19.07.2012 - East Midlands Cancer Network

Present:
East Midlands Cancer Network Chemotherapy Group
Minutes of the Meeting held on Thursday 19 th July 2012
2.00 pm – 4.00 pm
Whitehouse Hotel, Kegworth (J24 M1)
Carolyn Bennett CB Macmillan Lead Cancer Nurse, Sherwood Forrest Hospital
Dhiren Bharkhada DB Pharmacist, Kettering General Hospital
Janice Birkinshaw JB Clinical Educator, Royal Derby Hospital
Eileen Busby EB Pharmacist, United Lincolnshire Hospitals Trust
Christine Clarke CC EMCN Pharmacist (Chair EMCN Chemotherapy Group)
Elaine Davies ED Pharmacist, Northampton General Hospital
Catherine Loughran CL Pharmacist, University Hospitals of Leicester
Emma Luke EL Stem Cell/Apheresis Manager, Nottingham University Hospital
Lorraine MacDonald LM Pharmacist, Derby Hospitals NHS FT
Jennifer Moyes JM Pharmacist, Burton Hospital
Caroline Penn CP Professional & Practice Lead & Lead Chemotherapy Nurse,
Derby Hospitals (Chair EMCN Chemotherapy Nurses Group)
Di Ryan DR Chemotherapy Manager-Oncology, Nottingham University
Hospital
Apologies: Dr S Ahmed, Dr G Faust, L Joy, Dr AM Martin, Dr M Persic, Dr V Potter, C Ward
1. Welcome / Introductions and Apologies
Apologies noted as above.
2. Minutes of Meeting 18 th April 2012 (Paper A)
Accepted as an accurate record.
3. Matters Arising
Extravasation information leaflet-nursing group reviewing
To be discussed at nursing group later in the afternoon to clarify the way
forwards. The minutes of the last nursing meeting await confirmation and further
discussion after this meeting.
Extravasation Additional Drugs Plan
EB had proposed a practical solution at the last pharmacy meeting. Between
revisions new drugs will be listed on a separate addendum on the EMCN
website with hyperlinks to the main document. These will be incorporated into
the poster at major revisions. The list is going to the pharmacist meeting on
19/7/12 for approval prior to loading on the website. Post meeting note: See
additional drugs list
Action
Nursing
meeting
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Chemotherapy Administration policy - nursing group
To be discussed at nursing group later in the afternoon as to whether the
administration policy should be a shared network document or developed at a
local level. The EMCN Cytotoxic Policy doesn’t cover the administration of
chemotherapy in detail.
CDF Audits
All trusts had now made returns for 2011-12 with funding to support the process
from the CDF. There is a template in use to provide prospective data going
forwards.
Peer Review Support.
CC still to discuss with network team the feasibility of supporting this.
Chemotherapy Training & Assessment Framework for Nurses see
To be held over to next meeting following the nursing meeting.
4. Peer Review:
Visits anticipated in January for NUH Derby Lincolnshire and ?Sherwood Forest.
All trusts anticipating Acute Oncology visit.
With regards to local self assessment and timescales no issues were raised.
Medical training documentation was held to the next meeting as there were no
medical staff at the meeting.
5. Errors and Prevention:
Some centres reported having implemented the switch to sub cutaneous
bortezomib, others plan to shortly, with some awaiting the drug to be licensed by
the subcutaneous route.
Production problems relating to different strength of solution were discussed.
NUH reported an error with the route of administration which is being
investigated and will be discussed further at the next meeting. It was noted that
an IV/sub cut route now falls into a “never event” category in the same way
intrathecal/IV does.
The group agreed it was very useful to share the issues discussed at the
meeting and take the issues highlighted back to local centres still to implement
subcutaneous bortezomib.
KGH reported an error with chemotherapy prescribing of intrathecal
chemotherapy which was discussed by the group.
6. Capacity Modelling:
Di Ryan gave a very instructive presentation on the work undertaken around
productive oncology at NUH as part of the “better for you” initiative. The project
has been underway for 7 months and is still at an early stage. The 5 step plan
includes Set Up and Plan, Discovery, Design and Trial, Implementation and Roll
out and Embed and Sustain. Whilst challenging the project has enabled a
complete review of the service with detailed data collection and analysis. Many
ideas have been “designed and trialed” some of which have worked and others
have returned for further review. Chemotherapy Suite Standards were agreed by
all after discussion but are still to be achieved. Many working practices have
Nursing
meeting
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changed but there is still much to be done. Patients are very interested in the
project and read the information boards. Considerable time ensuring by in from
all staff groups has been essential to delivering the project. Haematology at NUH
are keen to see the project roll out to them.
DR agreed to share her presentation on powerpoint which could not be show for
technical reasons.
Di agreed to feedback on progress in 6 to 9 months time.
7. E prescribing
EMCN has invested £965,000 across the region to support E-prescribing (in
addition to DH central funding).
ULHT have tendered and are assessing responses. CC to meet ULHT at end of
July.
Derby are progressing but still to go live. The IT department is very supportive of
this part of the project at Derby.
Burton has two thirds of the colorectal regimens ready to go live. Breast and
lung live. Still issues with consultant cover. CC to follow up with local leads.
Northants project struggling to secure IT engagement. Andy Harvey and CC
working with trusts to progress.
NUH and SFH are progressing with IT issues almost resolved. There appears to
be an issue remaining with regards to information governance agreement
between the sites.
Paediatrics are recruiting at UHL but NUH still awaiting trust sign off to proceed.
EMCN are following this up and the link between sites with regards to IT.
8. Mandatory Dataset
The mandatory dataset return has been made by 4 sites-Burton, NUH UHL and
NGH. There has been joint working between the 3 sites using ChemoCare to
enable as many fields as possible and in a consistent format. The dataset has
still not been published but CC shared some of the key findings. It is hoped data
will be available in early August.
The cost of upgrading ChemoCare to deliver the dataset has been discussed
and CC awaits further information and a specification from CIS Oncology.
For trusts not yet submitting data CC has heard of plans from ULHT. There is
less clarity around how this will be delivered from Derby, and potentially SFH
and KGH as the E prescribing system is unlikely to deliver by September 2012.
CC to approach trusts for an update.
9. Non Protocol Chemotherapy returns
CC reported the submission for 2011-12 has been filtered to remove protocols
now within the EMCN algorithm.
There are a few algorithms outstanding for completing including melanoma and
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some haematology, although the haematology guidelines are mostly completed.
The trust comparative feedback is still ongoing. NUH have returned their
summary.
10. Future meeting dates –to be arranged
11. AOB
CB asked about the Annual report. CC confirmed she had still to write this.
12. Date and Time of Next Meeting
Wednesday, 17 th October 2012
2.00 pm to 4.00 pm
The Whitehouse Hotel, Kegworth DE74 2DF
Followed by separate nursing / pharmacy meetings 4.00pm - 5.30pm
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