Chemotherapy
Measures
What’s New?
Anne Hines
Marie Brazil
General – DRAFT still
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1A’s – network board
1E’s – Network chemotherapy group
3’s – Cross cutting – 3S chemotherapy
Numbering has changed
10 – 1E – 101s,102s etc
10 – 3S – 101,102 etc
100- chemotherapy service
200- oncology pharmacy
300 – intrathecal
Note – no more stars – all important!!
Pgs 11-13
Nomenclature
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Systemic chemotherapy im, oral, im,
 Topical,
intracavitary not included
 Intrathecal – separate topic
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Regimen – defined by the drugs used
Protocol – contains all the parameters specified
in the measure
Algorithm – acceptible regimen or range of
regimens which may be used for a stated site
specific situation
Pgs 15 -16
Nomenclature cont
Course – complete period of treatment for
a particular regimen
 Cycle – repeated pattern over which the
drugs are given
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1A’s – Network Board
Old, 22 measures, New, 5 measures
 Covers leadership of chemotherapy
services at network and board level
 Note that deliniation of chemotherapy
services is now an acute onc measure
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1E’s – Functions of Network
Chemotherapy group
Old 12 measures, new 13
 Requires – annual review, work
programme and annual report
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1E’s -Treatment Algorithms
Agree with NSSG a set of site specific
chemotherapy algorithms – eg breast,
haem, colorectal etc
 Network Algorithm Deviation Policy
 Network review of deviations
Further clarity requested on definition of algorithm and how this fits with
TYA measures – (no mention of algorithms)
1E’s – Error Reporting
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The NCG should review the reported
errors of the CCS’s and agreed remedial
actions.
1E’s Training and Assessment
policy
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Network policy covering
 Professional
groups, activities needed to
define process of chemotherapy, competency
needed to work independently,
 Network list of assessors
 Named area of competence
Networks appear to be being asked to maintain a current register of
competent people – not feasible – should be done locally
3S’s – 1’s chemotherapy services
Old – 55 measures new- 35 measures
 10-3S-103 – named wards
 10-3S-104- specified room policy
 107 – defining chemo MPT ? haematologist
 111 – quality management system
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Not feasible in the time given if not already in place –
no mention in NCAG or NCEPOD
3S’s - 1 con’t
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112 Error reporting – record and grade
chemotherapy errors according to NPSA
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113 Further pre-treatment consultation
with “sufficient” time between the previous
for pt to digest the information
 Patient
pathway
 Department timetable
3S’s - 1 con’t
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118 – agreed list of treatment algorithms
119 – preventing regular deviation from the
algorithm
Still need protocols as well – 120
Protocols are not now network driven but locally driven
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127 – patient experience exercise
128 – treatment plan to GP – regimen, startdate,
planned duration, intent
3S’s - 1 con’t
Chemotherapy dataset
 - this measure will be included following
implementation of the chemotherapy
dataset in 2012
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3S-2’s Oncology Pharmacy
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201 Lead pharmacist – single designated lead
only
204 But – also now need to list an aseptic lead
206 – computer generated prescriptions
Further clarity on definitions of hand written etc requested as well
Note
– no handwritten prescriptions is expected
as exceptions.
3S’s - 1 con’t
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207 – 209 – Electronic prescribing
 SOP,
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variations, validation
Vinca alkaloids – correction requested for
childrens services
10-3S-3 Intrathecal Chemotherapy
(ITC)
Old 50 measures – new 22 measures
 BUT
 A lot have just been condensed eg – no
major changes to requirements for ITC.
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Lead, divisions, local protocol, register, risk assessment,
hard copy of protocol, training competency assessors,
who can administer, sequencing, labelling, prescription,
collection, storage, room, normal working hours
Don’t forget acute oncology!! 3Y’s
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1A – 302 – declaration of clinical chemotherapy services
1A- 303 – declaration of oncology pharmacy services
1A – 304 – review of services by network
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3S-122 policies relating to acute oncology
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 Extrav,
anaphylaxis, NS, emesis, stomatitis
mucositis and diarrhoea
 Cross refs to 10-1E110y and 1E-107y
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Still not sure if need network policies for all of these as well