Peninsula Network Site
Specific Group for
Thoracic Oncology
Constitution
V1.0
Version: 1.0
Agreed Date: December 2015
Review Date: June 2018
Thoracic Oncology NSSG Constitution Approved V1.0 10.12.15
Constitution of the Peninsula Cancer Network Site Specific Group for Thoracic Oncology
Agreement cover sheet
The constitution of the Network Site Specific Group for Thoracic Oncology has been agreed by:
Position/Name
Chair PCN Thoracic Oncology Site Specific Group
Date agreed
Vacant
Date agreed
Position/Name
MDT Lead Clinicians/Organisation
Amy Roy
Plymouth Hospitals Trust
10.12.15
Georgina Hands
Northern Devon Healthcare NHS Trust
10.12.15
Stephen Iles
Royal Cornwall NHS Hospitals Trust
10.12.15
Liz Toy
Royal Devon & Exeter NHS Foundation Trust
Nicole Dorey
South Devon NHS Foundation Trust
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Contents
1. Background information…………………………………………………………………………………………………………….…..4
2. Terms of Reference for the Group ……………………………………………………………………………………….…………4
2.1 Role of the Group …………………………………………………………………………………………………………….….....5
2.2 Membership of the Group …………………………………………………………………………………………………..….5
2.3 Group meetings ………………………………………………………………………………………………………………….……7
2.4 Reporting arrangements ……………………………………………………………………………………………………….…7
3. Network configuration of services…………………………………………………………………………………………..……..7
3.1 Lung Cancer Teams ...………………………………………………………………………………………………..……………..7
4. Network guidelines …………………………………………………………………………………………..……………………………8
4.1 Primary Care referral guidelines ……………………………………………………………………………………………… 8
4.2 Referral guidelines for patients moving between teams……………………………………………………………8
4.3 Network policy on named medical practitioner with clinical responsibility…………………….………..8
4.4 Network agreed onward referral policy ……………………………………………………………………………………8
4.5 Clinical guidelines…..………………………………………………………………………………………………………………..9
5. Data collection………………………………………………………………………………………………………………………………..10
5.1 Network wide Minimum Dataset………………………………...…………………………………………………………..10
5.2 Network policy for collection of MDS……………………………………………………………………………………….10
7. Distribution of guidelines and protocols……..……………………………………………………………………………….. 11
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1.
Background Information
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 the Isles of Scilly.
The Peninsula Cancer Network serves a population of 1.7 million people and is comprised of the
following organisations:
Clinical Commissioning Groups
Northern, Eastern & Western Devon CCG
South Devon & Torbay CCG
NHS Kernow 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
Hospices
Hospiscare, Exeter
Mount Edgcumbe Hospice, Cornwall
North Devon Hospice
Rowcroft Hospice, Torquay
St Julia’s Hospice, Cornwall
St Luke’s Hospice, Plymouth
The following document outlines the constitution, roles and responsibilities of the Network Site Specific
Group (NSSG) for Thoracic Oncology.
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 the 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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Network site specific groups are multidisciplinary with representation from professionals across
the patient care pathway as well as involvement.
2.1 Role of the Group
•
•
•
•
•
Act as the Network Executive Board’s primary source of tumour site specific clinical opinion
for the network;
Advise and consult on service planning to ensure services are in line with national guidance
in order to promote high quality care and reduce inequalities in service delivery;
Ensure Network decisions become integrated into local practice;
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 Groups will be to:
• Adopt the NICE Lung Cancer Guidelines;
• Implement the National tumour site specific minimum data set and support consistent data
collection across the Network;
• Engage in service improvement by using appropriate redesign tools and techniques via
process mapping, capacity and demand measurement and redesign;
• 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 cross-cutting groups on issues involving chemotherapy, cancer imaging,
histopathology and laboratory investigation and specialist palliative care;
• 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.
2.2 Membership of the group
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 NSSG will be elected from within the membership of the group. The term of
office will be for two years.
All members of the group will be responsible for user issues and information for patients and
carers.
An NSSG Service Improvement Clinical Lead will be appointed from within the group for
identified projects.
An NSSG 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.
NSSG Patient Champion and Information Leads will be identified from within the membership of
the group.
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Named membership of the Group
Chair
To be agreed
Trial Recruitment Clinical Lead
Petra Jankowska
TST
Patient Champion & Information Leads
Carolyn Devine
NDHT
Sarah Earl
PHT
Sue Pascoe
RCHT
Sandra Pope
RDE
Jennifer Cook
SDHFT
Georgina Hands
Consultant
MDT Lead
Carolyn Devine
Respiratory Nurse Specialist
Mark Meller
Consultant Radiologist
Northern Devon Healthcare NHS Trust
Plymouth Hospitals NHS Trust
Amy Roy
Consultant Clinical Oncologist
Tim Howell
Consultant in Respiratory Medicine
Cyrus Daneshvar
Consultant Respiratory Physician
David Waine
Consultant Respiratory Physician
Sarah Earl
Lung Clinical Nurse Specialist
Katherine Syred
Consultant Histopathologist
MDT Lead
Royal Cornwall NHS Hospitals Trust
Stephen Iles
Consultant Physician
Sue Pascoe
Clinical Nurse Specialist
Paul Kneller
Clinical Nurse Specialist
Royal Devon & Exeter NHS Foundation
rust
Liz Toy
Consultant Clinical Oncologist
Peter Froeschle
Consultant Thoracic Surgeon
Felice Granato
Consultant Thoracic Surgeon
Tom Whitehead
Lead Respiratory Physician
Sandra Pope
Clinical Nurse Specialist
Sally Tapp
Clinical Nurse Specialist
Manish Powari
Consultant Histopathologist
Elizabeth O’Donovan
Consultant Radiologist
MDT Lead
MDT Lead
South Devon NHS Foundation Trust
Nicole Dorey
Consultant Clinical Oncologist
Louise Medley
Consultant Medical Oncologist
Jennifer Cook
Lung Cancer Nurse Specialist
Debbie Farn
Clinical Nurse Specialist
John Isaacs
Consultant Radiologist
MDT Lead
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Peninsula Cancer Network
Julie Cunningham
Liz Boylan
Mel Chandler
Peninsula Cancer Research Delivery Manager
Peninsula Cancer Network Manager
Peninsula Cancer Network Administrator
2.3 Group meetings
Meetings will be held at least twice per annum. Liz Boylan, Peninsula Cancer Network Manager
and Mel Chandler, Network Admin Support Officer, will provide managerial and administrative
support at Group meetings.
2.4 Reporting arrangements
Notes of the NSSG will be circulated to all group members, Trust management teams 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-specificgroups/lung-ssg/
A Network Annual Report and Work Programme will be prepared for Peer Review.
3. Network configuration of services
Improving Outcomes Guidance implementation summary
All patients with lung cancer are managed by a multidisciplinary team based in one of five Acute
Trusts.
All teams have access to Palliative Care services via core or extended MDT membership There is
confirmed funding and facilities available for the provision of CHART (continuous hyperfractionated accelerated radiation therapy) for patients with inoperable early stage non small
cell lung cancer
All patients with lung cancer have access to all modalities of radical and palliative treatment
including SABR and microwave ablation.
All patients with lung cancer have access to a trained clinical nurse specialist.
Services should be provided wherever and whenever possible.
3.1 Local Lung Cancer Teams
Local Teams
MDT Lead Clinician
Northern Devon
Healthcare NHS Trust
Plymouth Hospitals NHS
Trust
Royal Cornwall Hospitals
NHS Trust
Georgina Hands
Consultant
Amy Roy
Consultant Clinical Oncologist
Dr Stephen Iles,
Consultant Physician
Royal Devon & Exeter NHS Liz Toy
Foundation Trust
Consultant Clinical Oncologist
South Devon Healthcare
NHS Foundation Trust
Nicole Dorey
Consultant Clinical Oncologist
PCT
Referring PCTs
population
140,563 Devon
NHS
442,481 NHS
Plymouth
NHS Cornwall &
439,552
Isles of Scilly
401,841
NHS Devon
293,438
South Devon NHS
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Total
1,717,875
Each local team delivers:
 Diagnostic services including bronchoscopy and CT scanning for patients with lung cancer
chemotherapy for all lung malignancies.
 Thoracic surgery provided at PHT and RDE.
 Radiotherapy delivered locally except at North Devon. Patients from North Devon requiring
radiotherapy are cared for at the RD&E.
4. Network Guidelines
4.1 Primary Care referral guidelines
Primary Care practitioners will refer all patients defined by the “urgent, suspicious of cancer”
guidelines for thoracic oncology to the contact point of a single local thoracic oncology team.
4.2 Referral guidelines for patients moving between teams
All new thoracic oncology cancer patients should be discussed first in the locality MDT most
appropriate for that individual patient. This is here termed the first MDT, and this MDT will
usually assume lead responsibility for the patient.
In certain circumstances it may be appropriate for an onward referral to be made from the first
MDT to a second MDT within or outside the Network. These are categorised below according to
the indication for the referral.
What follows is not intended to be a complete list of possible indications for referral, and it is
assumed that in all circumstances the locality MDT will act in the best interests of each patient
for which it has lead responsibility, making onward referrals as necessitated by the clinical
circumstances.
• Referral to another specialist for further tests or treatment
Many staff participate in more than one thoracic oncology MDT. It is not necessary for cases to
be discussed at the second MDT if a patient is simply attending the centre for specialist
investigations or treatment not provided by the locality MDT (for instance radiotherapy or
surgery). However, these cases may be discussed at the second MDT if the person receiving the
referral from the first MDT feels that it would be helpful.
Good communication with the first MDT will be particularly important in this option. In this
situation the first MDT will consider the second MDT’s recommendations carefully, while
maintaining lead MDT responsibility.
•
Pulmonary problems associated with a non-thoracic cancer (e.g. a malignant pleural
effusion secondary to cancer at another site)
These patients will be considered at the thoracic oncology MDT and advice will be given or
onward referral made to the most appropriate site-specific MDT. In this situation the
appropriate site-specific MDT will take lead responsibility.
•
Patients with synchronous cancers at lung and other site.
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Such patients will be discussed in the thoracic oncology 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.
• Second opinion requested by first MDT or patient
All such cases must be discussed at the second MDT. Both the referring and second MDT
recommendations will be considered with each patient to develop the treatment plan. The
outcome of those discussions will determine the most appropriate MDT to lead the patient’s
further care.
•
Referral for further cancer centre multidisciplinary assessment of a complex /supra
specialist case
All such cases must be discussed after assessment at the second MDT. In this situation it is
anticipated that the recommendations of the second MDT would usually take precedence over
those of the first or referring MDT. In other words, the second MDT would take over lead
responsibility for the patient in this clinical situation.
Referring clinicians should ensure that all relevant information is provided to facilitate the
continuity of care and avoid unnecessary delays.
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.
4.3 Clinical guidelines
The NSSG has drawn up and agreed to follow Network specific clinical guidelines. These were
updated by a working party and formally ratified by the NSSG in December 2009. They are being
reviewed for approval in December 2015 and include both imaging and pathology guidelines.
The Group will follow the latest Royal College of Pathologist Guidelines 2014. The Network
Pathology Leads Group is responsible for producing all Network pathology guidelines for all
tumour sites. This guidance was also agreed in December 2009.
Minimum Data Set for Thoracic Oncology Histopathology Reports 2014 website:
https://www.rcpath.org/resource-library-homepage/publications/cancer-datasets.html
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 NSSG to ensure that all Network guidelines are up to
date and reflect current practice.
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5. Data Collection
5.1 Network-wide minimum dataset (MDS)
All Trusts have previously confirmed their compliance with data collection requirements for
cancer waiting times and the Cancer Registry.
In addition to this all Trusts participate in the National Lung Cancer Audit (NLCA)
http://www.hscic.gov.uk/lung.
The NSSG has agreed to include the 14 key data fields in the minimum dataset. Together
these constitute the MDS for the Thoracic Oncology NSSG (see Information for Members on
the website). http://www.swscn.org.uk/networks/cancer/site-specific-groups/peninsula-sitespecific-groups/lung-ssg/peninsula-thoracic-oncology-ssg-information-for-members/
5.2 Network policy for collection of the MDS
Responsibility for data
The Acute Trust first seeing a patient for a particular month or quarter is responsible for
ensuring that the mandated data fields are complete on the database by the national
deadline.
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 regarding that
patient 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.
6. 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/site-specific-groups/peninsula-site-specificgroups/lung-ssg/
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