Meeting of the SWAG Area Cancer Operational Group (formerly ASW) Held on Wednesday 20th June 2018, 10.00-12.00 Weston General Hospital, Grange Rd, Weston-super-Mare BS23 4TQ Present : Asha Sahni SSG Support Administrative Coordinator SWAG CA SSG Support Service Belinda Ockrim Lead Cancer Nurse Yeovil District NHS FT Caren Attree Lead Cancer Nurse Taunton and Somerset NHS FT Carol Chapman Lead Cancer Nurse North Bristol NHS Trust Catherine Donnelly Senior Analyst Somerset Cancer Register Christine Nagle Cancer Performance Manager North Bristol Trust Ed Nicolle Cancer Manager Royal United Hospitals Bath NHS FT Emma Newbold Lead Nurse Palliative Care Weston General Hospital Helen Dunderdale SSG Support Manager SWAG CA SSG Support Service James Curtis (Chair) Cancer Manager Gloucestershire Hospitals NHS FT Luke Curtis Cancer Manager Yeovil District NHS FT Nicola Gowen Project Manager SWAG Cancer Alliance Ruth Hendy Lead Cancer Nurse University Hospitals Bristol NHS FT Zena Lane Cancer Manager Taunton & Somerset NHS FT Apologies: Deirdre Brunton Lead Cancer Nurse Weston Area Health NHS Trust Hannah Marder Cancer Manager University Hospitals Bristol NHS FT Hazel Lear Product Specialist Somerset Cancer Register James Withers Data Liaison Manager National Cancer Registration Service Jessica Barrett Assistant Directorate Manager Salisbury NHS FT Jonathan Miller South West Cancer Alliance Manager NHS England South, South West Michelle Gregory Deputy Cancer Manager University Hospitals Bristol NHS FT Nathan Brasington Cancer Manager Weston Area Health NHS Trust Patricia McLarnon Programme Manager SWAG Cancer Alliance NHS England South, South West Samuel Wadham Cancer Manager North Bristol NHS Trust Sian Middleton Lead Cancer Nurse Gloucestershire Hospitals NHS FT Terry James Commissioning Manager Cancer Lead Wiltshire CCG Page 1 of 8 1. Welcome and apologies J Curtis welcomed all group members. Apologies received prior to the meeting were noted. 2. Notes and actions from the last meeting As there were no amendments or comments following distribution of the minutes from the meeting on Wednesday 18th April 2018, the notes were accepted. Actions: 004/17: Lung resection rates have been discussed at the SSG and Consultant Respiratory Physician A Low is investigating. 005/17: Network and pharmacy posts: a draft SLA based on the SSG SLA has been sent to the BHOC manager. 018/17: Feedback on cancer waiting times has been provided to the CWT team. Action closed. 019/17: The impact of the revised GP contract has been addressed. Action closed. 020/17: Support is being provided to address the 62 day target. Action closed. 021/17: A meeting has been arranged in July to discuss the Inter-patient Transfer policy. Action closed. 029/17: The SOP regarding transfer of cancer patients between organisations is being reviewed by SWAG SSGs. 034/17: The COG view on shared care patient ownership has been shared with WGH. Action closed. 037/17: Developing a resilience plan for chemotherapy protocols. A process is now in place for updating the most recent version of chemotherapy protocols on the website. 039/17: COG representation on the Prevention & Early Diagnosis group will be clarified. 039/17: Action N Gowen 040/17: Lead radiologist for lung – Danial Fox will act as the SWAG point of contact. 001/18: Cystectomy referral numbers will be assessed to see if there is a rising trend in referral. 001/18: Action J Curtis 002/18: Further information on the cause of delays in prostate referrals from RCH to NBT will be circulated. 002/18: Action J Miller 003/18: Issues regarding the Somerset CCG Service Level agreement have been resolved. Action closed. Page 2 of 8 004/18: A report on improving 62 day performance was circulated with the CA Board papers. Action closed. 005/18: P McLarnon has received information on Quality Surveillance quality indicators for lung cancer. Action closed. 006/18: Data collection funding support for prostate is still under review. 006/18: Action P McLarnon 007/18: A letter has been sent to Somerset CCG regarding parity in commissioning of breast reconstruction surgery post cancer. The action will remain open until this issue has been resolved. 007/18: Action H Dunderdale 008/18: Changes in fertility Cryopreservation following NBT service closure mean that NBT are now referring to RUH. Clarification is being sought about referrals to Exeter. 008/18: Action H Dunderdale 3. Somerset Cancer Register 3.1 SCR update The 18.1 spring release is undergoing testing after which it will be rolled out live – the release includes updated COS and CWT datasets. The 18.2 autumn release will have Living With and Beyond Cancer (LWBC) enhancements in the Clinical Nurse Specialist (CNS) module and will include a prostate tracker. E-import improvements will include the ability to update an imported or manually entered record. A variety of outputs including MDT outcomes will be available in pdf format. H Lear, who is leading on a remote monitoring project, attended a meeting in London last week regarding LWBC metrics (a slimmed down version of the current metrics) which are due to be signed off in August. SCR aim to provide dashboards for the new metrics and plan to consult with providers as this work develops to ensure it meets user needs and aligns with Cancer Transformation Fund reporting requirements. The Cancer Waiting Times (CWT) team have contacted SCR about amendments to the dataset which should be finalised by August. SCR hope to launch these changes with the autumn release but if timescales are not feasible they will be available in the spring 2019 release. The 19.1 spring release will include a chargeable remote monitoring application which will initially be rolled out for breast and colorectal. SCR have reviewed similar systems including My Health Record and True North to help inform development of this product. Due to cuts in SWAG Transformation Funding SCR are looking elsewhere for funding for this work. CWT centralisation will lead to back end changes; if front end changes are also required a training programme (including the option for onsite training) will be put in place. The SACT database will change in September – more drug delivery data will be required; organisations will need to be compliant by 1 December 2019. Page 3 of 8 It was noted that Gloucestershire Hospitals NHS Foundation Trust (Glos) and Royal Devon & Exeter NHS Foundation Trust use InfoFlex rather than SCR. 4. Lead Cancer Nurse Update 4.1 LCN Update Lead Cancer Nurses (LCNs) are still attending SSG meetings although it was originally intended that they would support SSGs for one year only. Colorectal and Urology SSGs have Cancer Nurse Specialist (CNS) co-chairs but it has been hard to engage CNSs from other cancer sites. CNSs are more likely to engage with items related to their area of work such as patient surveys and audits. YDH: 2.5 Cancer Support Workers (CSWs) have been appointed; due to service pressures they have to date received minimal support. CNS provision is chronically understaffed, presenting challenges in delivering transformation funded work. UH Bristol: Neuro-oncology CNS support is a challenge across Bristol. 2 new neuro-oncology CNS posts will work in tandem with melanoma CNS support. NBT: Consideration is being given to advanced nurse practitioner posts to fill clinical gaps at NBT – this is also being reviewed at WGH and UH Bristol who have just recruited to breast and TYA posts. Banding for these posts ranges across the region from Band 6 to Band 8a. The last Macmillan census report indicated that the CNS workforce was under-recruited and the majority of CNS staff were in lower paid bands. More and more is being asked of CNS staff who are given huge responsibility. It was agreed this would be raised with the CA in relation to work on workforce planning. 009/18: Action N Gowen GLOS: J Curtis is interested in any work utilising nurses systematically in CWT improvement. At NBT urology and lung nurses are involved in improvement work. It was agreed that a paragraph about such work would be sent to J Curtis from each provider. 010/18: Action LCNs As a provider Glos also works with the West Midlands which can cause difficulties in deciding which meetings to attend. LCNs are currently doing extensive work on the 28 day standard. Nurses do a lot of face to face work with patients supporting diagnosis. It is a good opportunity to give patient education on preventable behaviour to those who do not have cancer – it is possible Make Every Contact Count (MECC) and the research networks could be encouraged to support such posts. TST: Taunton has a new Upper GI Band 6 CNS. CSWs have been appointed and are being managed by a Band 5. CA funding is being used to recruit a Somerset wide Band 5 as well as a project manager. The urology service is struggling due to retirement and lack of succession planning. A business case has been approved for a skin CNS and CSW – the service is seeing a huge increase in 2ww referrals on top of seasonal variation. WGH: There is a CNS shortage in haematology but the main concern is oncologists – there will be no speciality staff grades at the end of July. Page 4 of 8 RUH: There is room for improvement in relation to utilisation of specialist nursing staff in the skin service. Lung and haematology are understaffed. RUH plans to cease their neuro service – they currently have no specific CNS coverage for these patients. A meeting with other providers to discuss practicalities and timeline is being arranged. 5. Cancer Alliance & Transformation Funding 5.1 Cancer Alliance Board Meeting Update SWAG CA has been awarded £750,000 from the National Support Fund (NSF) for Quarters 1 and 2 of 2018/19.