Network Site Specific Group for Gynae-Oncology

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: September 2015

Review Date: September 2018

Constitutionofthe CentralPeninsulaCancerNetwork

Site SpecificGroup 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:

VERSION / DATE ISSUED / SUMMARY OF CHANGE / OWNER
0.1 / June 2015 / 1st draft / PCN GynaecologyNSSG
0.2 / 3rd August 2015 / 2nd draft / PCN Gynaecology NSSG

Agreementcoversheet

Thisconstitution was prepared by:

David Milliken – Chair of the Central Peninsula Gynae-Oncology group

Tito Lopes – Chair of the Western Peninsula Gynae-Oncology group

Liz Boylan – Peninsula Cancer Network Manager

This constitution has been agreed by:

Name / Position / Organisation / Date agreed
David Milliken
(Chair) / Consultant Gynae-Oncologist / Taunton & Somerset NHS Foundation Trust
Mike Hannemann / Consultant Gynae-Oncologist / Royal Devon & Exeter NHS Foundation Trust
Stephen Bennett / Consultant Obstetrician & Gynaecologist / Northern Devon Healthcare NHS Trust
Morven Leggott / Consultant Gynae-Oncologist / South Devon Healthcare NHS Foundation Trust
Lydia Karamura / Consultant Gynaecologist / Yeovil District Hospital
Mr Tito Lopes / Consultant Gynae-oncologist / Royal Cornwall Hospitals NHS Trust
Mr Geoff Hughes / Consultant Gynaecologist / Plymouth Hospitals NHS Trust

Contents

1 Statement of Purpose

2 Terms of Reference fortheGroup

3 Structure and Function

3.1 Role and Function of theGroup

3.2 Network Configuration 14-1C-101e

3.3 LocalGynaecologicalCancer Teams 14-1C-101e

3.4 Network Group Members (14-1C101e, 14-1C-103e)

3.5 Network Agreed Authorised Surgeons for Diagnostic Service 14-1C-102e

3.6 Network Group Meetings

3.7 Reporting Arrangements

4 Service Mapping

5 Network Guidelines

5.1 Primary Care Referral Guidelines

5.2 Referral Guidelines for Patients moving between Teams

5.3 Network policy on named medical practitioner with clinical responsibility

5.4 Network Agreed Onward Referral Policy

5.5 Clinical Guidelines

5.6 Chemotherapy Algorithms

5.7 The Teenage and Young Adult pathway for initial management

6 Data Collection

6.1 Network-wide Minimum Data Set

6.2 Network policy for collection of the MDS

7 Distribution of Guidelines and Protocols

1

Peninsula Cancer Network Gynae-oncology NSSG

1 Statement of Purpose

ThePeninsula CancerNetworkexiststosecure equal accesstohighqualitycareforall cancer patients;striveforbetterclinicaloutcomesand improve the experience ofpatients,theircarersand families throughoutscreening,diagnosis,treatment,aftercare andsurvival.

The Networkhasan increasing role inthe prevention ofcancerandreducing health inequalities.To achieve thesegoalsitcollaborates with all healthcareproviders,commissioners, patientsandtheir carersthroughoutDevon, Cornwall and Somerset

ThePeninsula CancerNetworkserves apopulation of2.2million people andiscomprisedofthe followingorganisations:

Clinical Commissioning Groups

Northern, Eastern & Western Devon CCG

South Devon & Torbay CCG

NHS Kernow CCG

Somerset CCG

AcuteHospitals

Northern Devon HealthcareNHSTrust

Plymouth HospitalsNHSTrust

RoyalCornwall HospitalsNHSTrust

RoyalDevon & ExeterNHS FoundationTrust

South Devon Healthcare NHS FoundationTrust

Taunton & Somerset NHS Foundation Trust

Yeovil District Hospital

Hospices

Hospiscare, Exeter

MountEdgcumbe Hospice,Cornwall

North Devon Hospice

RowcroftHospice,Torquay

StJulia’sHospice,Cornwall

StLuke’sHospice,Plymouth

St Margaret’s Hospice, Yeovil

Thefollowingdocumentoutlinestheconstitution,roles andresponsibilities oftheGroup.

2 Terms of Reference fortheGroup

Inresponsetothepublication oftheManual forCancerServices (2004)anumberofclinicalsub- Groupswereestablishedtoaddress services for specifictypesofcancer.

NetworkSiteSpecific 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.

Networksite specific Groupsaremultidisciplinary with representationfromprofessionalsacrossthe patientcare pathwayas well as involvementandrepresentationfrompatientsandcarers.

The current Gynae-Oncology NSSG Terms of Reference are available in Appendix A.

3 Structure and Function

3.1 Role and Function of theGroup

NetworkSite SpecificGroupshave been establishedto:

• Actasthe NetworkExecutive 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;
• Monitorprogressonmeeting National Cancer Standardsandensureaction plansagreedfollowing PeerReviewareimplemented;
• Promote linksbetween teamsandotherrelevantNetworkGroups.

The keyobjectives ofNetworkSite SpecificGroupwillbeto:

• Establish commonreferraland clinicalguidelinesfortheNetwork/South West;
• Agreeaminimumdata setfor gynaecological cancer and a policy forconsistentdata collection acrossthe Network/South West;
• Engage inservice improvementbyusing appropriatemapping and other service improvement processes to understand patient flows and make recommendations for improvement to the patient pathway;
• Agreeandsupportanannualauditprogrammeboth atregionaland locallevel;
• Consult with relevant cross-cutting groups on issues involving chemotherapy, radiotherapy, cancer imaging, histopathology, genetics, laboratory investigation and specialist palliative care;
• Identifyemergingnewcancerdrug treatmentsand technologies which require appraisalby commissionersthrough the Peninsula HealthTechnologyAppraisalprocess;
• Supportthedevelopmentofeducation andtraining programmesforteams;
• Supporteffective patientand carerinvolvementin service planning and delivery;
• Promote research and clinical trials;
• Produce anannualworkplan.

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:

West Peninsula Gynae-Oncology SMDT / Central Peninsula Gynae-Oncology SMDT
Plymouth Hospitals NHS Trust / Royal Devon & Exeter NHS Foundation Trust
Royal Cornwall Hospitals NHS Trust / Taunton & Somerset NHS Foundation Trust
South Devon Healthcare NHS Foundation Trust
Northern Devon Healthcare NHS Trust
Yeovil District Hospital

The MDTs reviews the presentation, diagnosis, treatment, subsequent assessment, follow up and supportive care of all patients with Gynaecological malignancies.

• Each trusthasdedicateddiagnosticservicesforgynaecologicalcancer.
• Each trust (exceptNorth Devon)hasa weeklyMDTmeeting and attend their respective joint SMDTs
• North Devon has a fortnightly local MDT meeting.
• South Devonhasa weeklyMDTmeeting and coremembersalso join the weeklyRoyal Devon and ExeterMDT 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.

Check details above

3.3 LocalGynaecologicalCancer Teams 14-1C-101e

Distribution and Role of Local Support Teams 14-1C-103i

Trust / Team / Curative Surgical Centre / Locality
Population / Referring CCG
Plymouth Hospitals
NHS Trust / JointMDTwith Cornwall / 349,481 / NHS NEW Devon CCG
Western Locality
RoyalCornwall HospitalsNHS Trust / JointMDTwith
Plymouth / 534,503 / NHS Kernow CCG
Northern Devon Healthcare NHSTrust / Joint MDT with Exeter, South Devon and Taunton / RoyalDevon
Exeter NHS
Foundation
Trust / 164,997 / NHS NEW Devon CCG
Northern Locality
Eastern Locality
South Devon
Healthcare NHS FoundationTrust / Joint MDT with Exeter, North Devon and Taunton / South Devon
Healthcare NHS
Foundation Trust / 286,000 / NHS South Devon & Torbay CCG
Royal Devon & Exeter NHS FoundationTrust / Joint MDT with North Devon, South Devon and Taunton / RoyalDevon
Exeter NHS
Foundation
Trust / 383,040 / NHS NEW Devon CCG
Eastern Locality
Taunton andSomerset
NHS FoundationTrust / Joint MDT with Exeter, South Devon and North Devon / RoyalDevon
Exeter NHS
Foundation
Trust / 544,000 / NHS Somerset CCG
Total / 2,262,021

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 andcarers.

Gynaecology SSG Chairperson
To Be Confirmed
NSSG Trial Recruitment Clinical Leads
Jenny Forrest
Khadra Galaal / Subspecialty Lead
Consultant Gynae-oncologist / RDEHT
RCHT
Patient Champion & Information Leads
Zoe McCullogh
Fran Jones
Emma Kent / Cancer Nurse Specialist
Cancer Nurse Specialist
Cancer Nurse Specialist / RCHT
PHT
RCHT
Patient and Carer Representatives
Vacant
Northern Devon Healthcare NHS Trust
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
AdewunmiOriolowo
Dennis Yiannakis
SidharthDubey
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
Tito Lopes
Nigel Bailey
Alistair Thomson
Nagindra Das
Khadra Galaal
Emma Kent
Zoe McCullough
Hayley Carey
Simon Thorogood
Amanda Liddacott
JohnMcGrane
JulianeStolte
Rachel Newman
SamyBishieri / Consultant Gynaecologist
Consultant Medical Oncologist
Consultant Clinical Oncologist
Consultant Gynae 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
John Renninson
Kate Scatchard
Peter Bliss
Jenny Forrest
Jacky Stewart
Katharine Edey
TruptiMandalia
Nicole Dorey
Ann Hong
Carole Brewer
Jacky Coote
Tom Clark
Nichola Cope
Laura Gellett
Lisa Joels
Jane Ferguson / Consultant Gynae-oncologistConsultant Gynaecologist
Consultant Medical Oncologist
Consultant Clinical Oncologist
Clinical Oncologist
Clinical Nurse Specialist
Consultant Gynae-oncologist
Consultant Histopathologist
Consultant Clinical Oncologist
Consultant
Consultant Clinical Geneticist
Consultant Radiologist
Clinical Director of Diagnostics
Consultant HistoCytopathologist
Consultant Radiologist
Consultant
Consultant Radiologist / MDT Lead
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 / 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
Taunton & Somerset NHS Trust
David Milliken
Clare Barlow
Jo Morrison
John Hunter
Paul Burn
KirstyCoomber
Petra Jankowska
SurabhiAgrawal
Sue Slater
Sue Golby
Emma Cattell / 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
Yeovil District Hospital
Lydia Karamura
Sally Keates-Porter
Cenydd Thomas
HanyOmran / Consultant Gynaecologist
Clinical Nurse Specialist
Consultant Radiologist
Ass Specialist ObsGynae / MDT Lead
Patient Representatives
Peninsula Cancer Network
Liz Boylan / Peninsula Cancer Network Manager
Melanie Chandler / Network Admin Support
CCG Managers for Cancer
Lynne Kilner / NHS NEW Devon CCG Western Locality
Yash Patel / NHS NEW Devon CCG Eastern Locality
Sara Wright / NHS NEW Devon CCG Northern Locality
Emma Herd / NHS South Devon & Torbay CCG
Andy Gordon / NHS Kernow CCG
Amelia Randle / Somerset CCG

3.5 Network Agreed Authorised Surgeons for Diagnostic Service14-1C-102e

Belowisa listofnamedsurgeons in thehospitalsthat provide stand-alone diagnosticservices andwho areauthorisedto operateon lowriskendometrialcarcinoma within the Peninsula Cancer Network.

LocalHospital / Named Surgeon / MDTattendedas core
member
Northern Devon HealthcareNHS
Trust / Stephen Bennett / NorthDevon
GynaecologyMDT
South Devon Healthcare NHS
FoundationTrust / Morven Leggott
RajRanjit / SDHTGynaecologyMDT
SDHTGynaecologyMDT

3.6 Network Group Meetings

Meetingswill be held at leasttwice perannum.Liz Boylan, Peninsula Cancer Network Manager and theNSSG Admin SupportOffice will provide managerial and administrative support at Group meetings.

3.7 Reporting Arrangements

NotesoftheGroupwill be circulatedtoallGroupmembers,Cancer Service Managersand other interestedparties.Theywill also be published onthe Networkwebsite:

The Group will provide a Peninsula CancerNetworkannualreport 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).

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 (see appendix B for full details of the Peninsula Cancer Network Information Policy).

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 use the map of medicine 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 2.1.

Ovary

Endometrial

Cervical

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:

Pathology guidelines

The Group has adopted the guidelines of the Peninsula Cancer Network Pathology Group.

Click here for Pathology guidelines.

Click here for Pathology Network External Referral policy.

Click here for Pathology Reporting Guidelines.

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 indicuated 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.

Click here for Operation Procedures for TYA MDT

Click here for Peninsula Cancer Network MDT contact details 2012.

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.