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WEST MIDLANDS STRATEGIC CLINICAL NETWORK – CANCER MINUTES OF WEST MIDLANDS METASTATIC SPINAL CORD COMPRESSION (MSCC), ACUTE ONCOLOGY AND CANCER OF THE UNKNOWN PRIMARY EXPERT ADVISORYGROUP Held on Tuesday 23 September 2014 at Crowne Plaza Hotel, NEC Present: Dr Peter Correa PC Mrs Mandy Wilson Ms Nicky Adams Ms Jas Brent Ms Andrea Chatterley Dr Caroline Connolly Dr Alison Franks MW NA JBren AC CC AF Ms Alison Herbert Mr Paul Hickman Ms Lisa Kembery AH PH LK Mrs Anita Killingworth Dr Rakesh Mehra Dr Sarah Pickstock Dr Ben Ritzenthaler Ms Nicola Robottom Ms Clair Turner AK RM SP BR NR CT 1. University Hospital Coventry and Warwickshire NHS Trust West Midlands Strategic Cancer Network Walsall Healthcare NHS Trust Heart of England NHS Foundation Trust University Hospital North Staffordshire NHS Trust University Hospital North Staffordshire NHS Trust University Hospital Coventry and Warwickshire NHS Trust Walsall Healthcare NHS Trust Sandwell and West Birmingham Hospitals NHS Trust University Hospital Coventry and Warwickshire NHS Trust Royal Orthopaedic Hospital NHS Foundation Trust Royal Wolverhampton Hospital NHS Trust Mid Staffordshire Hospital NHS Trust Dudley Group NHS Foundation Trust Royal Wolverhampton Hospital NHS Trust University Hospital North Staffordshire NHS Trust Apologies: Ms Jayne Breen Ms Julie Bliss Ms Caroline Hunt Ms Charlotte Jackson Ms Michelle Judge Mrs Jill Kneale Ms Caroline Pemberton JBree JBl CH CJ MJ JK CP Ms Lynn Reaper Dr Andrea Stevens LR ASte Mr Alistair Stirling Ms Shona Underwood Ms Di Waldron ASti SW DW Heart of England NHS Foundation Trust Heart of England NHS Foundation Trust Shrewsbury and Telford Hospital NHS Trust Heart of England NHS Foundation Trust Worcestershire Acute Hospital NHS Trust Heart of England NHS Foundation Trust Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust Heart of England NHS Foundation Trust University Hospital Birmingham NHS Foundation Trust Royal Orthopaedic Hospital NHS Foundation Trust Shrewsbury and Telford Hospital NHS Trust University Hospital Birmingham NHS Foundation Trust D:\769823682.doc Page 1 of 7 ACTION 2. Minutes of the Meeting Held on 23 June 2014 These were agreed with the following amendment:CT and AK apologies to be added. MW will amend the minutes accordingly. 3. Matters Arising There were no items of matters arising. 4. Confirmation of Appointment of Deputy Chair Representing Cancer of the Unknown Primary The Group were informed that following the last meeting AF had expressed an interest in becoming the Cancer of the Unknown Primary Deputy Chair and this announcement had been circulated via e-mail to members to seek their approval which was duly given. AF was congratulated on her new appointment. Clarification was then given over the roles of Deputies for this Group:PJ AF BR 5. Acute Oncology Cancer of the Unknown Primary Metastatic Spinal Cord Compression Acute Oncology Database – update on progress and review of database form PJ began this item by informing members that she had been in contact with Stuart Baiby who used to work for Greater Midlands Cancer Network and who had been responsible for the acute oncology database. The purpose of contacting Stuart was to ask whether it would be possible for him to undertake a review and analysis of the data already entered and to also, if possible, make the database fit for purpose and easy to use. It was clarified that the first task would require members, predominately Clinical Nurse Specialists, looking at what information is needed and identifying what format and information the reports should include. D:\769823682.doc Page 2 of 7 MW ACTION It was also reported that West Midlands Cancer Intelligence Unit and Somerset Database have also been approached to see if new data fields could be added on to their systems thus making the acute oncology database and their systems more compatible. It was clarified that the ultimate aim is to have a database that is a working document with mandatory fields that must be completed. Although discussions will need to be undertaken with Stuart to ascertain whether the system could be a “live” one. It was acknowledged that the majority of Clinical Nurse Specialists, especially in acute oncology, are single handed and therefore the easier the database was to enter information the better. It was reported that acute oncology on the Somerset system has been put on hold until 2015 mainly for them to concentrate on the cancer of the unknown primary sections. PJ has ensured that the people running the Somerset system have received the fields that are being asked to be added and she has also informed them that it would be preferable for the system to be a working tool rather than just a by-product to collect data. Discussions on the database fields and what information should be collected had been undertaken by the Nurses Group and some amendments were made and PJ agreed to provide members with a copy of the latest version of the proposed database to enable them the ability to comment. PJ It is hoped that the data collected can be used as part of the evidence gathering procedure for future Peer Review visits\reports. Members were also informed that a new acute oncology service specification is being produced by the Health Education Service and as PJ is a member of this Group she can provide members with a copy of the specification to enable them to review and comment upon. It is intended for a wider consultation process to be undertaken but by PJ circulating the document to members of this Group it ensures everyone has the opportunity to review and comment. PJ then undertook a discussion against some of the categories within the specification and some members present expressed their concern that the collection of some of the items was not feasible. D:\769823682.doc Page 3 of 7 PJ\ Group ACTION PJ outlined that some of the data fields have the potential to become mandatory, similar to SACT, which means it will be a Trust requirement to ensure they are collected thus taking the onus off Clinical Nurse Specialists having to be responsible. Members were also informed that once the service specification had been finalised it would generate a review and rewrite of the Peer Review Measures to ensure that they are aligned which essentially means that no “new” data will need to be gathered. In terms of the next steps the Group were informed that Stuart Baiby had offered to attend the next meeting of the Nurses Group to identify what exactly is needed. It was outlined that currently the database in existence is a standalone model which means it is not able to communicate\share information with other Trusts. It was felt by some of those present that this would be more advantageous if the database could share information. It was then reported that such a database used to be in existence for collection of data for MSCC and this had been developed and managed by Pan Birmingham Cancer Network. It was reported that although the database was very good at collecting data it was not particularly good at generating reports. MW agreed to speak to Alison Davies, Quality Improvement Lead within West Midlands Strategic Clinical Network and Senate, to see if the Pan Birmingham database can still be accessed and amended. If so she will arrange a meeting for PJ with Alison to review how this could be done and also to review what data fields were being collected. 6. Scoping Exercise MW reported that responses had been received from the majority of Trust and a report showing these responses was tabled at the meeting. Members were informed that MW hopes to be able to transpose the information into graphs showing what service is provided and where. The report tabled showed that the Acute Oncology Service across the West Midlands was reasonably covered and that the gaps in service provision appeared to be MSCC and Cancer of the Unknown Primary. D:\769823682.doc Page 4 of 7 MW\ PJ ACTION 7. As outlined earlier MW hopes to be able to produce a West Midlands wide graph showing where services are provided and for those Trusts who have gaps in their service PC, as Chair of this Group, would write to them seeking information on what their plans are to rectify this. PC In the meantime MW reported that she intends to chase the Trusts who have not yet responded to enable a true reflection of service provision across the West Midlands to be given. MW It is intended, if MW is able to produce the graphs, for this item to be discussed again at the next meeting. Agenda Patient Survey for Cancer of the Unknown Primary Even though this is a Peer Review requirement it appears that some Trusts have struggled to produce this document largely because of the nature of the disease area to be surveyed. NR did report that some Cancer of the Unknown Primary patients have been identified who will be approached, ahead of their outpatient appointments, asking them if they would be happy to complete the survey and specifying that it is not compulsory. Some concern was raised by members present in relation to how do you “target” palliative care patients. It was outlined that the aim of the survey needs to be clarified ahead of anything being distributed for example is it looking at patients who have an unknown primary, is it to identify how patients were managed\dealt with etc. It was clarified that although there is a National patient survey in circulation this focuses more on the chemotherapy element of the patient pathway and looks more at whether patients were given information leaflets. It was agreed that a copy of the National survey would be circulated to members to allow them the opportunity to review and also copies of the survey produced by NR would be circulated to ascertain if this could be adopted by the Group. D:\769823682.doc Page 5 of 7 NR\ Group ACTION 8. Patient Information Leaflet for MSCC PJ informed members that she had approached Macmillan Cancer Support to ascertain if they would be happy to take over the development and production of the patient alert card. It was acknowledged that nationally there are various versions and designs of the alert card in circulation and the aim is to have a generic version produced which will be based on the current versions taking into account the best bits of each of them. PJ agreed to keep members informed in respect of Macmillan Cancer Support developing and producing the cards. 9. PJ MSCC, Acute Oncology and Cancer of the Unknown Primary Work Programme – to be reviewed This was a document produced initially by Pan Birmingham Cancer Network and it is intended that MW and PJ will meet to amalgamate the constitutions from the “old” Cancer Networks to produce a West Midlands wide version. MW\ PJ Some concern was expressed by those present in relation to the current lack of a West Midlands Chemotherapy Expert Advisory Group especially as a lot of the Measures for chemotherapy are connected to MSCC, Acute Oncology and Cancer of the Unknown Primary. To try and raise the awareness of the importance of having a West Midlands Chemotherapy Expert Advisory Group PJ reported that she will shortly be meeting with Rob Gornall, Clinical Director for the West Midlands Strategic Cancer Network to try and take this issue forward. Discussions were then undertaken in relation to the Macmillan Cancer Support e-learning tool for Acute Oncology Nurses. It was felt by those present that this is an excellent tool that should be more widely adopted and used. Of course this should be undertaken in conjunction with any local training that is also available. In respect of 24 hour Consultant cover it was outlined that this was managed and provided by the “old” Cancer Networks and again the intention is to produce a West Midlands wide version. It was acknowledged that the MSCC specification is a priority that again needs to be produced on a West Midlands footprint. This is something MW and PJ will undertake. D:\769823682.doc Page 6 of 7 MW\ PJ ACTION In the meantime PJ agreed to recirculate the Cancer of the Unknown Primary guideline initially produced by Greater Midlands Cancer Network to all Clinical Nurse Specialists to provide them with the opportunity to review and identify whether the contents are still appropriate. 10. PJ\ CNSs Any Other Business Website MW reported that the West Midlands Strategic Clinical Network and Senate is now live (www.wmscnsenate.nhs.uk) and it is intended for this Group to have their own section with the Cancer Network tab. MW agreed to ascertain if it was possible to have a Drop Box facility within this Group’s section. MW MSCC Workshop This is to be held on 19 November 2014 at the Holiday Inn, Birmingham. MW agreed to circulate information on this event and how to register. 11. MW Date and Time of Next Meeting The date and time of the next meeting is Thursday 17 December 2014 at 10.00 a.m. – venue to be confirmed. At the meeting a date for early 2015 was also agreed, which is Tuesday 10 March 2015 commencing at 10.00 a.m. – venue to be confirmed. D:\769823682.doc Page 7 of 7