South West Strategic Clinical Network Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services Cancer of Unknown Primary (CUP) Network Site Specific Group Annual Report 2015 Version 1.0 1 NSSG Annual Report South West Strategic Clinical Network Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services This Annual Report was prepared by: Tania Tillett, Chair of the SWAG CUP NSSG Helen Dunderdale, SWAG Cancer Network NSSG Support Manager This Annual Report has been agreed by: Name Position Trust Date agreed Matthew Sephton Consultant Medical Yeovil District Oncologist Hospital NHS Foundation Trust Saiqa Spensley Consultant Clinical Taunton and Oncologist Somerset NHS Foundation Trust David Farrugia Consultant Medical Gloucestershire Oncologist Hospitals NHS Foundation Trust Thomas Wells Consultant Medical Weston Area NHS Oncologist Health Trust Paola Di Nardo Consultant Medical University Hospitals Oncologist Bristol NHS Foundation Trust Vivek Mohan Consultant Medical University Hospitals Oncologist Bristol NHS Foundation Trust Anna Kuchel Consultant Medical University Hospitals Oncologist Bristol NHS Foundation Trust Version 1.0 2 NSSG Annual Report South West Strategic Clinical Network Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services Cancer of Unknown Primary NSSG Annual Report Contents Section Contents Measures Page 1 Overview, achievements and challenges 1.1 Overview of report 4 1.2 Overview of service 4 Achievements and key service 1.3 improvements over the past 4 12 months Challenges for the NSSG 1.4 5 moving forward The Network Group 2 Meeting and 5 membership 14-1C-102-103m 2.1 Chair of the NSSG 5 2.2 Network Group Membership 14-1C-102m 5 2.3 Attendance Spreadsheet 6 Extended Members of the 2.4 8 NSSG 2.5 Network Group Quoracy 8 The function of the NSSG 2.6 8 meeting Network CUP Guidelines 3 and Algorithms on the 8 Systemic Therapy of Treatable Syndromes 14-1C-106m Poorly Differentiated 3.1 Carcinoma with midline 8 distribution 3.2 Women with predominantly 9 peritoneal adenocarcinoma Women with adenocarcinoma 3.3 involving the axillary lymph 9 nodes Version 1.0 3 NSSG Annual Report South West Strategic Clinical Network Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services 3.4 Squamous cell carcinoma of 9 the lymph nodes in the neck 3.5 Poorly differentiated 9 neuroendocrine carcinoma 3.6 Inguinal lymph nodes involved 9 with squamous cell carcinoma 4 Patient Experience 14-1C-109m 10 4.1 User Involvement 10 4.2 Patient Experience Surveys 10 5 Clinical Outcome Indicators and Audits 14-1C-110m 5.1 Network Audit 2015 10 5.2 Network Audit 2016 10 6 Clinical Trials and Research Activity 6.1 Discussion of Clinical Trials 14-1C-111m 11 1. Overview, achievements and challenges 1.1 Overview of report This report reflects the period of activity for the NSSG from 1st January 2015 to 31st December 2015. It contains a summary of the activity of the Cancer of Unknown Primary NSSG for this period against several key performance indicators that have been outlined in the National Cancer Peer Review Programme. The report should be reviewed alongside three other key documents for the NSSG: the Constitution, Clinical Guidelines and the Work Programme. The Cancer of Unknown Primary NSSG Constitution provides an overview of how the NSSG operates, outlining the general working processes of the NSSG, the patient referral pathways and the guidelines to which the NSSG adheres. The Clinical Guidelines outline the diagnostic and treatment processes agreed by the network group. The Work Programme summarises the key areas for growth, development and improvement of the NSSG over the next financial year (and beyond where appropriate). All four documents should be reviewed together to give a full overview of the NSSG, its performance and future plans. 1.2 Overview of service The Cancer of Unknown Primary site-specific group aims to oversee, support and bring together the viewpoints of all the multi-disciplinary teams working within the CUP services across the Network. The group also aims to ensure the same standard of care and treatment with this type of cancer Version 1.0 4 NSSG Annual Report South West Strategic Clinical Network Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services across the Network. The NSSG serves to ensure implementation of NICE guidelines for the investigation and treatment of CUP, and to provide guidelines for supportive care. The group supports a programme of education on key developments in the field of CUP cancer and aims to continue and expand the clinical trials programmes available within individual Trusts. 1.3 Achievements and key service improvements over the past 12 months The following are noted as key achievements and service improvements of the Cancer of Unknown Primary NSSG over the past 12 months (during 2015). The NSSG has undergone reconfiguration in line with the national cancer clinical networks incorporating Gloucester and Cheltenham NHS Trust The NSSG has appointed patient representatives The NSSG has conducted a clinical audit The NSSG has formed meetings independent of the Acute Oncology Service The BNSSG has taken part in an ACE project that affirms the Group’s aspirations to receive referrals via an urgent pathway rather than via two week wait. 1.4 Challenges for the NSSG moving forward The key challenges for the Cancer of Unknown Primary NSSG moving forward have been highlighted below: CUP patients are a small group with heterogeneous tumours which means that research and development in this tumour site is difficult. 2. The NSSG Meeting and Membership (measure 14-1C-102–103m) 2.1 Chair of the NSSG Dr Tania Tillett undertook the role of Chair of the Cancer of Unknown Primary NSSG after the inaugural meeting held in May, Chaired by Dr Anna Kuchel, who is now on maternity leave. A list of responsibilities for the NSSG, for the Chair, and other members of the NSSG, plus the NSSG terms of reference, can be found in the paper Recurrent Arrangements for Cancer Network Clinical Groups and Responsibilities for Peer Review, found here, as proposed by the South West Strategic Clinical Network (SCRN) Cancer Network Manager, Jonathan Miller (14th July 2014). The NSSG meetings are also conducted in line with the Manual for Cancer Services, Cancer of Unknown Primary Measures (Version 1.1): 2.2 Network Group Membership (measure 14-1C-103m) The Cancer of Unknown Primary NSSG is held approximately every six months. In 2015, meetings were held on the 6th May 2015 and the 4th November 2015. Version 1.0 5 NSSG Annual Report South West Strategic Clinical Network Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services The table below shows the core members of the NSSG and their attendance. All participants at MDTs are welcome to attend the NSSG meetings. 2.3 Table 1.0 Cancer of Unknown Primary NSSG core members and attendance Name Position Organisation 06/05/2015 04/11/2015 Alfredo Addeo Consultant University Hospitals Bristol Newly Medical NHS Foundation Trust x appointed Oncologist Anna Kuchel Consultant University Hospitals Bristol Maternity Medical NHS Foundation Trust √ leave Oncologist Tania Tillett Consultant Royal United Hospital Bath Medical NHS Foundation Trust √ √ Oncologist Thomas Wells Consultant Weston Area NHS Trust Medical √ √ Oncologist Vivek Mohan Consultant University Hospitals Bristol Newly Medical NHS Foundation Trust x appointed Oncologist David Farrugia Consultant Gloucestershire Hospitals Medical NHS Foundation Trust x √ Oncologist Matthew Consultant Yeovil District Hospital Sephton Medical NHS Foundation Trust √ √ Oncologist Paola Di Nardo Consultant University Hospitals Bristol Newly Medical NHS Foundation Trust √ appointed Oncologist Saiqa Spensley Consultant Clinical Taunton and Somerset √ x Oncologist NHS Foundation Trust Eleni Toumazou Consultant Royal United Hospital Bath n/a √ Pathologist NHS Foundation Trust Robert Pitcher Consultant University Hospitals Bristol √ Retired Pathologist NHS Foundation Trust David Wilson Consultant University Hospitals Bristol √ x Version 1.0 6 NSSG Annual Report South West Strategic Clinical Network Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services Radiologist NHS Foundation Trust Colette Reid Consultant University Hospitals Bristol x x Palliative Care NHS Foundation Trust Rachel Royston Consultant in North Bristol NHS Trust √ x Palliative Care Colin Binks Oncology Gloucestershire Hospitals √ x Specialist Doctor NHS Foundation Trust Alliston Rossiter CUP Clinical Nurse Royal United Hospital Bath Newly √ Specialist NHS Foundation Trust appointed Claire Lynch CUP Clinical Nurse Yeovil District Hospital Newly √ Specialist NHS Foundation Trust appointed Julia Hardwick CUP Clinical Nurse University Hospitals Bristol √ √ Specialist NHS Foundation Trust Lisa Lilly White CUP Clinical Nurse North Bristol NHS Trust Newly √ Specialist appointed Maggy O'Donnell CUP Clinical Nurse Taunton and Somerset Newly √ Specialist NHS Foundation Trust appointed Michelle Samson CUP Clinical Nurse North Bristol NHS Trust X x Specialist Samantha Wells CUP Clinical Nurse University Hospitals Bristol x √ Specialist NHS Foundation Trust Sarah Colsey CUP Clinical Nurse North Bristol NHS Trust x x Specialist Sarah Maton CUP Clinical Nurse Gloucestershire Hospitals √ √ Specialist NHS Foundation Trust Laura Pope Upper GI Clinical Taunton and Somerset √ x Nurse Specialist NHS Foundation Trust Justine Lloyd Acute Oncology