Draft Minutes of Inaugural NICaN Haematology Regional Group Meeting
27th June 2006
NICaN
Inaugural NICaN Haematology Regional Group Meeting
Tuesday 27th June 2006
9.00 – 11.30 am
Seminar Room 3, Cancer Centre – Belfast City Hospital
Welcome and Introductions
A record of attendees is shown in Appendix I.
Dr Curly Morris welcomed everyone to the Inaugural NICaN Haematology Regional
Group Meeting. Apologies had been noted from Dr Denis Alexander, Dr Bernie
Corcorane, Dr Russell Houston, Ms Zoe Hunter and Dr Janet Lyttle.
HG_0607_A01 Matters arising from Minutes of Planning Meeting
There were no matters arising from the minutes of the Planning Meeting held on Friday
31st March 2006 not already covered in today’s agenda.
HG_0607_A02 Group Terms of Reference; sign off
The draft NICaN Haematology Regional Group Terms of Reference were projected and
copies were provided for all attendees. It was stated that the amendments suggested at
the Planning Meeting had been incorporated into the Terms of Reference and it was
highlighted that the two changes were the inclusion of biomedical scientists and social
workers in core membership. Dr Morris briefly outlined the purpose statement of the
group and core membership (to be discussed in next agenda item) before it was agreed
that the Terms of Reference were suitable and accordingly signed off.
HG_0607_A03 Membership of NICaN Haematology Regional Group; update on core nominations
A membership paper was projected and copies provided for all attendees highlighting
the constituencies for the core membership as highlighted in the Terms of Reference. It
also recorded who had been contacted to secure the core members and the nominations
received to date. Some time was spent going through the table and some additional
nominations were captured at the meeting. It was agreed that the updated core
membership paper would be circulated with the minutes. Dr Morris then briefly touched
on the responsibilities of core members stating that core members are required to attend
the Regional Group meetings or ensure a deputy, who is fully informed attends in their
place, and also that core members communicate back with their identified
constituencies. Core members will also be required to participate in working group(s).
HG_0607_A04 Baseline of Current Service; Inputs from representatives of each of the Units and
the centre
For this agenda item Dr Morris stated that there would be some inputs from
representatives in order to review current services provided across Northern Ireland. Dr
Yong Lee Ong provided a presentation on the UCHT Haematology Services highlighting
the management structure, members of the multidisciplinary team, the professionals
absent from the multidisciplinary team, training and accreditation at the site, an
indication of departmental workload and the possible implications for the new Trust
under the Review of Public Administration. A copy of the presentation will be circulated
with the minutes.
Draft Minutes of Inaugural NICaN Haematology Regional Group Meeting
27th June 2006
NICaN
Dr Morris then briefly highlighted the current service provision at the City Hospital;
highlighting the regional aspects of the workload as transplantation (Allo/Auto),
apheresis and photophoresis, the Regional Diagnostic Unit, the Regional MDMs for
lymphoma and myeloproliferative, clinical trials in terms of therapy and
radioimmunotherapy. It was also stated that as with all the cancer units it also functions
as the cancer unit for the local population of Belfast.
From these two inputs it was stated that the members had been given a very brief
snapshot of some of the service provision but that a more systematic approach could be
taken to fully inform a review of current services. It was suggested and subsequently
agreed that a baseline be developed using the framework of Dr Ong’s presentation and
be forwarded to all the units to capture data on current workloads and a compliment of
access to haematologists, pathology / labs etc.
Group Workplan
Dr Morris stated that inputs from the Planning Meeting has identified three workstrands
for the Regional Group,
 MDM practice
 data collection, and
 the development of strategic planning for haematology services.
Dr Morris stated that the aim of the next section of the agenda was to identify the
objectives of each of the workstrands along with leads and working group members.
HG_0607_A05 MDM Practice
It was proposed that the MDM standards within the Manual of Cancer Services (the
English Standards to implement IOG guidance) be reviewed as a first step for exploring
MDM practice for haematology. It was agreed that this is an appropriate way forward as
it prevented the “reinvention of the wheel” and it was proposed that Dr Lakshmi
Venkatraman lead this work and working members were sought from Haematology,
Pathology, Radiology, Clinical Scientist and Nursing as well as inviting Dr Lisa
Ranaghan for her work on MDM databases. The following members were subsequently
proposed: Ms Lorraine McKenna, Dr Tom Lynch or Dr Aine Shiels, Dr Mary Frances
Mullan, Mr Mark Calderwood, Dr Mary Drake, Dr Jim Carson, Dr Karel Dedic and Dr
Margaret Bowers. It was agreed that Dr Lakshmi Venkatraman would receive a briefing
with regards to the remit of the subgroup, following this morning’s meeting.
HG_0607_A06 Data Collection
It was agreed that there was a need for this piece of work to link into the subgroup
examining standards for MDMs. Linkages would also be required with the Northern
Ireland Cancer Registry, the Leukaemia Research Fund and the Regional Haematology
Audit Group. At this stage, in the meeting Ms Beth Malloy asked if she could provide the
update on the Department’s Service Delivery Unit as she saw clear linkage.
Ms Malloy stated that the Service Delivery Unit are looking towards cancer access
standards and the thinking is that the MDMs will be a key point for measurement. It is
proposed that 62 and 31 day targets are introduced as they currently are in England. 62
days being from time referral to first treatment and 31 days from diagnosis to treatment.
Ms Malloy requested feedback from the Haematology representatives on the proposed
targets and there followed some discussion with regards to there being good pathways
already established and that the targets might not be challenging to some as some
haematology treatment can start within 24 hours. Dr Morris did however provide a
caveat that there can be lengthy diagnosis for some diseases and Dr Mary Drake stated
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Draft Minutes of Inaugural NICaN Haematology Regional Group Meeting
27th June 2006
NICaN
that the issue can be a delay within the diagnostic pathways and in referrals from
primary care.
It was suggested by Dr Dermott Davison, the Lead GP for the Cancer Network, that
representatives from the Haematology Regional Group work with representatives of the
NICaN Primary Care Group to look at referral guidance. Dr Davison stated that this
work was currently underway with the lung community and was proving very beneficial.
Drs Bowers, Drake and Ong agreed to be the haematology nominees for this group and
will meet offline. With regards to evidence-based protocols it was stated that some
already exist but may need formalising. There was a question from the floor with
regards to guidelines for the treatment of children with the new legislation coming in from
the European Union. Dr Tom Lynch also stated that European Guidance for PET and
CT for paediatric Hodgkins disease are due to be circulated shortly. Dr Lynch agreed to
forward this in due course.
With regards to capturing data there followed some discussion with regards to the lack of
compatibility of IT systems and the wide range of different pathology reporting systems
currently in place. Ms Malloy stated that the Service Delivery Unit will be looking at the
blockages and would be proposing to work with teams on the ground to remove.
HG_0607_A07 Development of Strategic Plan for Haematology Services
It was stated that the baseline of current services would inform any future development
of the strategic plan. Dr Morris also highlighted that Dr Daly had made some contact
with representatives of the Department with regards to a strategic review and we
currently await a response.
HG_0607_A08 Others; based on issues captured at planning meeting
See information on Referral Guidance of Primary Care Group above.
HG_0607_A09 Emerging Issues
Regional Radionuclide Therapy Group
Dr Tom Lynch provided an update of the inaugural meeting of the Radionuclide Therapy
Group which took place on 13th June. It was stated that the agreed work was to
 investigate the change of practice for treatment of thyroid malignancies (and for
review of benign services for the Royal)
 to carry out an impact assessment of the provision of therapies for radionuclides
in Northern Ireland instead of referring to the Marsden in England
 an impact assessment is currently being produced for Zevalin; and
 the promotion of increased use and access to radionuclide therapies for bone
palliation (with direct linkages to the NICaN Supportive & Palliative Care Group).
It was stated that the next meeting of the Radionuclide Therapy Group meeting is due to
take place in late August.
Regional Drugs and Therapeutics Committee
It was stated that Dr Martin Eatock, as the proposed chair for the Regional Oncology and
Haematology Drugs and Therapeutics Committee, had contacted the Chief Executives
of the four Health Boards and the Chief Executives of the Cancer Units / Centre and the
Chair of RMSC to outline the proposed structure and membership of the Regional
Oncology and Haematology Drugs and Therapeutics Committee. It was clarified that
this Committee would look at Haematology as well as solid tumours. Dr Andrea
McKillen stated that RMSC are keen to get a transparent structure established and that
the Drugs & Therapeutics Committee for Oncology and Haematology may provide the
format for other Drugs and Therapeutics Committees.
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Draft Minutes of Inaugural NICaN Haematology Regional Group Meeting
27th June 2006
NICaN
Other Emerging Issues
Ms Sally Campalani questioned whether there should be work undertaken on the
guidelines for care of adolescence. It was stated that this is not exclusively haematology
and it was questioned whether this should be looked at a later stage.
HG_0607_A10 Network Developments
Public & Patient Involvement – Ms Janis McCulla
Ms Janis McCulla briefly outlined the work to date since she has been in post as the
NICaN Patient & Public Involvement Co-ordinator. Ms McCulla stated that five public
meetings took place across Northern Ireland during April and that the Steering Group of
the Cancer Experience Forum had their first meeting in June 2006. It was outlined that
the aim is to give a stronger voice to patients, carers and the public and to integrate
them into the planning and delivery of services. Ms McCulla highlighted that the key
messages coming out evolve around the timeliness of information, individuals that were
requesting to be treated as individuals and the lack of support for carers. The Cancer
Experience Forum Steering Group is currently looking at the membership of the Forum
and also of an appropriate chair (criteria is being developed for this).
Dates of Future Meetings
Future meetings will be held in October 2006, January 2007 and April 2007.
Dr Morris then thanked everyone for their participation and closed the meeting.
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Draft Minutes of Inaugural NICaN Haematology Regional Group Meeting
27th June 2006
NICaN
APPENDIX I
Record of attendees
27th June 2006
Present:
Margaret Bowers
Sally Campalani
Anne Marie Carey
Jim Carson
Marie Catherwood
Sylvia Cole
Simon Coulter
Robert Cuthbert
Dermott Davison
Karel Dedic
Mary Drake
Colin Goldsmith
Judith Lunn
Tom Lynch
Beth Malloy
Nicola Martin
Jayne McAuley
Caroline McCaughey
Andrée McCollum
Janis McCulla
Andrea McKillen
Ms Lisa McWilliams
Curly Morris
Lorna Nevin
Yong Lee Ong
Susan Piggott
Maurice Regan
Aine Shiels
Sarah Taggart
Lakshmi Venkatreman
Claire Walsh
Apologies: Dr Denis Alexander, Dr Bernie Corcorane, Dr Russell Houston,
Ms Zoe Hunter and Dr Janet Lyttle
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