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

PeninsulaCancerNetwork

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

NetworkSiteSpecificGroupforSkinCancer

Constitution

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 / June 2015 / 2nd draft / PCN Skin Cancer SSG
0.1v3 / October 2015 / 3rd draft / PCN Skin Cancer SSG

Constitution of the PeninsulaCancerNetwork Skin Cancer Group

Agreementcoversheet

Thisconstitution was prepared by:

Karen Davies – Chair of the Peninsula Cancer Network Skin Cancer SSG, Consultant Dermatologist, Northern Devon Healthcare NHS Trust

Liz Boylan – Peninsula Cancer Network SSG Manager

This constitution has been agreed by:

Name / Position / Organisation / Dateagreed
Karen Davies / Chair / Northern Devon HealthcareNHS Trust
Name / Position / Organisation / Dateagreed
Karen Davies / Consultant Dermatologist / Northern Devon Healthcare NHS Trust
Duncan Mackenzie / Consultant Plastic Surgeon / Plymouth HospitalsNHSTrust
Preshita Divekar / Consultant Dermatologist / RoyalCornwall HospitalsNHS Trust
Chris Bower / Consultant Dermatologist / RoyalDevon & ExeterNHS Foundation Trust
ClementNg / Consultant Dermatologist / South Devon Healthcare NHS Foundation Trust
Rachel Wachsmuth / Consultant Dermatologist / Yeovil District Hospital NHS Foundation Trust
Jill Adams / Consultant Dermatologist / Taunton & Somerset NHS Foundation Trust

1

Peninsula Cancer Network Skin Cancer SSG Constitution 2015

Table of Contents

Type chapter title (level 1)1

Type chapter title (level 2)2

Type chapter title (level 3)3

Type chapter title (level 1)4

Type chapter title (level 2)5

Type chapter title (level 3)6

1. Statement of Purpose

ThePeninsula CancerNetworkexiststosecure equal accesstohighqualitycareforall cancer patients;striveforbetterclinicaloutcomesand improve the experience ofpatients,theircarers andfamilies throughoutscreening,diagnosis,treatment,aftercareand survival.

The Networkhasan increasing role inthe prevention ofcancerandreducing health inequalities. Toachieve thesegoals itcollaborateswith all healthcare providers,commissioners, patients and theircarersthroughoutDevon,Cornwalland theIslesofScilly.

ThePeninsula CancerNetworkserves apopulation ofover1.7million people and is comprised ofthefollowingorganisations:

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 NHS Foundation Trust

Hospices

Hospiscare, Exeter

MountEdgcumbe Hospice,Cornwall North Devon Hospice

RowcroftHospice,Torquay

StJulia’sHospice,Cornwall

StLuke’sHospice,Plymouth

St Margaret’s Hospice, Taunton & Yeovil

Thefollowingdocumentoutlinestheconstitution,roles andresponsibilities ofthe Group.

2. TermsofReferencefortheGroup

Inresponsetothepublication oftheManual forCancerServices (2004)anumberofclinical sub-Groupswereestablished toaddressservicesforspecifictypesofcancer.

NetworkSiteSpecific Groups have collective responsibility,delegated bythe NetworkExecutive Board,forthe coordination and consistencyacrossthe Networkforcancerpolicy,practice guidelines,audit,andresearch andservice improvementforeachtype ofcancer.

Networksite specificGroupsaremultidisciplinary with representationfromprofessionalsacross the patientcarepathway aswell as involvementand representationfrompatientandcarers.

2.1 RoleoftheGroup

NetworkSite SpecificGroupshave been establishedto:

• Actasthe NetworkExecutive Board’s reference group for advice on all issues relating to skin cancer;
• Ensure coordination and consistency for cancer policy, governance, guidelines,, audit, research and service improvement relating to skin cancer;
• Monitorprogressonmeeting National Cancer Standardsandensureaction plansagreed followingPeerReviewareimplemented;
• Promote linksbetween teamsandotherrelevantNetworkGroups.

The keyobjectives ofNetworkSite SpecificGroupswillbeto:

• Establish commonreferraland clinicalguidelinesforthe Network;
• Agreeaminimumdata setfor skin cancers and a policy forconsistentdata collection across the Network;
• 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;
• Agreeacommon approach toresearch& developmentworkingwith theNetworkresearch team,participatinginnationallyrecognised studies wheneverpossible;
• Consultwith cross-cutting groups on issues involvingchemotherapy,radiotherapy, cancer imaging, histopathology, laboratory investigationand specialistpalliative care;
• Agreeing clinical, referral, imaging and pathology guidelines for skin 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 skin 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;
• Supportthedevelopmentofeducation and training programmesforteams;
• Supporteffective patientandcarerinvolvementin service planning and delivery;
• Produce anannualworkplan.

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.

2.2 MembershipoftheGroup (14-1C-104j)

Membership oftheGroup will be multi-disciplinary in naturewith representationfrom professionalsacrossthecarepathway.All coreand extendedmembersoftherelevantAcute TrustMDT(s) are invitedto participate ingroupactivities via groupmeetings,working parties and email communications asappropriate.AGP with aspecialinterestinskincancerwho practices in thecommunitywill beinvited tojointhegroup.

The ChairoftheGroupwill be electedfromwithin themembership oftheGroup.Thetermof office will beforthree years.

The Group willworktowardsdevelopingpatientand carerinvolvementintothegroup. Patient and carerrepresentativeswill be appointed when possible. In additiontothisaGroup memberwill be identified who will have specificresponsibilityfor patientissuesand informationforpatientsand carers.

A GroupTrial RecruitmentClinicalLead will be identifiedfromwithin the membershipofthe Group.Thispersonwillworkwith the ResearchNetworkteamand liaise with MDTResearch Representatives on researchissues.

A Group PatientChampion andInformation Leadwill be identifiedfromwithin themembership oftheGroup.Thisperson help integrate patientissuesand information intothe work ofthegroup.

Named Membership oftheGroup (14-1C-101j)

Skin Cancer Network Site Specific Group Chairperson
Karen Davies / ConsultantDermatologist / NorthDevon Healthcare NHS Trust
NSSG TrialRecruitmentClinicalLead
Toby Talbot / Consultant / Royal Cornwall Hospitals NHS Trust
Patient Champion &Information Lead
RuthDevlin / ClinicalNurseSpecialist / Plymouth HospitalsNHSTrust
Sarah Sandford / ClinicalNurseSpecialist / RoyalDevon & ExeterNHS FoundationTrust
PamLewins / ClinicalNurseSpecialist / South Devon Healthcare NHS FoundationTrust
Patientand CarerRepresentative(s)
Vacant
NorthernDevon HealthcareNHSTrust (NDHT)
Laura Beer / Chemotherapy Staff Nurse / MDT Lead
Andrew Watts / Consultant Plastic Surgeon
Karen Davies / ConsultantDermatologist
Plymouth Hospitals NHS Trust (PHT)
Duncan Mackenzie
Ruth Devlin
Toby Chave / Consultant
Clinical Nurse Specialist
Consultant Dermatologist / MDT Lead
RoyalDevon & Exeter NHS Foundation Trust (RDE)
Emily McGrath
Sarah Sandford
Kate Allington
Anne McCormack
David Oliver
Chris Stone
Claire Facey
Carolyn Charman
Chris Bower
Rebecca Batchelor / Specialist Registrar
Clinical Nurse Specialist
Clinical Nurse Specialist
Consultant
Consultant Plastic Surgeon
Consultant Plastic Surgeon
Clinical Nurse Specialist
Consultant Dermatologist
Consultant Dermatologist
Consultant Dermatologist / MDT Lead
Royal Cornwall Hospitals NHS Trust (RCHT)
Toby Talbot
Lisa Tripp
Samantha Hann
Sarah Carswell
Tom Lucke / ConsultantOncologist
Clinical Nurse Specialist
Consultant Dermatologist
Clinical Nurse Specialist
Consultant / MDT Lead
South Devon NHS Foundation Trust (SDHT)
Pam Lewins
Clement Ng
Rosie Davies
Stephanie Hale / Clinical Nurse Specialist
Consultant Dermatologist
Consultant
Macmillan Skin Cancer Support Nurse / MDT Lead
Taunton & Somerset NHS Foundation Trust (TST)
Jill Adams
Karen Curtis
Urmila Barthakur
Claire Barlow / Consultant Dermatologist
Clinical Nurse Specialist
Consultant Oncologist
Consultant Oncologist / MDT Lead
Yeovil District Hospital NHS Foundation Trust (YDH)
Rachel Wachsmuth
Felicity Edwards
Mihaela Savu / Consultant Dermatologist
Consultant Dermatologist
Clinical Nurse Specialist / MDT Lead
CCG Managers for Cancer
NHS NEW Devon CCG Western Locality
NHS NEW Devon CCG Eastern Locality
NHS NEW Devon CCG Northern Locality
NHS South Devon & Torbay CCG
NHS Kernow CCG
NHS Somerset CCG / Lynee Kilner
Yash Patel
Sara Wright
Emma Herd
Andy Gordon
Rachel Rowe

2.3 GroupMeetings (14-1C-105j)

Meetingswill be held at leasttwice perannum.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 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, Peninsular Cancer Network Manager and Mel Chandler, Administrative Assistant, will provide managerial and administrative support at group meetings.

The Group will submitanentrytothe Networkannualreport.

3. Networkconfigurationofservices (14-1C-101j)

Agreed network IOGimplementation summary

3.1 ImprovingOutcomes GuidanceImplementation Summary

Final implementation ofskinservices within the Peninsula in accordance to NICEguidance and PeerReviewhasbeen agreed(October2009)and completed.

Click herefor Implementation plan

3.2 LocalSkin CancerTeams (LSMDT)

Local Teams / MDT Lead Clinician / Locality population / Referring CCG
Northern Devon Healthcare NHSTrust / Karen Davies
Andrew Watts / 164,997 / NHS NEW Devon CCG
Northern Locality
Plymouth HospitalsNHS Trust / Duncan Mackenzie / 349,481 / NHS NEW Devon CCG
Western Locality
RoyalCornwallHospitalsNHSTrust / Tom Lucke / 534,503 / NHS Kernow CCG
RoyalDevon & Exeter NHS Foundation Trust / Chris Bower / 383,040 / NHS NEW Devon CCG Eastern Locality
South Devon Healthcare NHS
FoundationTrust / ClementNg / 286,000 / South Devon& Torbay CCG
Taunton & Somerset NHS Foundation Trust
Yeovil District Hospital NHS Foundation Trust / Rachel Wachsmuth / 544,000 / NHS Somerset CCG
Total / 2,262,021

3.3 NetworkConfiguration of Skin Cancer Services in the Community (14-1C-102j)

The individual GP practices referring toindividuallocal MDTsare listed in 7.2 AppendixE,along with theirlistsize.Any GP actingascommunityskincancerphysician willbe associatedwith the sameMDTatthepractice populations(s)theyserve.

3.4 Specialist SkinCancerTeams (SSMDT)

LocalTeams / MDT Lead
Clinician / Locality
Population1 / Equivalent
population of average incidence2 / ReferringCCGs
Plymouth Hospitals NHS Trust / Duncan Mackenzie ConsultantPlastic
Surgeon / 349,481 / 1,079,107 / NHS NEW Devon CCG
(Western Locality)
RoyalCornwall HospitalsNHS Trust / Tom LuckeConsultant
Dermatologist / 534,503 / 1,177,361 / NHS Kernow CCG
RoyalDevon & Exeter
NHS Foundation Trust / Chris Bower
Consultant Dermatologist / 834,037 / 2,258,215 / NHS NEW Devon (East & Northern Localities)
NHS South Devon & Torbay
Taunton & Somerset NHS Foundation Trust / Jill Adams
Consultant Dermatologist / Taunton and Somerset CCG

1IOG requires a catchment population of200,000.Duetohighratesofskincancerlocally,thelocalcatchmentpopulationsgeneratecasesequivalenttoamuchlargerpopulationwithanEnglandaverageincidence.

2IOGrequiresacatchmentpopulationof750,000.Duetohighratesofskincancerlocally,thelocalcatchmentpopulationsgeneratecasesequivalenttoamuchlargerpopulationwithanEnglandaverage incidence.

3.5 PolicyfortheProvisionofSkinCancerServices intheCommunity (14-1C-102j)

TBA

The group hasagreeda protocolforthe accreditation,training andgovernance of communitypractitionersin skin cancersurgery.This can befound in theGuidelinesforSkin CancerManagementonthe PCN website.

ClicklinkbelowtoaccessPCN skinclinicalguidelines

NSSGAgreedTrainingPolicyforModel2CommunityPractitionerswith named Trainers/Assessors(14-1C-108j)

TBA

Agreed Network Distribution of Clinics for Immunocompromised Patients with Skin Cancer (14-1C-103j)

TBA

3.6 NetworkConfigurationofMDTs (14-1C-101j)

• North Devon and South Devon localMDTsrelatestotheSpecialistMDTatthe RoyalDevonExeter Hospital.
• There will notbe aseparateMelanomaMDTin the Peninsula.

The NetworkhasagreedthatratherthanreferthefollowingpatientstoonenamedSSMDTin the Peninsula,patientswill be referreddirectlyto the relevantnon-skin cancerMDTasfollows:

Type ofcase / MDTto referto:
Cutaneous lymphoma / LocalHaematologicalMDT
Kaposi’ssarcoma
Cutaneous sarcoma abovesuperficialfascia / SarcomaMDTExeteror Plymouth (pending designationofa single centre in thePeninsula)
Otherrareskin cancers / Asperthe NetworkSkin CancerGuidelines

Network referralguidelinesto named Supra NetworkT-CellLymphomaMDT

3.7 Designated Hospital Practitioners for Mohs Surgery (14-1C-106j)

TBA

4. Service Mapping

Radiotherapy isdelivered locallyexceptatNorth Devon.PatientsfromNorth Devon requiring radiotherapyarecared foratthe Royal Devon & Exeter Hospital.

5. NetworkGuidelines

5.1 PrimaryCare ReferralGuidelines

ReferralguidanceforPrimaryCareisincluded inthe PCN Skin CancerClinicalGuidelines

Agreed networkprimarycarereferral guidelines andtheirdistribution

5.2 ReferralGuidelinesforPatientsmoving between Teams

Referring cliniciansshould ensurethatallrelevantinformation isprovided tofacilitatethe continuityofcareand avoid unnecessarydelays.

ThePeninsula Tertiary ReferralForm(TRF01)should be usedwhen referringpatientsto another AcuteTrustforspecialistinvestigation ortreatmentandsentwithinone working dayof thereferralbeing made.

Click hereforTRF01

Specificreferralguidelinesbetween teamsisincluded in thePCN Skin CancerClinical Guidelines.

6. ClinicalGuidelines (14-1C-109j)

The Group hasdrawn up and agreedtofollowNetworkspecificclinicalguidelineswhich include imagingguidelines.These were ratifiedon 30thApril 2012

Network guidelineswill be reviewed atleasteverythree yearsoronthe publication ofnew guidance.

Itistheresponsibilityofthe ChairoftheGrouptoensurethatall Networkguidelinesareupto date andreflectcurrentpractice.

Clicklinkbelowforaccess tothePCN Skin CancerGuidelines

6.1 PathologyGuidelines

The Group hasadopted thePathology NetworkReporting Guidelinesforskincancerandthe Pathology NetworkExternal ReferralPolicy.

Click onlinkbelowforNetworkSkinpathologyguidelines and externalreferralpolicy

6.2 Chemotherapy TreatmentAlgorithms (14-1C-110j)

TBA

7. DataCollection

7.1 Network-wideMinimumData Set

AllTrustshavepreviouslyconfirmedtheircompliancewithdatacollectionrequirementsfor cancerwaitingtimesandtheCancerRegistrytogethertheseconstitutetheMDSfortheSkin Group.

7.2 NetworkPolicyforCollectionofMDS

Responsibilityfordata

TheAcuteTrustfirstseeingapatientforaparticularmonthorquarterisresponsiblefor ensuring thatthemandated datafields are completeonthedatabase by the nationaldeadline.

TheAcuteTrustfirsttreatingorgivingsubsequenttreatmentto apatientin aparticularmonth or quarterisresponsibleforensuringthatthemandateddatafieldsregardingthatpatientare completeonthe database bythe nationaldeadline.

Themultidisciplinaryteamresponsibleforthecareofthepatientshouldensurethatinformation ismadeavailable to allowitto berecorded prospectivelyand electronically.

CancerServicesteamsineachAcuteTrustshouldensurethattheinformationistransferred withinthetimescalesspecifiedandshouldestablishrobustlinesofcommunicationwiththeir colleaguesin other AcuteTrusts.

Coordination of Care/Patient Pathways

8.1 Patient Pathways for Primary Care/Community Services and MDTs (14-1C-111j)

TBA

8.3 Patient Pathways Between MDTs (14-1C-112j)

TBA

8.4 Patient Pathways for Supranetwork MDTs/Services (14-1C-113j)

TBA

8.5 Patient Pathways Shared with Other MDTs (14-1C-114j)

TBA

8.6 Clinical Governance Arrangements for Community Practitioners (14-1C-117j)

TBA

8.7 Discussion of Clinical Trials (14-1C-118j)

TBA

1

Peninsula Cancer Network Skin Cancer SSG Constitution 2015