Download 4.1 Soft Tissue Sarcoma

Peninsula Cancer Network
(North, East & West Devon, South Devon & Torbay, Cornwall)
Network Site Specific Group for Sarcoma
Constitution
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Please check the website for the latest version available:
www.swscn.org.uk
VERSION
0.1 v2
Peninsula Cancer Network Sarcoma NSSG 2015
DATE ISSUED
May 2015
SUMMARY OF CHANGE
2nd draft
OWNER
PCN Sarcoma SSG
1
Constitution of the Peninsula Cancer Network
Site Specific Group for Sarcoma
Agreement cover sheet
This constitution was prepared by:
Toby Talbot – Chair of the Peninsula Cancer Network (PCN) Sarcoma SSG Group, Consultant Oncologist, Royal
Cornwall Hospitals NHS Trust.
Liz Boylan – Peninsular Cancer Network SSG Manager
This constitution has been agreed by:
Name
Position
Toby Talbot
Consultant Oncologist/Chair
Chris Mills
David Silver
Consultant Plastic &
Reconstructive Surgery
Consultant Radiologist
Col. Chris Taylor
Consultant Surgeon
Peninsula Cancer Network Sarcoma NSSG 2015
Date agreed
Royal Cornwall Hospitals NHS
Trust
Royal Devon & Exeter NHS
Foundation Trust
Royal Devon & Exeter NHS
Foundation Trust
Plymouth Hospitals NHS Trust
16/04/2015
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Contents
1.
Statement of Purpose
2.
Terms of Reference
3.
4.
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Structure and Function
3.1 Role & Function of the Group
Network Configuration
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4.2 Bone Sarcoma
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4.4 Network Group Membership
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4.5 Group Meetings
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4.6 Work Programme and Annual Report
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4.7 Designated Diagnostic Services
6.
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4.1 Soft Tissue Sarcoma
4.3 Network Group Members
5.
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4.8 Designated Chemotherapy Departments and Practitioners
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4.9 Designated Radiotherapy Departments and Practitioners
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5.1 Molecular Biology/Cytogenetic Facilities
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5.2 Designated GIST Histopathologists
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Pathology
Coordination of Care/Patient Pathways
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6.1 Primary Care Referral Guidelines
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6.2 Referral Guidelines for Patients moving between Teams
7.
8.
6.3 Clinical Guidelines for Soft Tissue Sarcoma (Limb & Trunk)
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6.4 Clinical Guidelines for Soft Tissue Sarcoma Presenting to Site Specialised
MDTs
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6.5 Chemotherapy Treatment Algorithms
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6.6 Patient Pathways for Initial Referral and Diagnosis for Soft Tissue Sarcoma
(Limb & Trunk)
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6.7 Patient Pathways for Assessment, Treatment & Follow up for Soft Tissue
Sarcoma (Limb & Trunk)
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6.8 Patient Shared Care Pathways for Soft Tissue Sarcomas Presenting to Site
Specialised MDTs
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Clinical Outcomes/Indicators
8.1 Clinical Outcomes Indicators and Audits
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8.2 Discussion of Clinical Trials
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Patient Experience
9. Data Collection
9.1 Network-wide Minimum Dataset
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9.2 Network Policy for Collection of MDS
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10.
App
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Distribution of Guidelines and Protocols
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PCN Terms of Reference for Sarcoma
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Peninsula Cancer Network Sarcoma NSSG 2015
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1.
Statement of Purpose
The Peninsula Cancer Network exists to secure equal access to high quality care for all cancer patients; strive
for better clinical outcomes and improve the experience of patients, their carers and families throughout
screening, diagnosis, treatment, aftercare and survival.
The Network has an increasing role in the prevention of cancer and reducing health inequalities. To achieve
these goals it collaborates with all healthcare providers, commissioners, patients and their carers throughout
Devon, Cornwall and the Isles of Scilly.
The Peninsula Cancer Network serves a population of 1.7 million people and is comprised of the following
organisations:
Clinical Commissioning Groups
Northern, Eastern & Western Devon CCG
South Devon & Torbay CCG
NHS Kernow
Acute Hospitals
Northern Devon Healthcare NHS Trust
Plymouth Hospitals NHS Trust
Royal Cornwall Hospitals NHS Trust
Royal Devon & Exeter NHS Foundation Trust
South Devon Healthcare NHS Foundation Trust
Hospices
Hospiscare, Exeter
Mount Edgcumbe Hospice, Cornwall
North Devon Hospice
Rowcroft Hospice, Torquay
St Julia’s Hospice, Cornwall
St Luke’s Hospice, Plymouth
The following document outlines the constitution, roles and responsibilities of the Group.
2.
Terms of Reference for the Group
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In response to the publication of the Manual for Cancer Services (2004) a number of clinical sub- groups
were established to address services for specific types of cancer.
Network Site Specific Groups have collective responsibility, delegated by the Network Executive Board, for
the coordination and consistency across the Network for cancer policy, practice guidelines, audit, and
research and service improvement for each type of cancer.
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Peninsula Cancer Network Sarcoma NSSG 2015
Network site specific Groups are multidisciplinary with representation from professionals across the patient
care pathway as well as involvement and representation from patient and carers.
3. Structure and Function
3.1 Role of the Group
Network Site Specific Groups have been established to:
 Act as the Network Executive Board’s primary source of tumour site specific clinical opinion for the
network;
 Advise and consult on service planning to ensure services are in line with national guidance in order to
promote high quality care and reduce inequalities in service delivery;
 Ensure Network decisions become integrated into local practice;
 Monitor progress on meeting National Cancer Standards and ensure action plans agreed following Peer
Review are implemented
 Promote links between teams and other relevant Network Groups
The key objectives of Network Site Specific Groups will be to:
 Establish common referral and clinical guidelines for the Network
 Agree a tumour site specific minimum data set and support consistent data collection across the
Network
 Engage in service improvement by using appropriate redesign tools and techniques via process
mapping, capacity and demand measurement and redesign
 Agree and support an annual audit programme both at regional and local level
 Agree a common approach to research & development working with the Network research team,
participating in nationally recognised studies whenever possible;
 Consult with cross-cutting Groups on issues involving chemotherapy, cancer imaging,
histopathology and laboratory investigation and specialist palliative care;
 Identify emerging new cancer drug treatments and technologies which require appraisal by
commissioners through the Peninsula Health Technology Appraisal process;
 Support the development of education and training programmes for teams;
 Support effective patient and carer involvement in service planning.
4. Network Configuration
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This constitution covers services delivered for adults only (i.e. over 19). Services for those 19 or under are
cared for under the South West Children’s Cancer Network, young people aged between 15 and 19 are
discussed with the Bristol TYA team.
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Peninsula Cancer Network Sarcoma NSSG 2015
4.1 Soft Tissue Sarcoma
The Network Board has agreed with the SWSCG that two Soft Tissue Sarcoma MDTs will be established
to service the populations of the Peninsula Cancer Network. The Soft Tissue Sarcoma MDTs will be
hosted by:
 Plymouth Hospitals NHS Trust
 Royal Devon & Exeter NHS Foundations Trust
The two MDTs will work jointly to establish the best care pathway for patients with complex needs.
Joint meetings will be held on a quarterly basis by either a videoconferencing link or face to face
meeting.
 Curative resections will take place at both sites.
 The Sarcoma MDT will deal with retroperitoneal sarcomas
4.2 Bone Sarcoma
The Network Board has agreed with the SWSCG that the Bone Sarcoma MDT for populations of the
Peninsula will be at Birmingham (Royal National Orthopaedic Hospital) and Oxford. The soft tissue MDT will
develop its relationship with the bone MDT to further facilitate onward referral and follow up according to
the Bone MDT’s protocols.
Click here for Birmingham Bone Sarcoma agreed pathways
Click here for Oxford Bone Sarcoma agreed pathways
4.3 Network Group Members 14-1C-101l, 14-1C-104l
Sarcoma Network Site Specific Group Chairperson
Toby Talbot
Consultant Oncologist/Chair
Royal Cornwall Hospitals NHS Trust
NSSG Trial Recruitment Clinical Lead
Rory Rickard
Consultant Plastic Surgeon
Patient Champion & Information Leads
Sarah Sandford
Clinical Nurse Specialist
Plymouth Hospitals NHS Trust
Royal Devon & Exeter NHS Foundation
Trust
Patient and carer representative
John Osborne
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Plymouth Hospitals NHS Trust
Rory Rickard
Col Chris Taylor
Phil Hughes
David Gay
Priya Suresh
Francis Daniel
Mark Smith
Abdul Gafoor
Liz Ridgeway
Ann Davies
Udaiveer Panwar
Consultant Plastic Surgeon
Consultant Surgeon
Consultant Radiologist
Consultant Radiologist
Consultant Radiologist
Consultant Clinical Oncologist
Consultant Histopathologist
Consultant Radiologist
Clinical Nurse Specialist
Clinical Nurse Specialist
Consultant Clinical Oncologist
Royal Devon and Exeter NHS Foundation Trust
David Silver
Peter Bliss
Patrick Sarsfield
Chris Mills
Sarah Sandford
Claire Facey
Chris Stone
Kate Allington
Mark Napier
Andrew Redfern
Consultant
Consultant Clinical Oncologist
Consultant Histopathologist
Consultant Surgeon
Clinical Nurse Specialist
Clinical Nurse Specialist
Consultant Plastic Surgeon
Clinical Nurse Specialist
Oncologist
Radiologist
Royal Cornwall NHS Hospitals Trust
Toby Talbot
Kim Farmer
Benjamin Casey
Consultant Oncologist
Radiologist
Clinical Nurse Specialist
South Devon NHS Foundation Trust
Richard Seymour
Pam Lewins
Consultant
Clinical Nurse Specialist
4.4 Network Group Membership
Membership of the Group will be multi-disciplinary in nature with representation from professionals
across the care pathway. All core and extended members of the relevant Acute Trust MDT(s) are invited
to participate in Group activities via Group meetings, working parties and email communications as
appropriate.
The Group will work towards developing patient and carer involvement in to the Group and patient and
carer representative(s) will be appointed whenever possible. In the absence of patient and carer
representatives the appointed patient champion and information lead will support the group to ensure
that user issues are recognised and addressed.
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Dr. Toby Talbot has been elected as Chair of the group. The term of office will be for two years.
Dr. Rory Rickard has been appointed cancer research sub specialty lead and assumes responsibility for
recruitment to trials.
4.5 Group Meetings 14-1C-105l
Meetings will be held at least twice per annum. Liz Boylan, Peninsula Cancer Network Manager and Mel
Chandler, Admin Assistant, will provide managerial and administrative support at group meetings. The group
agrees to operate under the Terms of Reference (Appendix 1). All members will be informed of meeting
dates and location and be included in distribution of the Agenda and Minutes. Minutes, actions and notes of
the group meetings will be circulated to oall members, trust management teams and other interested parties.
They will also be published on the SWSCN website.
www.swscn.org.uk/networks/cancer/site-specific-groups
4.6 Work Programme and Annual Report 14-1C-106l
The group will produce an Annual Work Programme for Soft Tissue Sarcoma and submit an entry to the
Network Annual Report.
4.7 Designated Diagnostic Services
Soft Tissue Sarcoma
These clinics have been deemed able to perform biopsies of suspected sarcomas (i.e. the relevant surgical
staff of the clinic have the necessary expertise relating to the specific requirements of sarcoma biopsies).
Local Teams
MDT Lead Clinician
Locality Population
Referring CCG
Plymouth Hospitals
NHS Trust
Rory Rickard
349,481
NHS NEW Devon CCG
Western locality
Royal Cornwall
Hospitals NHS Trust
Royal Devon & Exeter
NHS Foundation Trust
Toby Talbot
534,503
NHS Kernow CCG
David Silver
383,040 East Devon locality
164,997 North Devon locality
NHS NEW Devon CCG
Eastern locality
286,000 South Devon locality
NHS South Devon &
Torbay CCG
South Devon Healthcare Peter Bliss
NHS Foundation Trust
Total
1,718,021
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4.8 Designated Chemotherapy Departments & Practitioners 14-1C-102l, 14-1C-107l
Chemotherapy for radical (including adjuvant) and palliative treatments of soft tissue sarcoma will be only be
provided by core members of the MDTs who have specified time in their job plans for the care of patients with
the relevant sarcoma including time worked in a designated department. See local MDT operational policy
uploads for job plans.
Chemotherapy Service
Consultant Oncologists
Northern Devon Healthcare NHS Trust
Via RD&E
Plymouth Hospitals NHS Trust
Royal Cornwall Hospitals NHS Trust
Royal Devon & Exeter NHS Foundation Trust
Francis Daniel
Toby Talbot
Peter Bliss/ Mark Napier
South Devon Healthcare NHS Foundation Trust
Peter Bliss
4.9 Designated Radiotherapy Departments & Practitioners 14-1C-102l, 14-1C-107l
Radiotherapy for radical (including adjuvant) and palliative treatments of soft tissue sarcoma will be only be
provided by core members of the MDTs who have specified time in their job plans for the care of patients
with the relevant sarcoma including time worked in a designated department. See local MDT operational
policy uploads for job plans.
Radiotherapy Service
Consultant Oncologists? (should this be radiologists)
Northern Devon Healthcare NHS Trust
Plymouth Hospitals NHS Trust
Royal Cornwall Hospitals NHS Trust
Royal Devon & Exeter NHS Foundation Trust
South Devon Healthcare NHS Foundation Trust
Via RD&E
Francis Daniel
Toby Talbot
Peter Bliss
Peter Bliss
5. Pathology 14-1C-108l
The Group has adopted the guidelines of the Peninsula Cancer Network Pathology Group.?
Pathology Network Reporting Guidelines
Click here for Sarcoma pathology guidelines Link to be inserted
Pathology Network External Referral Policy
Click here for pathology network referral policy Link to be inserted
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5.1 Molecular Biology/Cytogenetic Facilities 14-1C-103l,
Cytogenetic and molecular biology investigations on sarcoma cases will be provided by the following
hospitals:



Royal Marsden Hospital: Prof. Cyril Fisher
Birmingham Hospital: Chaz Mangham
5.2 Designated GIST Histopathologists 14-1C-108l
The designated consultant histopathologists who and only who will be responsible for the final reporting and
reviewing of the histological diagnosis of GIST is Dr Bracey, Plymouth Hospitals NHS Trust, who is a Lead
Pathologist for the Plymouth Hospitals NHS Trust Upper GI SMDT and participate s in a EQA scheme.
6. Coordination of Care/Patient Pathways
6.1 Primary Care Referral Guidelines
Primary Care practitioners will refer all patients defined by the “urgent, suspicious of cancer”
guidelines for sarcomas to the contact point at the local designated Diagnostic Clinic.
6.2 Referral Guidelines for Patients Moving Between Teams
Referring clinicians should ensure that all relevant information is provided to facilitate the continuity of care
and avoid unnecessary delays.
The Peninsula Tertiary Referral Form (TRF01) should be used when referring patients to another Acute
Trust for specialist investigation or treatment and sent within one working day of the referral being made
see PCN information policy to support data transfer, this form accompanies the clinical referral.
Click here for TRF01?
Patients with synchronous sarcomas and cancers at other sites
Such patients will be discussed in the Sarcoma MDT. Lead responsibility will be shared with the other sitespecific MDT, until it becomes clear which MDT would be best to lead in each individual case.
Network guidelines will be reviewed at least every three years or on the publication of new guidance.
It is the responsibility of the Chair of the Group to ensure that all Network guidelines are up to date and
reflect current practice.
6.3 Clinical Guidelines for Soft Tissue Sarcoma – Limb & Trunk 14-1C-109l
The Sarcoma Group has agreed clinical guidelines for the management of soft tissue sarcoma.
The Group has adopted the Peninsula Radiotherapy Guidelines and Protocols for soft tissue sarcoma.
Click here for Radiotherapy Guidelines and Protocols(new one needed)
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Link to be inserted
6.4 Clinical Guidelines for Soft Tissue Sarcomas Presenting to Site Specialised MDTs
14-1C-111l
TBA
6.5 Chemotherapy Treatment Algorithms 14-1C-112l
The NSSG, in consultation with the Network Chemotherapy Group (NCG) will agree a list of acceptable
chemotherapy treatment algorithms to be reviewed bi-annually.
6.6 Patient Pathways for Initial Referral and Diagnosis for Soft Tissue Sarcoma (Limb &
Trunk) 14-1C-113l
TBA NB: NCAT now closed.
The NCAT rehabilitation pathway has been adopted by the group. Distribution of the pathway to all MDT
leads is verified through their agreement to the PCN Sarcoma NSSG Constitution.
6.7 Patient Pathways for Assessment, Treatment and Follow up for Soft Tissue Sarcoma
(Limb & Trunk) 14-1C-115l
TBA
6.8 Patient Shared Care Pathways for Soft Tissue Sarcomas Presenting to Site Specialised
MDTs 14-1C-117l
TBA
7. Patient Experience 14-1C-118l
See Annual Report
8. Clinical Outcomes/Indicators
8.1 Clinical Outcomes Indicators and Audits 14-1C-119l
TBA
8.2 Discussion of Clinical Trials 14-1C-120l
TBA
9. Data Collection
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9.1 Network-wide Minimum Dataset
All Trusts have previously confirmed their compliance with data collection requirements for cancer
waiting times and the Cancer Registry which are within the Cancer Outcome and Services dataset
(COSD).implemented in January 2013.
Click here for Cancer Outcomes and Services Dataset Link to be inserted
Together these constitute the MDS for the Sarcoma Advisory Group
9.2 Network Policy for Collection of MDS
Responsibility for data
The Acute Trust first seeing a patient for a particular month or quarter is responsible for ensuring that the
mandated data fields are complete on the database by the national deadline.
The multidisciplinary team responsible for the care of the patient should ensure that information is made
available to allow it to be recorded prospectively and electronically. Cancer Services teams in each Acute
Trust should ensure that the information is transferred within the timescales specified and should establish
robust lines of communication with the colleagues in other Acute Trusts.
Click below for Peninsula Cancer Network information policy which contains a link to the minimum datasets:
http://www/swscn.org.uk/networks/cancer/site-specific-groups
10. Distribution of Guidelines and Protocols
Once agreed by the NSSG, documents will be circulated to all core and extended members of the local
MDTs. The MDT Lead for each locality is responsible for forwarding them to relevant clinical colleagues
within their organisation and publishing on local document libraries where applicable. All network agreed
documents will be added to the Network website:
http://www.swscn.org.uk/networks/cancer/site-specific-groups
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APPENDIX 1.
Peninsula Sarcoma Cancer Network Group
Terms of Reference
Draft v0.1
1. Purpose of Groups
The group will support clinicians to improve patient care by performing the following functions:
The provision of clinical opinion on issues relating to sarcoma cancer for the network;
 Manage operational delivery of pathways of care between providers;

Share best practice, provide education and peer support;

Advise on the strategic direction for services;

Agreement of network standards;

Assess care against standards (both nationally and locally determined);

Assess local capacity to deliver services;

Agree and implement service developments to meet standards;

Provide more specific clinical advice to commissioners on issues identified as a priority by commissioners;

Engage with patients;

Promote the recruitment of patients into clinical trials.
The performance of network clinical groups will be tested as follows:
 Performance of member organisations against agreed clinical outcomes and patient experience;

Performance of the Group in Peer Review assessments;

Performance of member organisations in their own Peer Review;

Engagement of patients will be assessed by the Peninsula and ASW Patient Groups.
2. Objectives
2.1. Clinical Guidelines
 To coordinate and provide consistency across the network for cancer policy, practice guidelines, audit,
research and service development.

To articulate best clinical practice across the Network using patient pathways, clinical guidelines and
protocols taking into account nationally mandated standards (such as by NICE or national service
specifications).

The Group will consult with other interested Network Groups when necessary.
2.2. Clinical outcome and patient experience standards
 To agree clinical outcome and patient experience standards.

To agree data used to test these standards.

Where data is not routinely available to agree local audits.
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2.3. Peer Review
 The Group will carry out the work required for the Group by Peer Review and that required in turn by
member organisations.

Documents will be deemed agreed when each of the MDT Chairs has agreed – either at a meeting or via
e-mail. MDT Chairs will be responsible for ensuring their members’ views have been considered.
2.4. Advice to commissioners
 To advise commissioners on issues raised either by the Group or by commissioners.
2.5. Education & Training
 To provider education for Group members.

To agree standards for education and training for clinicians.
3. Meeting Organisation
3.1. Chair
 The Chair should be a core member of one of the associated MDTs.
3.2. Members
 MDT lead clinician from each of the associated MDTs;

at least one nurse core member of an associated MDT;

a clinical oncologist;

a medical oncologist;

a radiologist;

a histopathologist;

user representative(s);

administrative support;
3.3. Member roles
 An NHS employed member of the Group should be nominated as having specific responsibility for users'
issues and information for patients and carers.

A member of the Group should be nominated as responsible for ensuring that recruitment into clinical
trials and other well designed studies is integrated into the function of the Group.
3.4. Frequency of meetings
 The group will meet at least twice a year.

Two months’ notice will be given for all meeting dates.
3.5. Agendas
 Agendas will be circulated two weeks before the meeting.
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3.6. Notes
Notes will be produced for each meeting capturing;
 Attendance;

Actions for Group members;

Agreements;

Recommendations for commissioners or providers.
Draft notes, agreed by the Chair, will be circulated within one month of the meeting.
4. Accountability
The Group will report to the Clinical Directors for Cancer in the Peninsula Cancer Network but will also be
accountable to the South West Cancer Steering Group, which will set the priorities and strategy for Cancer in the
South West. Groups should request commissioning decisions via the South West Cancer Network Manager, who
will facilitate a collective commissioning response – using the Steering Group where necessary.
4.1. Communication
The following documents will be made public on the South West Cancer Network website
http://www.swscn.org.uk/networks/cancer/site-specific-groups/

Meeting papers

Agreed documents (guidelines, protocols etc.)
Peer Review documents will be available on the Peer Review website http://www.cquins.nhs.uk/home.
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