WEST MIDLANDS STRATEGIC CLINICAL NETWORK – CANCER

MINUTES OFWEST MIDLANDS COLORECTAL EXPERT ADVISORY GROUP”

Held on Tuesday 15 July 2014 at Birmingham Research Park

Present:

Mr Neil Borley / NB / Gloucestershire Hospital NHS Trust
Mrs Mandy Wilson / MWi / West Midlands Strategic Cancer Network
Mr Rob Gornall / RG / West Midlands Strategic Cancer Network
Mr Marimuthu Kalimuthu / MK / George Elliot Hospital NHS Trust
Mr Anthony Kawesha / AK / Dudley Group NHS Foundation Trust

1. Apologies:

Mr Dayo Adeyemo / DA / Wye Valley NHS Trust
Mr Rob Church / RC / Walsall Healthcare NHS Trust
Mr James Eccersley / JE / Burton Hospital NHS Foundation Trust
Ms Caroline Ferris / CF / Hereford Hospital NHS Trust
Mr Chris Keh / CK / University Hospital Birmingham NHS Foundation Trust
Ms Tracy Lunt / TL / Shrewsbury and Telford Hospital NHS Trust
Mr David McArthur / DMc / Heart of England NHS Foundation Trust
Ms Elaine Swan / ES / Walsall Healthcare NHS Trust
Mr Graham Williams / GW / Royal Wolverhampton Hospital NHS Trust
Ms Maddie White / MWh / University Hospital Birmingham NHS Foundation Trust
Ms Jane Worlding / JW / University Hospital Coventry and Warwickshire NHS Trust
ACTION
2. / Minutes of the Meeting Held on 05 March 2014
These were agreed as a true record.
3. / Matters Arising
3.1 2 Week Wait Pathways
It was felt, following discussions that the preferred option, if available, would be for a Consultant led clinic with patients going straight to test.
It was agreed that information from Commissioners on what is sustainable is required especially as there is no requirement for specific targets to be met such as Peer Review. The only target against this item is the waiting times targets.
ACTION
It was generally perceived without this information there is no specific need for the current services to change. RG outlined that if the Group wished to continue with the review of the 2 week wait pathways then a Quality Improvement Lead from the Network would be identified to help the Group undertake this piece of work.
NB agreed to ask members if they considered a review of this item to be beneficial and who would be willing to work with the Quality Improvement Lead.
3.2 Liver Metastases
MK reported that for George Elliot Hospital NHS Trust they have links with University Hospital Coventry and Warwickshire NHS Trust and for Dudley Group NHS Foundation Trust AK reported that patients are discussed by the Multi Disciplinary Team and then referred to the “live” Multi Disciplinary Team that is with the exception of patients who are palliative.
He continued by reporting that those patients who have undergone resections the liver Surgeon will attend the Multi Disciplinary Team every 3 months to give feedback.
It was agreed by those present that there is a need to ensure equity of access across the Network and RG agreed to speak to Specialised Commissioners about this issue.
RG continued by informing members that the current Hepatobiliary service within the Network is being reviewed.
3.3 TEMS Review
MW reported that information had been received from the majority of Trusts and she agreed to chase those that had not yet responded.
Members were reminded that the aim of gathering this information, together with information relating to early rectal, anal and advanced rectal cancer, was to enable MW to produce a directory of services within the West Midlands and if possible also for a map to be produced showing the location of these services.
3.4 NBOCAP
RG shared with those present a copy of the latest report for the period of 2012\2013 which showed that the majority of Trusts within the Network had not achieved the appropriate target level. / NB\
Group
MW\
Group
RG
ACTION
It was agreed that there is a need to review this report in depth to find out why targets had not been met and that this would be undertaken at the next meeting.
3.5 Peer Review 2012\2013
Members were informed that the outlining Trust registering serious concerns was Worcestershire Acute Hospital NHS Trust and it was agreed that investigations would be undertaken to ascertain why this may be.
RG, as Clinical Director the Cancer Network, felt that any Trust who scored red in the Peer Review reports should be presented with the opportunity to discuss the matter at a future Expert Advisory Group meeting. / Group\
Agenda
4. / Update on Early Rectal Cancer Provision
Dudley Group NHS Foundation Trust
AK reported that the Trust does not offer a TEMS service but do have EMR which is undertaken by Professor Isaac. Those patients requiring TEMS are referred to University Hospital Birmingham NHS Foundation Trust.
George Elliot Hospital NHS Trust
MK reported that patients from this Trust are referred to either Leicester or Coventry.
Heart of England NHS Foundation Trust
Although DMc was unable to attend today’s meeting MW reported that an e-mail had been received which outlined that early rectal cancers at Heartlands Hospital are referred to Stephan Korsgen at Good Hope Hospital for TEMS and that he also offers ERUS.
Wye Valley NHS Trust
DA was also unable to attend today’s meeting but had sent MW information on service provision and on his behalf MW reported that Hereford Hospital has a TEO kit (Storz), a Radiologist trans rectal ultra sound service is scheduled to commence September 2014 and that MRI are already widely used with all cases being discussed at the Multi Disciplinary Team.
ACTION
It was felt that it would be nice to have a map showing where this service is provided within the Network. It was outlined that if TEMS was an option for consideration of treatment then discussions would be undertaken with the patient before undertaking the procedure.
5. / Update on Anal Cancer Provision
It was reported that the following occurs:-
Heart of England NHS Foundation Trust
Patients referred to University Hospital Birmingham NHS Foundation Trust.
Wye Valley NHS Trust
Patients referred to Gloucestershire Hospital NHS Trust.
Dudley Group NHS Foundation Trust
Patients referred to Royal Wolverhampton Hospital NHS Trust.
George Elliot Hospital NHS Trust
Patients referred to University Hospital Coventry and Warwickshire NHS Trust.
Shrewsbury and Telford Hospital NHS Trust
Patients referred to University Hospital North Staffordshire NHS Trust.
It was outlined that previously the agreement for this service provision had been one site per Network but it appears that a dispensation had been given to Greater Midlands Cancer Network as they had 2 sites in operation, Royal Wolverhampton Hospital NHS Trust and University Hospital North Staffordshire NHS Trust.
6. / Update on Advanced\Recurrent Rectal Cancer
It was felt, by those present, that it would be helpful to define clinical pathways for this category of patients.
George Elliot Hospital NHS Trust
It was reported that patients are sent to Leeds with the MRI being undertaken locally.
ACTION
Dudley Group NHS Foundation Trust
Patients are sent to University Hospital Birmingham NHS Foundation Trust.
Heart of England NHS Foundation Trust
At Heartlands we offer a service for managing patients with advanced and recurrent rectal cancer. We have a multi-disciplinary team for this. Over the last three years we have received tertiary referrals from Coventry, Warwick and Good Hope. We are happy to extend this provision to other centres in the Midlands.
Wye Valley NHS Trust
Patients are currently referred to Christie Hospital or Leeds.
Following a discussion it was agreed that NB would contact the Team at Leeds to find out what service they provide and once this information had been received it would be shared with the Group to enable them to identify whether it can be provided locally.
It was clarified that if patients are being seen out of Region then it is important to ascertain whether the service they are receiving is value for money. / NB
7. / Any Other Business
Survivorship
RG reported that this is a National driver with the intention to have a package which includes a discharge summary, holistic needs and patient support.
AK responded that he intended to discuss this item at his next Multi Disciplinary Team business meeting. In terms of holistic needs assessment he felt that this would be something undertaken by the Clinical Nurse Specialist.
Those present felt there was some confusion over what was meant by a discharge summary as some Trusts, through agreement with their Clinical Commissioning Groups, actually do an end of treatment summary which outlines all the patient treatment information plus additional information that might be useful to the GP such as what to expect if the patient reports with a suspected recurrence and what procedure should be followed. / AK
ACTION
It was further reported that it is unclear whether all Clinical Commissioning Groups are undertaking\providing a survivorship programme even though it is a National project.
Following a discussion it was agreed that MW would contact Multi Disciplinary Team Leads to clarify if they were aware of the risk stratified pathway, end of treatment summaries and the need to undertake a holistic needs assessment. / MW
8. / Date and Time of Next Meeting
It was agreed that the next meeting would be a virtual meeting undertaken by e-mail rather than face to face.

H:\Data\NHSCB BBC LAT\Networks and Senates\Cancer Network\Expert Advisory Groups\Colorectal\2014\Minutes - 15 July 2014 - draft.doc

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