ACHIEVING NICE COMPLIANCE FOR SPECIALIST CANCER SERVICES

  1. BACKGROUND

The surgical services to be considered are those for Head & Neck, Gynaecological, Urological and Upper Gastrointestinal Cancers. NICE Improving Outcomes Guidance mandates that these be carried out in a single centre serving a population of approximately

1 million. The rationale is that this achieves better short and long term benefits for the patients in terms of survical and surgical morbidity.

The Mount Vernon Cancer Network (MVCN) made interim proposals to achieve NICE compliance in 2005 predicated on the basis these Cancer Surgical Services would ultimately move to a new hospital at Hatfield. Following the decisions in 2006 to cancel the new hospital project, the East of England Strategic Health Authority instructed the Network to revise its plans to bring specialist cancer surgical services in line with NICE Guidance by the end of 2007.

  1. PROCESS

The three NHS trusts (West Herts, East & North Herts, Luton & Dunstable) were asked for expression of interest as to whether or not they would like to be consider as the host site for each of the four specialist cancer services. The responses are shown below.

Which specialist service(s) do you want to provide
E&N Herts / L&D / West Herts
Gynae / Gynae / Gynae
Head & Neck / Head & Neck
Upper GI / Upper GI / Upper GI
Urology / Urology / Urology

A self-assessment proforma was subsequently devised after consultation with Clinical Specialists, the MVCN team and with involvement with MVCN User Groups. This asked for factual information about each Trust’s existing activity, outcomes, logistical support, participation in clinical governance, service improvement, access to supportive care services, achievability and commitment. The proforma was sent to each Trust for completion and “sign off” by the Chief Executive, Cancer Lead Clinician and User Group Representatives in August 2007.

An outline of the existing work volumes is shown in the table below.

Tumour Site / Network Average / E&N Herts / L&D / West Herts
Gynae / 234 / 90 / 9 / 129
Upper GI / 60 / 15 / 11 / 35
Urology / 220 / 135 / 30 / 64
Head & Neck / 102 / 58 / 57 / 0
Total / 616 / 298 / 107 / 228

Numbers approximate and unverified

The MVCN team is collating the results and assembling the accompanying documentation.

An evaluation panel will be convened to consider the applications and make recommendations to the MVCN Board regarding the proposed reconfiguration for each Cancer Surgical Service. The Panel will comprise Board Level Representatives and Cancer Lead Clinicians from each Trust, PCT Commissioners, Members of the MVCN Executive Team, Representative from Public Health, Patient/User Representatives from each area and an external nationally recognised specialist for each of the cancers to be considered. The Panel is scheduled to meet on the 28th September and 5th October 2007.

  1. IMPLEMENTATION

The MVCN Board will consider recommendations from the Panel. Findings will then be published back to the NHS Trusts. Proposals will then be submitted to the Cancer Action Team at the Department of Health through the East of England SHA.

Following due consultation the MVCN team anticipates its involvement in the development of an implementation programme and action plan.

Estimated time scale

Oct 2007 Formalised report from evaluation panel

Nov 2007Report to MVCN Board

Publication of outcome

Dec 2007 Report and recommendations to EoE SHA

Jan 2008Feedback from CAT

MVCN Implementation Programme

Ivan F Trotman MD FRCP

Medical Director

Mount Vernon Cancer Network