Acute Oncology & Chemotherapy Clinical Network …...2014/07/29 · Consolidate Acute Oncology Services across network, with a view to 7 day service provision Raise C&M profile nationally

CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 – approved 29.07.2014) Page 1 of 12

Acute Oncology & Chemotherapy Clinical Network Group (CNG) Work Programme 2014-2015 Version 1.0

This Work Programme has been agreed by:

Title Name Date Agreed

AO & Chemotherapy CNG Chair Ernie Marshall 29.07.2014

CMSCN Clinical Lead Chris Warburton 29.07.2014

CWW Area Team Medical Director Kieran Murphy 29.07.2014

This programme has been agreed by the AO & Chemotherapy CNG and will be reviewed 3 times a year

29.07.2014


Version Control

This is a controlled document please destroy all previous versions on receipt of a new version.

Date Approved: July 2014 Review Date: April 2015

Version Date Issued Review Date Brief Summary of Change

1.0 July 2014 April 2015 Approved

AO & Chemotherapy CNG

This work programme sets out how the AO & Chemotherapy CNG intends to deliver improved outcomes and quality improvements. It details, the key deliverables and measures of success that exist for each objective. Progress will be reviewed 3 times a year at each CNG meeting.

For the latest version of this Work Programme please see website

http://www.cmscn.nhs.uk

http://www.cmscn.nhs.uk/


3 Year Service Delivery Plan Minimise number of people developing disease and improve survival rates

Domain/Goal Strategic Direction

2014

Domain 1/Goal 1 Treatment

AO/CUP MDS collection by each MDT/service

Improved SACT compliance

Monitor the number of palliative patients dying in their preferred place of care

Increase number of CUP patients receiving active treatment

Increasing portfolio of trials with equal access for patients

Monitoring new approaches to cancer drug pricing

Improved planning for new drugs on the horizon and all cancer teams should be using a capacity planning tools

Exploring new ways of delivering chemotherapy/skill mix changes

Domain 2/Goal 2 Holistic Care

HNA & patient information prescriptions embedded in routine practice

Implementation of care plans & end of treatment summaries

Domain 2/Goal 3 MSCC Management

Agreed implementation plan for NICE QS & revision of network guideline

Annual audit - Timeliness of the Investigation of MSCC

Annual audit - Timeliness of Definitive Treatment of MSCC

Annual audit - Outcome of Definitive Treatment of MSCC

Domain 4/Goal 4 Service Improvement

Improved patient experience survey results

Implement network AO/CUP audit programme


Reduce emergency admissions

Reduce length of stay

Consolidate Acute Oncology Services across network, with a view to 7 day service provision

Raise C&M profile nationally

Exploring chemotherapy closer to home where possible

Domain 5/Goal 5 Clinical Governance

E-prescribing – agreed procurement plan in place by each provider

30 day SACT M&M reviews in place in each provider

2015

Domain 1/Goal 6 Epidemiology:

Improved SACT compliance

Analysis and agreed actions to support improvements in emergency presentation rates



Care closer to home




Domain 3/Goal 6 Follow up

Consensus on risk stratified follow-up


HNA & patient information prescriptions embedded in routine practice


Improved patient experience survey results

Improved door to needle time

2016

Domain 1/Goal 8 Epidemiology:

Benchmarking local outcomes data



Regular monitoring of C&D within chemotherapy outpatient units and pharmacy aseptics identifying trends and safe working limits (SWL)

Dedicated In-patient beds

Community AO model & interface with LTC team agreed




24 hour Integrated Helpline in place


Equitable access to high quality survivorship programmes in each locality – supported by risk stratified follow-up


http://www.england.nhs.uk/wp-content/uploads/2013/09/outcomes-framwrk.png


Work Programme Purpose: To ensure co-ordination and consistency across the network for cancer policy, practice guidelines, audit, research and service development in relation to the acute oncology, cancer of unknown primary & chemotherapy services.

Progress rating: BLUE Completed GREEN On target AMBER Minor concerns RED Major concern

Clin

ical

Go

vern

ance

(R

ef:

Can

cer

SCN

Pri

ori

ty 2

& D

om

ain

1, 2

& 4

)

Objective 1: Full compliance with national peer review quality measures (2014) to quality assure acute oncology, cancer of unknown primary & chemotherapy services cancer services

Measure of success Task Lead Target Date Progress 100% compliance with

AO/CUP/Chemotherapy

Peer Review Measures

Update constitution Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by

25.07.14

Produce annual report Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by

25.07.14

Review work programme Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by

25.07.14

Annual self- assessment Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by

25.07.14

Update clinical guidelines Individual CNG authors July 2014 Sign off remotely by

25.07.14

Objective 2: To have a fully functioning CNG which supports improving the quality of acute oncology, cancer of unknown primary &

chemotherapy services, safeguards high standards of care and creates an environment in which excellence in clinical care flourishes

Measure of success Task Lead Target Date Progress

100% organisational

representation

MDT Lead Clinicians or

representative in

attendance for 2/3 of CNG

meetings

Review and confirm membership Jo Myler June 2014 Sign off remotely by

25.07.14

Agree meeting dates and venue Jo Myler March 2014 Completed. Agree work programme 2014-

2015 including areas for service

development

Ernie Marshall June 2014

Sign off remotely by

25.07.14

Review outcome indicators

AO MDS

CUP MDS

SACT compliance

NS – time to antibiotics

AO Leads/CNG July 2014

Sign off remotely by

25.07.14

http://www.nice.org.uk/aboutnice/ccgois/?domedia=1&mid=0741AD8C-CCB1-EAC5-DBDECFB41C1ECC38


Su

rviv

ors

hip

(R

ef:

Can

cer

SCN

Pri

ori

ty 2

& D

om

ain

2)

Objective 3: Ensure that those living with and beyond cancer get the care and support they need to lead as healthy and active a life as possible, for as long as possible

Measure of success Task Lead Target Date Progress 100% completion of HNA at

diagnosis 100% treatment summary 100% Cancer Care Review

completed Agreed stratified follow up

protocol Access to education and

support programme in each locality

Implement ‘recovery package’

which includes:

a. Holistic Needs Assessments

and care planning at key points

of the care pathway

CNG Nursing representatives March 2015 Planned

b. A Cancer Care Review

completed by GP or practice

nurse to discuss the person’s

needs

Primary Care CRG March 2015 Planned

c. A Treatment Summary

completed at the end of each

acute treatment phase, sent to

patient and GP


Offering a patient education and

support event, such as a Health

and Wellbeing Clinic, to prepare

the person for the transition to

supported self- management,

which will include advice on

healthy lifestyle and physical

activity


NICE Smoking cessation - supporting people to stop smoking (QS43) – identify smokers/refer to smoking cessation services routinely

MDT Lead Clinicians/CNG March 2015 Planned


Baseline survivorship support &

develop further action plan

A. Bass Sept 2015 Planned

Pat

ien

t Ex

pe

rie

nce

(R

ef:

Can

cer

SCN

Pri

ori

ty 4

& D

om

ain

5)

Objective 4: To monitor network progress and to use the findings to drive quality improvements locally

Measure of success Task Lead Target Date Progress National Cancer &

Chemotherapy Patient

Experience Surveys + CMSCN

AOT surveys results

discussed at CNG

Remedial Action Plan

developed based on survey

results to drive year on year

improvements in results. (%

improvement to be

determined in 2014)

Reduced LOS

Results reviewed by CNG. Mike Varey May 2014 Completed

MDT remedial action plans

presented to CNG & actions

agreed.

MDT Leads July 2014 CNG to discussion

Progress reviewed at year end. MDT Lead Clinicians/CNG March 2015 Planned

MSCC high risk patients

identified by CNG, clinical advice

given to patient reinforce with

written information.


Explore strategies & develop

supporting ‘case of need’ to

prevent emergency admissions

e.g.

o Fast track clinic access

o Day case

capacity/chemotherapy

clinic utilisation

o Dedicated In-patient beds

o Community AO model &

interface with LTC team

o 24 hour Integrated Helpline


Network AO patient & HCP

survey undertaken annually.

Results presented to CNG &

actions agreed.


Clin

ical

Au

dit

/Se

rvic

e Im

pro

vem

en

t/Ed

uca

tio

n

(Re

f: C

ance

r SC

N P

rio

rity

4 &

Do

mai

n 5

)

Objective 5: Patients have equitable access to treatments that could potentially improve outcome.

Measure of success Task Lead Target Date Progress Reducing inequalities and variation in quality and performance Variances in clinical outcomes will be analysed & addressed.

Improved SACT compliance MDT Lead Clinicians/CNG Nov 2014 Ongoing

Network-wide collection of

AO/CUP MDS & annual

monitoring of outcomes data

MDT Lead Clinicians/CNG Nov 20154 Ongoing

Promote secondary prevention

through specialist advice

Diet

Exercise

Smoking cessation


Increase recruitment into

randomised, non-randomised

trials and commercial studies

MDT Lead Clinicians/CNG March 2015 Ongoing

Develop a research infrastructure

to share learning and best practice

Helen Neville-Webb/MDT

Lead Clinicians/CNG

March 2015 Ongoing

Host an education/audit day to

share good practice

Ernie Marshall Sept 2014 Planned

Chemotherapy algorithms

developed. Deviations monitored.


E-prescribing – procurement plans

agreed by each provider.

CSC Leads /CNG March 2015 Ongoing

Dose banding pilot evaluated &

action plan developed.

NPG March 2015 Ongoing


Continued MSCC Clinical Case

Reviews & sharing of lessons

learnt.

MSCC Leads Sept 2014 Planned

Annual network NS Audit & year

on year improvements in door to

needle time.

NS Leads Dec 2015 In progress

Work with primary care on

admission avoidance strategies

MDT Lead Clinicians March 2015 In progress

Morbidity & Mortality Meetings in

place in each Trust

MDT Lead Clinicians Dec 2014 In progress

Explore strategies & develop

supporting ‘case of need’ to

prevent emergency admissions

e.g.

o Fast track clinic access

o Day case

capacity/chemotherapy clinic

utilisation

o Dedicated In-patient beds

o Community AO model &

interface with LTC team

o 24 hour Integrated Helpline

MDT Lead Clinicians/CNG Sept 2015 Planned


Cheshire & Merseyside Strategic Clinical Networks (CMSCN) Vision

To improve the health & wellbeing of our population through collaborative working

CMSCN Values

Cheshire and Merseyside Strategic Clinical Networks and Senate will work within the values of NHS England. Central to our ambition is to place patients and the public at the heart of everything we do through: clinical leadership, patient & people focus, continuous

improvement,

Strategic Goals

CMSCN have agreed the following strategic objectives for this period:

Champion equitable access to high quality services supported by evidence & best practice

Meaningful & effective patient & public involvement in strategic decision making

Support commissioners to reduce unwarranted variations in service delivery

Support commissioners & providers to deliver whole system improvement and act as a vehicle to ensure equitable outcomes

for the population of Cheshire & Merseyside

Support commissioners in ensuring best value for money in addition to improving the quality of care and outcomes

Cancer SCN Priorities

To support overall delivery of CMSCN’s strategic objectives, the following priorities have been agreed by the Cancer Strategic Clinical

Network

1. Improving outcomes for cancer patients: prevention and earlier diagnosis (NHS Outcomes Framework – Domain 1)

2. Improved quality of life for patients living with & beyond cancer (NHS Outcomes Framework – Domain 2)

3. Improved patient experience through high quality, cost effective cancer pathways (NHS Outcomes Framework – Domain 4)

4. Supporting commissioners to reduce variation: through high quality, cost effective cancer pathways high quality cancer care

guided by national guidance and best practice (NHS Outcomes Framework – Domain 5)

Documents

Acute Oncology & Chemotherapy Clinical Network …...2014/07/29 · Consolidate Acute Oncology Services across network, with a view to 7 day service provision Raise C&M profile nationally