Draft Minutes of Chemotherapy Regional Group Meeting NICaN
18/06/2007
NICaN Chemotherapy Group Meeting
Friday 18th May 2007
Seminar Room 3, Cancer Centre – Belfast City Hospital
Record of Attendees
Ms Sally CampalaniMs Rosemary Campbell / Ms Collette Knowles
Ms Fidelma Connor
Ms Joanne Cullen / Ms Pearl Lynn
Dr Jonathan McAleese
Ms Eileen Deery / Ms Heather McAllister
Mr Noel Dunn
Ms Hazel Eagleson
Dr Martin Eatock
Ms Elizabeth England
Ms Fionnuala Green
Ms Enda Hanna
Dr Robert Harte
Ms Liz Henderson
Dr Russell Houston
Ms Ruth Johnston
Dr Suneil Jain
Dr Yogesh Manikyam / Ms Nichola McCabe
Ms Heather McCarty
Ms Anne McCosh
Ms Caitlin McCoy
Ms Lynne McCrory
Ms Dympna Mc Parlan
Ms Jackie Quinn
Ms Patricia Rogers
Dr Paula Scullion
Ms Elaine Shaw
Dr B Sinnott
Dr D Steward
Dr S Stranex
Apologies: Ms Wilma Boyd Carson, Ms Pearl Millar, Mr Maurice Regan, Mr David Robinson
Welcome and Introductions
Dr Harte welcomed members to the meeting and apologies were noted as recorded above.
CH0607_26 Matters arising from February Meeting
· Arrival of Adam
Dr Harte expressed his congratulations on behalf of the group to Ms Lisa McWilliams on the birth of Adam who arrived four weeks early, hence the absence of the minutes from the last chemotherapy meeting, however all the action points have been picked up on and are included in today’s agenda.
· Chemotherapy Services Project Manager
Dr Harte reported that an appointment had not been made. Ms Henderson confirmed that the job specification was being revised and the post would be
readvertised.
CH06/07_27 Update since last meeting (ref: April 07 E-Update)
§ GP Referral Guidance
§ Regional Care Pathways
§ Clinical Data Sets
§ Service Improvement Workshop Wed 9th May 2007
§ Network Team Update
Ms Henderson gave a brief update in relation to all of the above which can be viewed on the recent E-Update
Group Work Plan Updates
CH06/07_28 Capacity and Demand Work Strand
§ CPORT – Ms Fionnuala Green
CPORT is a “Chemotherapy Planning Oncology Resource Tool”.
It is a capacity planning tool which has been developed through the Pharmaceutical Oncology Initiative Partnership. This is partnership working between the Department of Health and the Pharmaceutical Industry. The Regional Co-ordinator for cancer services pharmacist is working with others to set up an information meeting in September 2007. The meeting will provide and opportunity to learn about the concept, practical experiences and the benefits of the system. CPORT has been piloted in six sites across England and Wales and the pilots are currently reporting back.
§ Chemotherapy Nursing Workload Strand 11 – Ms Alison Porter Service
See attached presentation: Ms Porter updated members on progress to date:
Nursing activity times have been collated and circulated for first consultation. Focus group meetings with district nurses are ongoing and a GP questionnaire has also been circulated. Ms Porter advised that engagement with community colleagues is generating extremely useful information to inform the development of chemotherapy services and that the value of having tangible information about activity is essential to inform the capacity / demand debate.
Dr Russell Houston welcomed the work and endorsed the need to factor it into regional chemotherapy service 10-year plan with clear objectives.
Dr Martin Eatock, highlighted the need for chemotherapy service redesign, informed by active horizon scanning and lessons learned from elsewhere.
Ms R Campbell from SE Belfast Community Services informed the group that district nurses were keen for greater integrated services and had undoubtedly a key role in chemotherapy service development (citing their partnership working with cancer centre in securing Bradbury Court Blood Transfusion Initiative). However, in relation to escalated future development she cautioned that current workload and limited resources would need to be addressed.
CH06/07_29 Standards and Guidelines Development for NI Chemotherapy Services
§ Self Assessment report against NICaN Chemotherapy Service Standards
Ms Henderson reported that multi professional groups at each of the cancer units and at the cancer centre had undertaken a self assessment against the NICaN Chemotherapy Service Standards. A group of nurses and pharmacists had subsequently met to collate the regional picture. Generally the service measures up well with many standards fully achieved. However, some of the key areas for action were identified by the subgroup as:
o There is a need to develop a robust system for clinical management guidelines.
o A robust system is needed to review chemotherapy protocols at each location.
o Timely evidence is required by pharmacy for treatment outside guidelines.
o Greater clarity around a shared understanding of treatment intent is needed (UHD includes this in their consent form).
o Agreement needed re acceptable system to record the consultation.
o There is a need for a lead chemotherapy team with authority at each location.
Actions Agreed: The assessment group will reconvene to complete the collation of self assessment. Suggested minor amendments to the standards will be forwarded to the standards drafting group. (L Henderson)
§ Guidelines for patients who become ill within 6 weeks of chemotherapy treatment
These have been endorsed by the NICaN board and are now available on the NICaN website. Circulation of the guidance to GPs is imminent. Workshops for GPs and local executive cancer teams are planned for the autumn at which these will be shared.
Ms Campalani highlighted the need to have copies of the guidance communicated to nursing and medical staff in chemotherapy settings to ensure consistency.
Action Agreed: Guidance to be circulated to nursing and medical staff in chemotherapy settings via lead cancer teams (NICaN office).
§ Management of Chemotherapy Hypersensitivity Reactions-
Dr Paula Scullion
Dr Scullion reported that comments/suggested amendments received from the cancer units and cancer centre colleagues had now been incorporated and all were thanked for their help with this.
Dr Robert Harte agreed to quality assure the final version which will render it signed off by the group. This guideline will be officially communicated to the lead cancer teams and made available on the NICaN website.
Action Agreed: Dr Harte to quality assure policy for sign off.
§ Cytotoxic Handling Policy – Ms Fionnuala Green
A multi professional working group of the NICaN Pharmacy Group have been working on a prescribing dispensing and administration of cytotoxic chemotherapy policy. Initially the group reviewed policies from other networks across the UK. The group has taken the North London and North East London Network Policy and adapted for local use. The policy has been circulated to the NICaN Pharmacy group for consultation. Comments have been received back and the subgroup has met to consider them. Currently, amendments are being made to the policy and it is anticipated that a draft policy will be circulated shortly.
§ Management of Neutropenic Sepsis
Dr Brendan Sinnott (BCH A&E) and Mr Noel Dunn (A&E Network Pharmacist) were welcomed. Ms Henderson gave a brief background to this policy and the need to update same. It was agreed that the key stakeholders required to progress this work included, Oncologists, Haematologists, Lead Cancer Nurses, Pharmacists, A&E and Primary Care. A subgroup is required to agree the clinical content with local elements (to do with care pathways) factored in.
Dr Sinnott volunteered to lead on this and interested parties were invited to give their names to Ms Henderson at the end of the meeting. It was agreed that Ms Campbell would ask Dr Ursuala Brennan a GP Facilitator if she would consider being a member of the group. The first meeting of the Neutropenic Guidance Group will take place in June.
Actions Agreed: Ms Campbell to invite Dr Ursuala Brennan to join the sub group.
L Henderson to link with Dr Sinnott re establishing regional meeting
CH06/07_30 Emerging Issues
§ Regional Oncology / Haematology Drugs and Therapeutics Committee Update and Audit.
Dr Eatock advised that funding had been approved for 3 recently submitted business cases. The importance was now placed upon the distribution of funds and ensuring that resources were allocated appropriately. He also stated that sign off regarding the implementation of the proposals was still required from some of the Trusts. The mechanism for monitoring and evaluation of the projects will be the responsibility of the NICaN Drugs and Therapeutics Committee, who will feedback to the other regional groups.
§ Sharing Good Practice: UHD Near Patient Chemotherapy
Ms Caitlin McCoy outlined the systematic phased approach being taken in partnership with community colleagues to pilot a near patient chemotherapy project at Bangor. They have developed guidelines and protocols and intend to commence with chemo supportive therapies, such as blood transfusions, PICC dressings, bisphosphates etc. Patient information is also being developed. This innovation is in line with the vision for Cancer Chemotherapy Services.
Date and Time of Next Meetings:
The next meetings have been scheduled for Friday 17th August 07
And Friday 16th November 07.