Peninsula_Gynaecology_NSSG Constitution_2015 v0.2

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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
Constitution of the Central Peninsula Cancer Network
Site Specific Group 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:
http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-site-specific-groups/gynae-ssg/
VERSION
0.1
0.2
DATE ISSUED
June 2015
rd
3 August 2015
SUMMARY OF CHANGE
1st draft
2nd draft
OWNER
PCN Gynaecology NSSG
PCN Gynaecology NSSG
Agreement cover sheet
This constitution 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
David Milliken
(Chair)
Consultant GynaeOncologist
Taunton & Somerset NHS
Foundation Trust
Mike Hannemann
Consultant GynaeOncologist
Royal Devon & Exeter NHS
Foundation Trust
Stephen Bennett
Consultant Obstetrician &
Gynaecologist
Northern Devon Healthcare
NHS Trust
Morven Leggott
Consultant GynaeOncologist
South Devon Healthcare NHS
Foundation Trust
Lydia Karamura
Consultant Gynaecologist
Yeovil District Hospital
Consultant Gynaeoncologist
Royal Cornwall Hospitals NHS
Trust
Consultant Gynaecologist
Plymouth Hospitals NHS Trust
Mr Geoff Hughes
Date agreed
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Peninsula Cancer Network Gynae-oncology NSSG
Contents
1 STATEMENT OF PURPOSE ......................................................................................................................................................... 3
2 TERMS OF REFERENCE FOR THE GROUP ............................................................................................................................. 3
3 STRUCTURE AND FUNCTION ..................................................................................................................................................... 4
3.1
3.2
3.3
3.4
3.5
3.6
3.7
Role and Function of the Group ............................................................................................................................................ 4
Network Configuration 14-1C-101e ...................................................................................................................................... 4
Local Gynaecological Cancer Teams 14-1C-101e .................................................................................................................. 5
Network Group Members (14-1C101e, 14-1C-103e) ............................................................................................................. 6
Network Agreed Authorised Surgeons for Diagnostic Service 14-1C-102e ........................................................................... 9
Network Group Meetings ...................................................................................................................................................... 9
Reporting Arrangements ....................................................................................................................................................... 9
4 SERVICE MAPPING .................................................................................................................................................................... 9
5 NETWORK GUIDELINES ............................................................................................................................................................. 9
5.1 Primary Care Referral Guidelines ........................................................................................................................................... 9
5.2 Referral Guidelines for Patients moving between Teams ................................................................................................... 10
5.3 Network policy on named medical practitioner with clinical responsibility ........................................................................ 10
5.4 Network Agreed Onward Referral Policy ............................................................................................................................ 10
5.5 Clinical Guidelines ............................................................................................................................................................... 10
5.6 Chemotherapy Algorithms .................................................................................................................................................... 11
5.7 The Teenage and Young Adult pathway for initial management ......................................................................................... 11
6 DATA COLLECTION .................................................................................................................................................................. 12
6.1 Network-wide Minimum Data Set ........................................................................................................................................ 12
6.2 Network policy for collection of the MDS.............................................................................................................................. 12
7 DISTRIBUTION OF GUIDELINES AND PROTOCOLS ................................................................................................................... 12
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Peninsula Cancer Network Gynae-oncology NSSG
1 Statement of Purpose
The Peninsula Cancer Network exists to secure equal access to high quality care for all cancer patients;
strive for better clinical outcomes and improve the experience of patients, their carers and families
throughout screening, diagnosis, treatment, aftercare and survival.
The Network has an increasing role in the prevention of cancer and reducing health inequalities. To
achieve these goals it collaborates with all healthcare providers, commissioners, patients and their carers
throughout Devon, Cornwall and Somerset
The Peninsula Cancer Network serves a population of 2.2 million people and is comprised of the following
organisations:
Clinical Commissioning Groups
Northern, Eastern & Western Devon CCG
South Devon & Torbay CCG
NHS Kernow CCG
Somerset CCG
Acute Hospitals
Northern Devon Healthcare NHS Trust
Plymouth Hospitals NHS Trust
Royal Cornwall Hospitals NHS Trust
Royal Devon & Exeter NHS Foundation Trust
South Devon Healthcare NHS Foundation Trust
Taunton & Somerset NHS Foundation Trust
Yeovil District Hospital
Hospices
Hospiscare, Exeter
Mount Edgcumbe Hospice, Cornwall
North Devon Hospice
Rowcroft Hospice, Torquay
St Julia’s Hospice, Cornwall
St Luke’s Hospice, Plymouth
St Margaret’s Hospice, Yeovil
The following document outlines the constitution, roles and responsibilities of the Group.
2 Terms of Reference for the Group
In response to the publication of the Manual for Cancer Services (2004) a number of clinical sub- Groups
were established to address services for specific types of cancer.
Network Site Specific 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.
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Peninsula Cancer Network Gynaecology NSSG 2015
Network site specific Groups are multidisciplinary with representation from professionals across the
patient care pathway as well as involvement and representation from patients and carers.
The current Gynae-Oncology NSSG Terms of Reference are available in Appendix A.
3 Structure and Function
3.1 Role and Function of the Group
Network Site Specific Groups have been established to:

Act as the Network Executive 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;

Monitor progress on meeting National Cancer Standards and ensure action plans agreed following
Peer Review are implemented;
Promote links between teams and other relevant Network Groups.

The key objectives of Network Site Specific Group will be to:

Establish common referral and clinical guidelines for the Network/South West;

Agree a minimum data set for gynaecological cancer and a policy for consistent data collection
across the Network/South West;

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;


Consult with relevant cross-cutting groups on issues involving chemotherapy, radiotherapy,
cancer imaging, histopathology, genetics, laboratory investigation and specialist palliative care;

Identify emerging new cancer drug treatments and technologies which require appraisal by
commissioners through the Peninsula Health Technology Appraisal process;
Support the development of education and training programmes for teams;
Support effective patient and carer involvement in service planning and delivery;
Promote research and clinical trials;
Produce an annual work plan.




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
Plymouth Hospitals NHS Trust
Central Peninsula Gynae-Oncology SMDT
Royal Devon & Exeter NHS Foundation Trust
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Peninsula Cancer Network Gynaecology NSSG 2015
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 trust has dedicated diagnostic services for gynaecological cancer.
 Each trust (except North Devon) has a weekly MDT meeting and attend their respective joint
SMDTs
 North Devon has a fortnightly local MDT meeting.
 South Devon has a weekly MDT meeting and core members also join the weekly Royal
Devon and Exeter MDT 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 Local Gynaecological Cancer Teams 14-1C-101e
Distribution and Role of Local Support Teams 14-1C-103i
Trust
Team
Curative Surgical
Centre
Locality
Referring CCG
Population
Plymouth Hospitals
NHS Trust
Joint MDT with Cornwall
349,481
NHS NEW Devon CCG
Western Locality
Royal Cornwall
Hospitals NHS
Trust
Joint MDT with
Plymouth
534,503
NHS Kernow CCG
Northern Devon
Healthcare NHS
Trust
Joint MDT with Exeter,
South Devon and
Taunton
Royal Devon
& Exeter NHS
Foundation
Trust
164,997
NHS NEW Devon CCG
Northern Locality
Eastern Locality
South Devon
Healthcare NHS
Foundation Trust
Joint MDT with Exeter,
North Devon and Taunton
286,000
NHS South Devon &
Torbay CCG
Royal Devon &
Exeter NHS
Foundation Trust
Joint MDT with North
Devon, South Devon
and Taunton
383,040
NHS NEW Devon CCG
Eastern Locality
Taunton and Somerset
NHS Foundation Trust
Joint MDT with Exeter,
South Devon and North
Devon
South Devon
Healthcare NHS
Foundation
Trust
Royal Devon
& Exeter NHS
Foundation
Trust
Royal Devon
& Exeter NHS
Foundation
Trust
544,000
NHS Somerset CCG
Total
2,262,021
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Peninsula Cancer Network Gynaecology NSSG 2015
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
and carers.
Gynaecology SSG Chairperson
To Be Confirmed
NSSG Trial Recruitment Clinical Leads
Jenny Forrest
Subspecialty Lead
RDEHT
Khadra Galaal
Consultant Gynae-oncologist
RCHT
Zoe McCullogh
Cancer Nurse Specialist
RCHT
Fran Jones
Cancer Nurse Specialist
PHT
Emma Kent
Cancer Nurse Specialist
RCHT
Patient Champion & Information Leads
Patient and Carer Representatives
Vacant
Northern Devon Healthcare NHS Trust
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Peninsula Cancer Network Gynaecology NSSG 2015
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
Adewunmi Oriolowo
Dennis Yiannakis
Sidharth Dubey
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
John McGrane
Juliane Stolte
Rachel Newman
Samy Bishieri
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
Consultant Gynae-oncologist
John Renninson
Consultant Gynaecologist
Kate Scatchard
Consultant Medical Oncologist
Peter Bliss
Consultant Clinical Oncologist
Jenny Forrest
Clinical Oncologist
Jacky Stewart
Clinical Nurse Specialist
Katharine Edey
Consultant Gynae-oncologist
Trupti Mandalia
Consultant Histopathologist
Nicole Dorey
Consultant Clinical Oncologist
Ann Hong
Consultant
Carole Brewer
Consultant Clinical Geneticist
Jacky Coote
Consultant Radiologist
Tom Clark
Clinical Director of Diagnostics
Nichola Cope
Consultant HistoCytopathologist
Laura Gellett
Consultant Radiologist
Lisa Joels
Consultant
Jane Ferguson
Consultant Radiologist
MDT Lead
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Peninsula Cancer Network Gynaecology NSSG 2015
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
Taunton & Somerset NHS Trust
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
David Milliken
Clare Barlow
Jo Morrison
John Hunter
Paul Burn
Kirsty Coomber
Petra Jankowska
Surabhi Agrawal
Sue Slater
Sue Golby
Emma Cattell
Yeovil District Hospital
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
Lydia Karamura
Sally Keates-Porter
Cenydd Thomas
Hany Omran
Patient Representatives
Consultant Gynaecologist
Clinical Nurse Specialist
Consultant Radiologist
Ass Specialist Obs & Gynae
MDT Lead
Peninsula Cancer Network
Liz Boylan
Peninsula Cancer Network Manager
Melanie Chandler
Network Admin Support
CCG Managers for Cancer
Lynne Kilner
Emma Herd
NHS NEW Devon CCG Western
Locality
NHS NEW Devon CCG Eastern
Locality
NHS NEW Devon CCG Northern
Locality
NHS South Devon & Torbay CCG
Andy Gordon
NHS Kernow CCG
Yash Patel
Sara Wright
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Peninsula Cancer Network Gynaecology NSSG 2015
Amelia Randle
Somerset CCG
3.5 Network Agreed Authorised Surgeons for Diagnostic Service 14-1C-102e
Below is a list of named surgeons in the hospitals that provide stand-alone diagnostic services and
who are authorised to operate on low risk endometrial carcinoma within the Peninsula Cancer
Network.
Local Hospital
Named Surgeon
MDT attended as core
member
North Devon
Northern Devon Healthcare NHS
Stephen Bennett
Gynaecology MDT
Trust
SDHT Gynaecology MDT
South Devon Healthcare NHS
Morven Leggott
SDHT Gynaecology MDT
Foundation Trust
Raj Ranjit
3.6 Network Group Meetings
Meetings will be held at least twice per annum. Liz Boylan, Peninsula Cancer Network Manager and
the NSSG Admin Support Office will provide managerial and administrative support at Group
meetings.
3.7 Reporting Arrangements
Notes of the Group will be circulated to all Group members, Cancer Service Managers and other
interested parties. They will also be published on the Network website:
http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-site-specific-groups/gynaessg/
The Group will provide a Peninsula Cancer Network annual report 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
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Peninsula Cancer Network Gynaecology NSSG 2015
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.
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Peninsula Cancer Network Gynaecology NSSG 2015
Ovary
http:// www.nhs.uk/conditions/cancer-of-the-ovary/pages/mapofmedicine
Endometrial
http://healthguides.mapofmedicine.com/choices/map/endometrial_cancer1
Cervical
http://healthguides.mapofmedicine.com/choices/map/cervical_dysplasia_and_cancer1
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:
http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-site-specific-groups/gynaessg/
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.
Click here for the TYA Pathway for follow up on completion of first line of treatment.
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Peninsula Cancer Network Gynaecology NSSG 2015
6 Data Collection
6.1 Network-wide Minimum Data Set
All Trusts have previously confirmed their compliance with data collection requirements for cancer
waiting times and the Cancer Registry, together these constitute the MDS for the Gynaecology
Group.
Click here for minimum dataset
6.2 Network policy for collection of the MDS
Responsibility for data
The Acute Trust first treating or giving subsequent treatment to a patient in a particular month or
quarter is responsible for ensuring that the mandated data fields are complete on the database by the
national deadline.
The multidisciplinary team responsible for the care of the patient should ensure that information is
made available to allow it to be recorded prospectively and electronically.
Cancer Services teams in each Acute Trust should ensure that the information is transferred within the
timescales specified and should establish robust lines of communication with their colleagues in other
Acute Trusts.
The Peninsula Cancer Network information policy can be found at:
http://www.swscn.org.uk/networks/cancer/
7 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: http://www.swscn.org.uk/networks/cancer/sitespecific-groups/peninsula-site-specific-groups/gynae- ssg/
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Peninsula Cancer Network Gynaecology NSSG 2015
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