [email protected] by Friday 13 July.
NBCWG EOI
form.doc
Appointment process
Chair of NBCWG, clinical directors of regional cancer networks and the
National Clinical Director of Cancer Clinical will make appointment
decisions by 31 July 2012.
Membership of the NBCWG will be communicated to stakeholders.
First meeting
Date: Wednesday 26 September 2012
Venue: Miramar Golf Club Conference Facility, Wellington
Time: 9:30am – 3:30pm (tbc)
Topics for breast cancer standards
Please send potential topics for breast cancer standards to Loryn Scanlan
([email protected])
Other key
discussion
points
Communication
 Workshop invitations were sent to:
o Breast SIG members
o regional cancer networks
o members of regional cancer network breast cancer work groups
o national DHB chief operating officers, directors of nursing and chief
medical advisors
o Royal New Zealand College of General Practitioners
o New Zealand Society of Pathologists
o New Zealand Committee of Pathologists
o Royal Australian and New Zealand College of Radiologists
o Royal Australasian College of Surgeons
o Breast Surgeons of Australia and New Zealand Inc
o BreastScreen Aotearoa
o New Zealand Breast Cancer Foundation
o Sweet Louise
o Breast Cancer Network NZ
o Breast Cancer Aotearoa Coalition
o Cancer Society.
 Issues noted with communications
o invitation did not get sent to the appropriate people in some areas
o short notice especially for radiologists.
 Breast cancer stakeholder database will be developed.
Size of breast cancer working group
Page 3 of 6


Breast cancer working group is expected to be of similar size to the
National Lung Cancer Working Group.
National Lung Cancer Working has sixteen members. There were
seventeen attendees at its last meeting.
NBCWG work programme
 Developing standards not clinical guidance.
 The suggestion was made to use cluster topics and standard
statements from lung cancer standards and adapt for breast cancer.
 Patient pathway describes ideal breast cancer care pathway. Service
framework informs the provision of breast cancer services. It brings
together standards, guidance, position statements and useful resources
to support best practice and improve overall care of patients with breast
cancer.
Faster cancer treatment indicators
 Indicators to apply to all cancers.
 Complexity is not a good enough excuse for delays.
 Two of the faster cancer treatment indicators focus on front end of
pathway from:
o
referral to first specialist assessment (14 days)
o
referral to first treatment (62 days)
 Shorter waits for cancer treatment radiotherapy and chemotherapy
targets remain in place.
 Delivering health care that is timely is a dimension of quality health
care.
 Standards to act as drivers to establish quality care and to move
services forward.
 Other national focus areas are care coordination and cancer related
multi-disciplinary meetings.
Breast cancer care pathway
 Diagnostic and staging work-up for breast cancer is complex.
 BreastScreen Aotearoa evaluation target of four weeks from diagnosis
to treatment which has been in place for thirteen year is not achieved.
 Even in private in the Waikato only 80% of women receiving surgery as
their first treatment meet the four week target.
 Attendees agreed that:
o from a patients perspective we should try to offer treatment within
62 days of secondary care receiving a referral
o by becoming more patient focused delays in diagnostic and staging
work-up should be reduced.
Use of radiological resources
 Need to reduce wait times to access diagnostic imaging examinations.
 Need to ensure appropriate use of imaging in the breast care clinical
community.
 Need for appropriate classification and standardisation of imaging
surveillance and care of high-risk women
Page 4 of 6
Appendix 1
The following list is made up of:
 persons unable to attend workshop but interested in the working group
 persons nominated at workshop for consideration to be members
It is being used as a work in progress list of persons interested in being considered
for appointment to the membership of the NBCWG
Breast and general surgeons
Birgit Dijkstra (Canterbury DHB)
Garth Poole (Counties Manukau DHB)
Belinda Scott (Auckland)
Malcolm Ward (Canterbury DHB)
Semisi Aiono (Whanganui DHB)
Etienne Truter (Lakes DHB)
Plastic surgeons
Professional group to recommend interested persons for
membership
Breast physicians
Could be covered by Marli Gregory (Clinical Lead for
BreastScreen Aotearoa and breast physician) or possibly
Morag Baruch (GP and breast physician)
Radiation oncologists
Carol Johnson (Capital & Coast DHB)
Glenys Round (Waikato DHB)
Lyndell Kelly (Southern DHB
Medical oncologists
David Porter (Auckland DHB; chair Breast SIG)
Marion Kuper (Waikato DHB; chair Midland Breast Cancer
Work Group)
Bridget Robinson (Canterbury DHB)
Vernon Harvey (Auckland DHB)
Richard Isaacs (MidCentral DHB)
Palliative care
Could be covered by Glenys Round (Radiation oncologist
and a palliative care physician)
Radiologists
Barbara Hochstein (Lakes DHB)
Gill Beveridge (Counties Manukau DHB)
Jenny Walker (Waitemata DHB)
Marcel Brew (Christchurch Radiology Group)
Deborah McMutrie (Medex Radiology)
Anne Harkness (Hibiscus Radiology)
Madeleine Wall (Capital & Coast DHB)
Stephen Wood (Auckland Radiology Group)
Shelley Boyd (Canterbury DHB)
Pathologists
Gavin Harris (Canterbury DHB)
Murray Thorburn (Pathlab Waikato)
Nurses
Rachael Collier (Waikato DHB)
Cheryl MacDonald (MidCentral DHB)
Page 5 of 6
Jan McMullen (Auckland DHB)
Lyn Little (Waikato DHB)
Primary care physician (GP)
Alison Foster (Wellington)
Morag Baruch (Tauranga)
Phyllida Cotton-Barker (Auckland)
Mary Obele (Christchurch)
Consumer representatives
Libby Burgess (Breast Cancer Aotearoa Coalition)
Raewyn Calvert (Midland Cancer Network)
Sheldon Ngatai (Central Cancer Network)
Rowena Lewis (Northern Cancer Network)
Rowena has advised that she is happy to input via Northern
Cancer Network
Maori perspective
Sheldon Ngatai (Consumer representative, Central Cancer
Network)
BreastScreening
Marli Gregory (Clinical Lead BreastScreen Aotearoa and
breast physician)
Geneticists
Alison McEwen
Francesca Pigatto (Auckland DHB)
Public health expert
Charlotte Paul (Professor Preventative and Social
Medicine, University of Otago)
Brian Cox (Public Health Physician, University of Otago)
Mark Elwood (Professor of Cancer Epidemiology,
University of Auckland)
NGO representatives
Van Henderson (New Zealand Breast Cancer Foundation)
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