North, East & West Devon, South Devon & Torbay, Cornwall, Somerset

Peninsula Cancer Network

(North, East & West Devon, South Devon & Torbay, Cornwall, Somerset )

Urological Cancer Network Site Specific Group

Constitution

Approved: January 2016

Review: June 2018

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 v2 / May 2015 / 2nd draft / PCN UrologyNSSG
0.1 v3 / November 2015 / 3rd draft / PCN Urology NSSG
1.0 / January 2016 / Final Approved by Chair / PCN Urology NSSG

ConstitutionofthePeninsulaCancerNetwork

Urological Cancer Site SpecificGroup

Agreementcoversheet

This constitution was prepared by:

Rob Mason (Acting) Chair of the Peninsula Cancer Network Urology SSG, Consultant Urologist, South Devon Healthcare NHS Trust

Liz Boylan – Peninsula Cancer Network SSG Manager

This constitution has been agreed by:

Name / Position / Organisation / Date agreed
Rob Mason / Consultant Urologist/Chair / South Devon Healthcare NHS Foundation Trust (SDHT)
Martin Moody / Consultant Urologist / Northern Devon Healthcare NHS Trust (NDHT)
Elizabeth Waine / Consultant Urologist / Royal Devon & Exeter NHS Foundation Trust (RDE)
Paul Hunter-Campbell / Consultant Urologist / South Devon Healthcare NHS Trust (SDHT)
Mark Mantle / Consultant Urologist / Royal Cornwall Hospitals NHS Trust (RCHT)
Nick Burns-Cox / Consultant Urologist / Taunton & Somerset NHS Foundation Trust (TST)
Yeovil District Hospital NHS Trust (YDHT)

1

Peninsula Cancer Network Uro-oncology Constitution 2015

Contents

1. / Statement of Purpose / 4
2. / Terms of Reference for the Group / 14-1C-101g / 4
3. / Structure and Function /

14-1C-101g

/ 5
3.1 / Role and Function of the Group / 5
3.2 / Network Configuration / 14-1C-101g / 6
3.3 / Network Group Members /

14-1C-101g,14-1C-102g

/ 6
3.4 /

LocalUrologicalCancer Teams

/ 14-1C-101g, 14-1C-102g / 8
3.5 /

Specialist Urological Cancer Teams

/ 14-1C-101g, 14-1C-102g / 9
3.6 /

Network Group Membership

/ 14-1C-102g, 14-1C-103g / 9
3.7 / GroupMeetings / 14-1C-103g / 9
3.8 / Work Programme and Annual Report / 14-1C-104g / 10
4. /

Coordination of Care/Patient Pathway

/ 10
4.1 /

PrimaryCare ReferralGuidelines

/ 10
4.2 /

Referral Guidelines for Patients moving between Teams

/ 10
4.3 /

Clinical Guidelines

/ 11
4.3.1 /

Clinical Guidelines for Kidney Cancer

/ 14-1C-105g / 11
4.3.2 /

Clinical Guidelines for Bladder Cancer

/ 14-1C-106g / 11
4.3.3 /

Clinical Guidelines for Prostate Cancer

/ 14-1C-107g / 11
4.3.4 /

Clinical Guidelines for Testicular Cancer

/ 14-1C-108g / 11
4.3.5 /

Clinical Guidelines for Penile Cancer

/ 14-1C-109g / 11
4.3.6 /

Chemotherapy Treatment Algorithms

/ 14-1C-110g / 11
4.4 /

Patient Pathways for Kidney Cancer

/ 14-1C-111g / 12
4.4.1 /

Patient Pathways for Bladder Cancer

/ 14-1C-112g / 12
4.4.2 /

Patient Pathways for Prostate Cancer

/ 14-1C-113g / 12
4.4.3 /

Patient Pathways for Testicular Cancer

/ 14-1C-114g / 12
4.4.4 /

Patient Pathways for Penile Cancer

/ 14-1C1-115g / 12
5. /

Patient Experience

/ 14-1C-116g / 12
6. /

Clinical Outcomes/Indicators

/ 12
6.1 /

Clinical Outcomes Indicators and Audits

/ 14-1C-117g / 12
6.2 /

Discussion of Clinical Trials

/ 14-1C-118g / 12
7. /

Data Collection

/ 12
7.1 /

Network-wide Minimum Data Set

/ 12
7.2 /

Network Policy on collection of MDS

/ 12
8. /

Distribution of Guidelines & Protocols

/ 13
App 1 /

Terms of Reference

/ 14

Peninsula Cancer Network Urology Constitution 2015

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,Cornwalland theIslesofScilly.

ThePeninsula CancerNetworkserves apopulation of1.7million people andiscomprisedofthe followingorganisations:

Clinical Commissioning Groups (CCGs)

Northern, Eastern & Western Devon CCG

South Devon & Torbay CCG

NHS Kernow CCG

NHS 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 NHS Foundation Trust

Hospices

Hospiscare, Exeter

MountEdgcumbe Hospice,Cornwall

North Devon Hospice

RowcroftHospice,Torquay

StJulia’sHospice,Cornwall

StLuke’sHospice,Plymouth

St Margaret’s Hospice, TauntonYeovil

Thefollowingdocumentoutlinestheconstitution,roles andresponsibilities oftheGroup.

2. Terms of Reference fortheGroup14-1C-101g

Inresponsetothepublication oftheManual forCancerServices (2004)anumberofclinicalsub- Groupswereestablishedtoaddressservicesforspecifictypesofcancer.

NetworkSiteSpecific Groupshave collective responsibility,delegated bythe Network Executive Board,forcoordination and consistencyacrossthe Networkforcancerpolicy,practiceguidelines, audit,researchandservice improvementforeach type ofcancer.

Networksite specific Groupsaremultidisciplinary with representationfromprofessionalsacrossthe patientcare pathwayas well as involvementandrepresentationfrompatientandcarers. (see Appendix 1)

3. Structure and Function

3.1 Role and Function of theGroup

NetworkSite SpecificGroupshave been establishedto:

• Actasthe NetworkExecutive Board’sprimarysourceoftumoursitespecificclinicalopinionforthe network;
• Advise and consultonservice planningtoensureservices are in line with nationalguidance in ordertopromotehighqualitycareandreduce inequalities inservice delivery;
• Ensure Networkdecisionsbecome integrated into local practice;
• Monitorprogressonmeeting National Cancer Standardsandensureaction plansagreedfollowing PeerReviewareimplemented;
• Promote linksbetween teamsandotherrelevantNetworkGroups.

The key objectives of the Urology Network Site Specific Group will be to:

• Establish common referral and clinical guidelines for the Network;
• Agree a minimum data set for urological cancers and a policy for consistent data collection across the Network;
• 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 ;
• Agree a common approach to research & development working with the Network Research Team, participating in nationally recognised studies whenever possible;
• Consult with relevant cross-cutting groups on issues involving chemotherapy, radiotherapy, cancer imaging, histopathology, laboratory investigation and specialist palliative care;
• Agreeing clinical, referral, imaging and pathology guidelines for urological cancer. To subsequently review, agree and update these guidelines on a regular basis and to audit the implementation of these guidelines.
• Identifying, compiling and agreeing a list of clinical trials for urological cancers and facilitate the means by which patients managed by the MDTs may be entered into trials. MDT responses to the list should be discussed at NSSG meetings.
• Support the development of education and training programmes for teams;
• Support effective patient and carer involvement in service planning and delivery;
• Produce an annual work plan.

3.2 Network Configuration 14-1C-101g

Membership oftheGroupwill be multi-disciplinary in naturewith representationfromprofessionals acrossthecarepathway.All coreandextended membersoftherelevantAcuteTrustMDT(s)are invited toparticipate inGroupactivities viagroupmeetings,working parties and email communicationsasappropriate.

The ChairoftheGroupwill be electedfromwithin themembership oftheGroup.Thetermofofficewill befortwoyears.

Thememberswillworktowardsdevelopingpatientand carerinvolvementin thegroup. Patientand carerrepresentatives willbe appointedwhenever possible. A patient champion and information leadwill be identified from within the group who will have specificresponsibilityforpatient issuesand informationforpatientsandcarers.

A clinical trial recruitment lead will be identified from within the membership of the group who will work with the research network team and liaise with MDT representatives on research issues.

3.3 Network Group Members 14-1C-101g, 14-1C-102g

Urology Network Site Specific Group Chairperson
Rob Mason / Consultant Urologist / South Devon Healthcare NHS Trust
NSSG Trial Recruitment Clinical Lead
MohiniVarughese / Consultant Clinical Oncologist / Taunton & Somerset NHS Foundation Trust
PatientChampionInformationLead
vacant
PatientandCarerRepresentatives
David Rundle
Richard Scheffer
NorthernDevonHealthcareNHSTrust (NDHT)
Martin Moody / ConsultantUrologist / MDT Lead
McBride Tracey / Clinical Nurse Specialist
CatherineDring / Clinical Nurse Specialist
PlymouthHospitalsNHSTrust (PHT)
Paul Hunter-Campbell / Lead Cancer Clinician / MDT Lead
Andrew Dickinson / ConsultantUrologist
VanessaWilcox / Uro-oncologyNurseSpecialist
MartinHighley / ConsultantMedicalOncologist
Jane Ripley / Clinical Nurse Specialist
Frances McCormick / ConsultantHistopathologist
PaulMcInerney / ConsultantUrologist
FrancisDaniel / ConsultantClinicalOncologist
RichardPearcy / ConsultantUrologist
Sarah Pascoe / ConsultantClinicalOncologist
SalvatoreNatale / AssociateSpecialistInUrology
Anna Wilson / Clinical Nurse Specialist
EstherMcLarty / ConsultantUrologicalSurgeon
Henry Sells / Consultant Urologist
RoyalCornwallNHSHospitalsTrust (RCHT)
Mark Mantle / Lead Cancer Clinician / MDT Lead
WendyMeyers / Clinical Nurse Specialist
RobertCox / ConsultantUrological Surgeon
Richard Ellis / ConsultantOncologist
DeborahVictor / Clinical Nurse Specialist
AlastairThomson / ConsultantClinicalOncologist
John McGrane / Consultant Oncologist
RoyalDevonExeterNHSFoundationTrust (RDE)
Elizabeth Waine / Consultant Urologist / MDT Lead
Malcolm Crundwell / Consultant Urologist
Karen Green / Clinical Nurse Specialist
Richard Guinness / Consultant Radiologist
DeniseSheehan / ConsultantClinicalOncologist
Claire Turner / Clinical Nurse Specialist
JaneBilling / Clinical Nurse Specialist
JohnMcGrath / ConsultantUrologist
MarkStott / ConsultantUrologist
Carole Brewer / ConsultantClinicalGeneticist
SouthDevonNHSFoundationTrust (SDHT)
Rob Mason / Lead Cancer Clinician / MDT Lead
Seamus MacDermott / ConsultantUrologist
Gillian Dell / Clinical Nurse Specialist
DorettaBoone / UrologyNursePractitioner
AnnaLydon / ConsultantOncologist
Anne Carroll / Clinical Nurse Specialist
LindaWelsh / ProstateSpecialistResearch Radiographer
Taunton & Somerset NHS Foundation Trust (TST)
Nick Burns-Cox / Consultant Urologist / MDT Lead
Julia Pollard / Clinical Nurse Specialist
RuMacdonagh / Consultant Urologist
MohiniVarughese / Consultant Clinical Oncologist
Emma Gray / Consultant Clinical Oncologist
John Graham / Consultant Medical Oncologist
Yeovil District Hospitals NHS Foundation Trust (YDHT)
Tim Porter / Consultant Urologist
Chris Parker / Consultant Clinical Oncologist
Susan Adams / Consultant Pathologist
Karen Moffett / Urological Clinical Nurse Specialist
CCG Managers for Cancer
NHS NEW Devon CCG Western Locality / Lynne Kilner
NHS NEW Devon CCG Eastern Locality / Yash Patel
NHS NEW Devon CCG Northern Locality / Sara Wright
NHS South Devon & Torbay CCG / Emma Herd
NHS Kernow CCG / Andy Gordon
NHS Somerset CCG / Rachel Rowe

N.B. All Core Members of MDTs to be invited to attend NSSG Meetings.

3.4 LocalUrologicalCancer Teams 14-1C-101g, 14-1C-102g

LocalTeams / MDTLeadClinician / Locality
population / ReferringCCGs
Northern Devon Healthcare NHSTrust (NDHT) / MartinMoody / 164,997 / NHS NEW Devon CCG Northern locality
Plymouth Hospitals NHS Trust (PHT) / Paul Hunter-Campbell / 349,481 / NHS NEW Devon CCG Western locality
RoyalCornwall HospitalsNHS Trust (RCHT) / Mark Mantle / 534,503 / NHS Kernow CCG
RoyalDevon & Exeter NHS FoundationTrust (RDE) / Malcolm Crundwell / 383,040 / NHS NEW Devon CCG
Eastern locality
South Devon Healthcare NHS
FoundationTrust (SDHT) / Rob Mason / 286,000 / NHS South DevonTorbay CCG
Taunton & Somerset NHS Foundation Trust (TST) / Nick Burns-Cox / 544,000 / NHS Somerset CCG
Yeovil District Hospital NHS Foundation Trust (YDHT) / NHS Somerset CCG
Total / 2,262,021

3.5 Specialist Urological Cancer Teams 14-1C-101g, 14-1C-102g

LocalTeams / MDTLead
Clinician / Catchment
population / ReferringLocal
MDTs / Referring CCGs
Plymouth Hospitals
NHS Trust (PHT) / Paul Hunter-Campbell / 883,984 / PHT
RCHT / NEW Devon CCG
Western Locality
NHS Kernow CCG
RoyalDevon & Exeter NHS FoundationTrust (RDE) / Malcolm Crundwell / 1,378,037 / RDE
NDHT
SDHT
TST
YDH / NEW Devon CCG
Eastern Locality
Somerset CCG
Total / 2,262,021

3.6 Network Group Membership14-1C-102g, 14-1C-103g

The Chair(Rob Mason) has been elected from within the membership of the group. The term of officewill be two years.

The group will work towards developing patient and carer involvement and will appoint patient and carer representatives whenever possible. In addition to this, a member of the group will be identified who will have specific responsibility for patient issues and information for patients and carers. MohiniVarughesehas been appointed cancer research sub specialty lead and assumes responsibility for recruitment to trials.

3.7 GroupMeetings 14-1C-103g

Meetingswill be heldtwice perannum as a minimum. The group agrees to operate under the Terms of Reference (Appendix 1). All members will be informed of meeting dates and location and be included in distribution of the Agenda and Minutes. Minutes, actions and notes of the group meetings will be circulated to all members, trust management teams and other interested parties. They will also be published on the SWSCN website

Records of attendance will be maintained and shared with the Cancer Unit Managers in order to inform them of their trust’s representation at network level. Liz Boylan, Peninsula Cancer Network Manager and Mel Chandler, Administrative Assistant, will provide managerial and administrative support at group meetings.

3.8 WorkProgramme and Annual Report 14-1C-104g

The group will produce an Annual Work Programme for Urology and submitanentrytothe NetworkAnnualReport.

4. Coordination of Care/Patient Pathways

4.1 PrimaryCare ReferralGuidelines

PrimaryCarepractitionerswill referall patientsdefinedbythe“urgent,suspiciousofcancer” guidelinesforurologicalcancertothecontactpointofasingle localurological team.

4.2 ReferralGuidelines for Patients moving between Teams

All newurological cancerpatientsshould bediscussedfirstin the locality MDT mostappropriatefor thatindividual patient.ThisisheretermedthefirstMDT,andthisMDTwill usuallyassume lead responsibilityforthe patient.

In certaincircumstances itmaybeappropriateforan onwardreferraltobemadefromthefirstMDT to a second MDTwithin oroutside the Network.These arecategorised belowaccording tothe indication forthereferral.

Whatfollowsisnotintended tobe acompletelist ofpossible indicationsforreferral,and itisassumed thatin all circumstancesthe localityMDTwill actin thebestinterestsofeach patientforwhich ithas lead responsibility,making onwardreferralsas necessitatedbytheclinicalcircumstances.

Referraltoanotherspecialistforfurthertestsortreatment

Manystaffparticipate inmorethanoneurological cancerMDT.Itisnotnecessaryforcasesto be discussed at the secondMDTifa patientissimplyattendingthe centreforspecialistinvestigationsor treatmentnotavailable to the locality MDT(forinstanceradiotherapyorsurgery).However, these casesmaybe discussedatthesecondMDTifthe personreceiving thereferralfromthefirstMDT feelsthatitwould be helpful.

Good communication with thefirstMDTwill be particularly importantin thisoptionalsituation.Inthis situationthefirstMDTwill considerthesecond MDT’srecommendationscarefully,while maintaining lead MDTresponsibility.

Patientswith synchronous cancers aturologicalandothersite

Such patientswill be discussed intheUrologicalMDT.Leadresponsibilitywill be sharedwith the other site-specificMDT,until itbecomesclearwhich MDTwould be bestto lead in each individualcase.

Second opinionrequested byfirstMDTorpatient

All such casesmustbediscussed at thesecondMDT.Boththereferringand second MDT recommendationswill beconsideredwith each patientto develop the treatmentplan.Theoutcomeof those discussionswill determine themostappropriateMDT to leadthepatient’sfurthercare.

Referring cliniciansshould ensurethatallrelevantinformation isprovided tofacilitatethecontinuityof careandavoid unnecessarydelays.

ThePeninsula Tertiary ReferralForm(TRF01)should be usedwhen referringpatientstoanother AcuteTrustforspecialistinvestigation ortreatmentandsentwithin one working dayofthereferral being made.

4.3 ClinicalGuidelines

The Group has agreed to adopt the current NICE guidelines for:

• BladderCancer 14-1C-106g
• Prostate Cancer14-1C-107g
• KidneyCancer14-1C-105g
• TesticularCancer14-1C-108g
• Penile Cancer(in which the Group signsuptotheguidelinesproduced bythe Avon,SomersetWiltshire Network). 14-1C-109g

Network guidelineswill be reviewed atleasteverythree yearsoronthe publication ofnewguidance.

Itistheresponsibilityofthe ChairoftheGrouptoensurethatall Networkguidelinesareupto date and reflectcurrentpractice.

Penile Cancer14-1C-109g, 14-1C-101g

Thenamednominated localleads and MDTswho can undertake biopsy,localfollowup and someof the cancermanagementcareofpatientswith penile canceras agreed bythe NSSGandtheChairof the Supra NetworkGroupare:

Name / Role / MDT
Richard Pearcy / ConsultantUrologist / Plymouth NHS HospitalsTrust
John Palmer / ConsultantPlasticSurgeon / RD&E

Chemotherapy Treatment Algorithms14-1C-110g

TBA

Patient Pathways for Kidney Cancer 14-1C-111g

TBA

Patient Pathways for Bladder Cancer 14-1C-112g

TBA

Patient Pathways for Prostate Cancer 14-1C-113g

TBA

Patient Pathways for Testicular Cancer 14-1C-114g

TBA

Patient Pathways for Penile Cancer 14-1C-115g

TBA

Patient Experience 14-1C-116g

TBA

Clinical Outcomes/Indicators

Clinical Outcomes Indicators and Audits 14-1C-117g

TBA

Discussion of Clinical Trials 14-1C-118g

TBA

Data collection

Network-wide Minimum Data Set

All Trustshave previouslyconfirmedtheircompliance with data collection requirementsforcancer waiting timesandtheCancerRegistry.The group has also adoptedthe datasetoftheBritish AssociationofUrological Surgeons. Togethertheseconstitute theMDS fortheUrological Group

Goto linkbelowforMDS:

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NetworkPolicyfor Collection of MDS

TheAcuteTrustfirstseeing a patientforaparticularmonthorquarterisresponsibleforensuring that themandateddatafieldsarecomplete onthedatabase bythenationaldeadline.

TheAcuteTrustfirsttreating orgivingsubsequenttreatmenttoa patientina particularmonthor quarterisresponsibleforensuring thatthemandated datafieldsregardingthatpatientarecomplete on thedatabasebythenational deadline.

Themultidisciplinaryteamresponsibleforthecare ofthepatientshould ensurethatinformation is made available to allowitto berecorded prospectivelyand electronically.

CancerServicesteamsin each AcuteTrustshould ensurethatthe information istransferred within the timescalesspecified andshould establish robustlinesofcommunication with theircolleaguesinother AcuteTrusts.

8. 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

1

Urology NSSG Constitution draft v0.3 – November 2015