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Peninsula Cancer Network (North, East & West Devon, South Devon & Torbay, Somerset, Cornwall and Isles of Scilly) Network Site Specific Group for Gynae-Oncology Constitution Approval Date: December 2015 Review Date: September 2018 Constitution of the Peninsula Cancer Network Site Specific Group for Gynae-Oncology VERSION CONTROL THIS IS A CONTROLLED DOCUMENT - PLEASE ARCHIVE ALL PREVIOUS VERSIONS ON RECEIPT OF THE CURRENT VERSION. Please check the website for the latest version available: http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-site-specific-groups/gynae-ssg/ VERSION 0.1 0.2 DATE ISSUED June 2015 rd 3 August 2015 SUMMARY OF CHANGE 1st draft 2nd draft OWNER PCN Gynaecology NSSG PCN Gynaecology NSSG Agreement cover sheet This constitution was prepared by: Khadra Galaal, Consultant Gynae-Oncologist, Royal Cornwall Hospital NHS Trust (NSSG Chair) Liz Boylan – Peninsula Cancer Network Manager This constitution has been agreed by: Name Position Organisation David Milliken (Chair) Consultant GynaeOncologist Taunton & Somerset NHS Foundation Trust Mike Hannemann Consultant GynaeOncologist Royal Devon & Exeter NHS Foundation Trust Stephen Bennett Consultant Obstetrician & Gynaecologist Morven Leggott Consultant GynaeOncologist Northern Devon Healthcare NHS Trust South Devon Healthcare NHS Foundation Trust Lydia Karamura Consultant Gynaecologist Yeovil District Hospital Miss Khadra Galaal Consultant GynaeOncologist Royal Cornwall Hospitals NHS Trust Mr Geoff Hughes Consultant Gynaecologist Plymouth Hospitals NHS Trust Date agreed 1 Peninsula Cancer Network Gynae-Oncology NSSG Constitution Contents 1 STATEMENT OF PURPOSE ......................................................................................................................................................... 3 2 TERMS OF REFERENCE FOR THE GROUP ............................................................................................................................. 3 3 STRUCTURE AND FUNCTION ..................................................................................................................................................... 4 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Role and Function of the Group ............................................................................................................................................ 4 Network Configuration 14-1C-101e ...................................................................................................................................... 4 Local Gynaecological Cancer Teams 14-1C-101e .................................................................................................................. 5 Network Group Members (14-1C101e, 14-1C-103e) ............................................................................................................. 6 Network Agreed Authorised Surgeons for Diagnostic Service 14-1C-102e ........................................................................... 8 Network Group Meetings ...................................................................................................................................................... 9 Reporting Arrangements ....................................................................................................................................................... 9 4 SERVICE MAPPING .................................................................................................................................................................... 9 5 NETWORK GUIDELINES ............................................................................................................................................................. 9 5.1 Primary Care Referral Guidelines ........................................................................................................................................... 9 5.2 Referral Guidelines for Patients moving between Teams ................................................................................................... 10 5.3 Network policy on named medical practitioner with clinical responsibility ........................................................................ 10 5.4 Network Agreed Onward Referral Policy ............................................................................................................................ 10 5.5 Clinical Guidelines ............................................................................................................................................................... 10 5.6 Chemotherapy Algorithms .................................................................................................................................................... 11 5.7 The Teenage and Young Adult pathway for initial management ......................................................................................... 11 6 DATA COLLECTION .................................................................................................................................................................. 11 6.1 Network-wide Minimum Data Set ........................................................................................................................................ 11 6.2 Network policy for collection of the MDS.............................................................................................................................. 12 7 DISTRIBUTION OF GUIDELINES AND PROTOCOLS ................................................................................................................... 12 2 Peninsula Cancer Network Gynae-Oncology NSSG Constitution 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 Somerset The Peninsula Cancer Network serves a population of 2.2 million people and is comprised of the following organisations: Clinical Commissioning Groups Northern, Eastern & Western Devon CCG South Devon & Torbay CCG NHS Kernow CCG Somerset CCG 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 Taunton & Somerset NHS Foundation Trust Yeovil District Hospital Hospices Hospiscare, Exeter Mount Edgcumbe Hospice, Cornwall North Devon Hospice Rowcroft Hospice, Torquay St Julia’s Hospice, Cornwall St Luke’s Hospice, Plymouth St Margaret’s Hospice, Yeovil The following document outlines the constitution, roles and responsibilities of the Group. 2 Terms of Reference for the Group 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 coordination and consistency across the Network for cancer policy, practice guidelines, audit, research and service improvement for each type of cancer. 3 Peninsula Cancer Network Gynaecology NSSG 2015 Network site specific Groups are multidisciplinary with representation from professionals across the patient care pathway as well as involvement and representation from patients and carers. The current Gynae-Oncology NSSG Terms of Reference are available on the SWSCN website: http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-site-specific-groups/gynaessg/peninsula-gynaecological-cancer-ssg-information-for-members/ 3 Structure and Function 3.1 Role and Function of the Group Network Site Specific Groups have been established to: Act as the Network Executive Board’s reference group for advice on all issues relating to gynaecological cancer; Ensure coordination and consistency for cancer policy, governance, guidelines, audit, research and service improvement relating to gynaecological cancer; 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 Group will be to: Establish common referral and clinical guidelines for the Network/South West; Agree a minimum data set for gynaecological cancer and a policy for consistent data collection across the Network/South West; Engage in service improvement by using appropriate mapping and other service improvement processes to understand patient flows and make recommendations for improvement to the patient pathway; Agree and support an annual audit programme both at regional and local level; Consult with relevant cross-cutting groups on issues involving chemotherapy, radiotherapy, cancer imaging, histopathology, genetics, 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 and delivery; Promote research and clinical trials; Produce an annual work plan. 3.2 Network Configuration 14-1C-101e The Peninsula Gynae-Oncology Network Group embraces the services provided across the peninsula and managed by two discrete MDTs, comprised as follows: 4 Peninsula Cancer Network Gynaecology NSSG 2015 West Peninsula Gynae-Oncology SMDT Plymouth Hospitals NHS Trust Royal Cornwall Hospitals NHS Trust Central Peninsula Gynae-Oncology SMDT Royal Devon & Exeter NHS Foundation Trust Taunton & Somerset NHS Foundation Trust South Devon Healthcare NHS Foundation Trust Northern Devon Healthcare NHS Trust Yeovil District Hospital The MDTs review the presentation, diagnosis, treatment, subsequent assessment, follow up and supportive care of all patients with Gynaecological malignancies. Each trust has dedicated diagnostic services for gynaecological cancer. Each trust (except North Devon) has a weekly MDT meeting and attend their respective joint SMDTs North Devon has a fortnightly local MDT meeting. South Devon has a weekly MDT meeting and core members also join the weekly Royal Devon and Exeter MDT meeting via video link. Royal Cornwall Healthcare NHS Trust and Plymouth Hospitals NHS Trust hold weekly local MDT meetings and via video link between the two sites to discuss all confirmed cancers . 3.3 Local Gynaecological Cancer Teams 14-1C-101e Distribution and Role of Local Support Teams 14-1C-103i Trust Team Curative Surgical Centre Locality Referring CCG Population Plymouth Hospitals NHS Trust Royal Cornwall Hospitals NHS Trust Joint MDT with Cornwall 349,481 NHS NEW Devon CCG Western Locality Joint MDT with Plymouth 534,503 NHS Kernow CCG Northern Devon Healthcare NHS Trust South Devon Healthcare NHS Foundation Trust Joint MDT with Exeter, South Devon and Taunton Joint MDT with Exeter, North Devon and Taunton 164,997 NHS NEW Devon CCG Northern Locality Eastern Locality NHS South Devon & Torbay CCG Royal Devon & Exeter NHS Foundation Trust Joint MDT with North Devon, South Devon and Taunton Taunton and Somerset NHS Foundation Trust Joint MDT with Exeter, South Devon and North Devon Royal Devon & Exeter NHS Foundation Trust South Devon Healthcare NHS Foundation Trust Royal Devon & Exeter NHS Foundation Trust Royal Devon & Exeter NHS Foundation Trust Total 286,000 383,040 NHS NEW Devon CCG Eastern Locality 544,000 NHS Somerset CCG 2,262,021 5 Peninsula Cancer Network Gynaecology NSSG 2015 3.4 Network Group Members (14-1C101e, 14-1C-103e) 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 Chair of the Group will be elected from within the membership of the Group. The term of office will be for three years. The Group will work towards developing patient and carer involvement in to the Group. Patient and carer representatives will be appointed when possible. In addition to this a Group member will identified who will have specific responsibility for patient issues and information for patients and carers. A Group trial Recruitment Clinical Lead will be identified from within the membership of the Group. This person will work with the Research Network team and liaise with MDT Research Representatives on research issues. A Group Patient Champion and Information Lead will be identified from within the membership of the Group. This person will work with the Network User Facilitator and Network Patient Information Manager with specific responsibility for users’ issues and information for patients and carers. Gynaecology NSSG Chairperson Khadra Galaal NSSG Trial Recruitment Clinical Leads Jenny Forrest Subspecialty Lead RDEHT Khadra Galaal Consultant Gynae-oncologist RCHT Zoe McCullogh Cancer Nurse Specialist RCHT Fran Jones Cancer Nurse Specialist PHT Emma Kent Cancer Nurse Specialist RCHT Patient Champion & Information Leads Patient and Carer Representatives Vacant Northern Devon Healthcare NHS Trust 6 Peninsula Cancer Network Gynaecology NSSG 2015 Stephen Bennett Mary Alexander Jo Gordon James Rhymer Consultant Gynaecologist Consultant Clinical Nurse Specialist Consultant Radiologist MDT Lead Plymouth Hospitals NHS Trust Geoff Hughes Paul Dubbins Diane de Friend Petra Williams Ahmed Talaat Fran Jones Adewunmi Oriolowo Dennis Yiannakis Sidharth Dubey Martin Highley Ann Jones Cathy Herd Consultant Gynaecologist Consultant Radiologist Consultant Radiologist Consultant Radiologist Consultant Oncologist Clinical Nurse Specialist Histopathologist/Cytopathologist Consultant Oncologist Clinical Oncologist Medical Oncologist Consultant Radiologist Clinical Nurse Specialist MDT Lead Royal Cornwall NHS Hospitals Trust Khadra Galaal Nigel Bailey Alistair Thomson Nagindra Das Emma Kent Zoe McCullough Hayley Carey Simon Thorogood Amanda Liddacott John McGrane Juliane Stolte Rachel Newman Samy Bishieri Consultant Gynae Oncologist Consultant Medical Oncologist Consultant Clinical Oncologist Consultant Gynae Oncologist Clinical Nurse Specialist Clinical Nurse Specialist Clinical Nurse Specialist Consultant Radiologist Consultant Radiologist Oncologist Histopathologist Consultant in Palliative Medicine Associate Specialist MDT Lead Royal Devon & Exeter NHS Foundation Trust Mike Hannemann Consultant Gynae-oncologist John Renninson Consultant Gynaecologist Kate Scatchard Consultant Medical Oncologist Peter Bliss Consultant Clinical Oncologist Jenny Forrest Clinical Oncologist Jacky Stewart Clinical Nurse Specialist Katharine Edey Consultant Gynae-oncologist Trupti Mandalia Consultant Histopathologist Nicole Dorey Consultant Clinical Oncologist Ann Hong Consultant Carole Brewer Consultant Clinical Geneticist Jacky Coote Consultant Radiologist Tom Clark Clinical Director of Diagnostics Nichola Cope Consultant HistoCytopathologist Laura Gellett Consultant Radiologist Lisa Joels Consultant Jane Ferguson Consultant Radiologist MDT Lead 7 Peninsula Cancer Network Gynaecology NSSG 2015 South Devon NHS Foundation Trust Morven Leggott Nangi Lo Debbie Fitzgerald Sarah Higgins Tracy Hill Raj Ranjit Sarah Harrison Suzanne Hill John Bridger Pat Lye Ryley Nick Tanwen Wright Maria Consuelo Garrido Taunton & Somerset NHS Trust Consultant Gynaecologist Consultant Medical Oncologist Gynae-oncology Nurse Specialist Consultant Radiologist Clinical Nurse Specialist Consultant Consultant Radiologist Radiographer Consultant Pathologist Clinical Nurse Specialist Consultant Consultant Consultant Pathologist MDT Lead David Milliken Clare Barlow Jo Morrison John Hunter Paul Burn Kirsty Coomber Petra Jankowska Surabhi Agrawal Sue Slater Sue Golby Emma Cattell Yeovil District Hospital Consultant Gynae-oncologist Consultant Medical Oncologist Consultant Gynae-oncologist Consultant Radiologist Consultant Radiologist Clinical Nurse Specialist Consultant Clinical Oncologist Consultant Pathologist Consultant Pathologist Gynae-oncology CNS Consultant Medical Oncologist MDT Lead Lydia Karamura Sally Keates-Porter Cenydd Thomas Hany Omran Peninsula Cancer Network Consultant Gynaecologist Clinical Nurse Specialist Consultant Radiologist Ass Specialist Obs & Gynae MDT Lead Liz Boylan Peninsula Cancer Network Manager Melanie Chandler Network Admin Support CCG Managers for Cancer Lynne Kilner Yash Patel Sara Wright Emma Herd Andy Gordon Amelia Randle NHS NEW Devon CCG Western Locality NHS NEW Devon CCG Eastern Locality NHS NEW Devon CCG Northern Locality NHS South Devon & Torbay CCG NHS Kernow CCG Somerset CCG 3.5 Network Agreed Authorised Surgeons for Diagnostic Service 14-1C-102e Below is a list of named surgeons in the hospitals that provide stand-alone diagnostic services and who are authorised to operate on low risk endometrial carcinoma within the Peninsula Cancer Network. 8 Peninsula Cancer Network Gynaecology NSSG 2015 Local Hospital Northern Devon Healthcare NHS Trust South Devon Healthcare NHS Foundation Trust Named Surgeon Stephen Bennett Morven Leggott Raj Ranjit MDT attended as core member North Devon Gynaecology MDT SDHT Gynaecology MDT SDHT Gynaecology MDT 3.6 Network Group Meetings Meetings will be held at least twice per annum. Liz Boylan, Peninsula Cancer Network Manager and the NSSG Admin Support Office will provide managerial and administrative support at Group meetings. 3.7 Reporting Arrangements Notes of the Group will be circulated to all Group members, Cancer Service Managers and other interested parties. They will also be published on the Network website: http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-site-specific-groups/gynaessg/ The Group will provide a Peninsula Cancer Network annual report for Peer Review purposes. 4 Service Mapping The Gynaecology service has been mapped in previous years, and a full portfolio of gynaecological cancer services across the Network is available. This informs future service development and delivery planning and will be updated when required. 5 Network Guidelines 5.1 Primary Care Referral Guidelines Primary Care practitioners will refer all patients defined by the ‘urgent, suspicious of cancer’ guidelines for Gynaecological cancer to the contact point of a single local Gynaecology team as agreed in each local MDT operational policy. General practitioners and nurse practitioners should be aware of the various routes by which patients satisfying the high-risk criteria can gain access to diagnostic services in their locality. All suspected gynaecological cancers are referred to a central point in all 5 acute hospitals via one of the 3 routes below: 1. All such referrals should be made (via primary care proforma within 24 hours usually through a dedicated fast track system. The patient will be offered a date within 2 weeks of referral (2 week wait). 2. Patients who describe symptoms which don’t entirely fulfill the criteria but are a source of concern to the GP can be referred urgently to the gynaecology service via the fast track system (Choose & Book). 9 Peninsula Cancer Network Gynaecology NSSG 2015 5.2 Referral Guidelines for Patients moving between Teams Referring clinicians should ensure that all relevant information is provided in a timely fashion to facilitate the continuity of care and avoid unnecessary delays. Any patient suspected of having cancer but not referred via the urgent referral route may be upgraded by a consultant member of the MDT at any time prior to decision to treat. The upgrade should be undertaken using the internal upgrade referral proforma and following processes outlined in individual Trust operational policies. 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. Patients with synchronous cancers at Gynaecological and other site(s) Such patients will be discussed in the Gynaecology MDT. Lead responsibility will be shared with the other site-specific MDT, until it becomes clear which MDT would be best to lead in each individual case. 5.3 Network policy on named medical practitioner with clinical responsibility The network policy on the named medical practitioner with responsibility for the patient at each stage is that unless already under a named clinician, the responsible clinician will be determined after discussion at the MDT. The radiologist does not take clinical responsibility for the patients at any stage of the pathway. 5.4 Network Agreed Onward Referral Policy All patients who have gynaecological diagnostic procedures are discussed at the Gynaecology MDT. The responsible clinician identified at the MDT will take responsibility for informing the patient of the diagnosis and the GP within one working day after the patient has been informed. The radiologist does not take responsibility for the patient at any stage of the clinical pathway. 5.5 Clinical Guidelines The Group has agreed to adopt the NICE clinical guidelines as below for ovary, endometrial and cervical cancer which includes follow up, and the SWICS guidelines for other tumour sites. Patients suitable for cytoreductive (surgical or non-surgical) treatment for recurrent cancer are referred to the named specialist teams from the named local teams as listed in 3.3. Ovary http://www.nice.org.uk/guidance/cg122 Endometrial - TBC 10 Peninsula Cancer Network Gynaecology NSSG 2015 Cervical - TBC 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. For Peninsula Cancer Network Gynaecology guidelines click link below: http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-site-specific-groups/gynaessg/ Pathology guidelines The Group has adopted the guidelines of the Peninsula Cancer Network Pathology Group which follow the latest Royal College of Pathologist Guidelines 2014. The Network Pathology Leads Group is responsible for producing all Network pathology guidelines for all tumour sites. 5.6 Chemotherapy Algorithms The Group does not yet have agreed network chemotherapy treatment algorithms. 5.7 The Teenage and Young Adult pathway for initial management The pathway for initial management of teenagers and young adults as specified by the TYACNCG is as below. The pathway for cases involving NHS specialist services is indicated in the operational procedures policy. Distribution of the pathway to all MDT leads is verified through their agreement to the PCN Gynaecology NSSG Constitution. Click here for South West TYA Patient Pathway for Initial Management of Cancer for 15 – 24 year olds. http://www.swscn.org.uk/networks/cancer/children-young-people/ 5.8 The TYA pathway for follow up on completion of first line of treatment The pathway for follow up on completion of first line treatment of teenagers and young adults as specified by the TYACNCG is as below; distribution of the pathway to all MDT leads is verified through their agreement to the PCN Gynaecology NSSG Constitution. http://www.swscn.org.uk/networks/cancer/children-young-people/ 6 Data Collection 6.1 Network-wide Minimum Data Set All Trusts have previously confirmed their compliance with data collection requirements for cancer waiting times and the Cancer Registry, together these constitute the MDS for the Gynaecology Group. 11 Peninsula Cancer Network Gynaecology NSSG 2015 Link for Minimum dataset to be confirmed 6.2 Network policy for collection of the MDS Responsibility for data The Acute Trust first treating or giving subsequent treatment to a patient in 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 their colleagues in other Acute Trusts. 7 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/sitespecific-groups/peninsula-site-specific-groups/gynae- ssg/ 12 Peninsula Cancer Network Gynaecology NSSG 2015
