Colorectal Cancer Services Multidisciplinary Team Cancer Services Multidisciplinary Team William Harvey Hospital Operational Policy Documentation ... Dr Arun Dhiman Gastroenterologists and Lead

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<ul><li><p>Colorectal Cancer Services Multidisciplinary Team William Harvey Hospital </p><p>Operational Policy Documentation </p><p>September 2010 </p><p>Prepared by Mr Pradeep S Basnyat </p><p>Status: </p><p>Expiry Date: </p><p>Version Number: </p><p> Publication Date: September 2010 </p></li><li><p>DOCUMENTATION </p><p>Document Location </p><p>The master electronic version of this document is kept by Mr Pradeep S Basnyat at William Harvey Hospital. Hardcopies are available on appropriate inpatient and outpatient areas. It is also available from Cancer Service Nurse (CNS) Ruth Burns and Maggie Moore from 1</p><p>st October 2010. This policy </p><p>will be circulated to all members of the Colorectal MDT. Access to the document is also possible via the Trusts Intranet/website </p><p>Revision History </p><p>Date Version Status Author Summary of Changes </p><p>2008 Mr Nagesh Rao </p><p>2010 Mr Pradeep s Basnyat Changed according to new colorectal measures </p><p>Approvals Record </p><p>This document has been agreed by all Core Members of the Colorectal MDT and has been signed off by the Colorecal MDT Lead Clinician and Trusts Lead Cancer Clinician and visiting Consultant Clinical Oncologist. Signed copies of this approval are filed and kept by William Harvey Hospital (WHH), Queen Elizabeth The Queen Mother Hospital (QEQMH), East Kent Hospitals University NHS Foundation Trust. </p><p>Approval </p><p>Date Name / Title Signature </p><p> Mr PS Basnyat MDT (MDT Lead WHH) </p><p> Mr G Harinath (Colorectal Surgeon) </p><p> Dr Catherine Harper-Wynne (Medical Oncologist) </p><p> Dr Julia Hall (Clinical Oncologist) </p><p> Dr A Santhakumaran (Radiologists) </p><p> Dr N Bagla (Histopathologists) </p><p> Dr G Vittay (Histopathologists) </p><p> Dr Arun Dhiman (Gastroenterologists and Lead Colonoscopists) </p><p> Mr George Stavellas (MDT Lead QEQM) </p><p> Mr Samer Doughan (Lead QEQM) </p><p> NSSG and Cross-Cutting Group Policy Documentation developed and managed by the Kent &amp; Medway Cancer Network is referenced and incorporated into this policy document and the approvals and sign-off process of the original documents is managed by the Kent &amp; Medway Cancer Network. </p></li><li><p>Enquiries </p><p>All enquiries relating to this document should be addressed to: </p><p>Addressee: Mr PS Basnyat </p><p>Telephone: 01233 616677 </p><p>Email: PRADEEP.BASNYAT@ekht.nhs.uk </p><p>Addressee: Mr George Stavellas </p><p>Telephone: 01843 225544 Ext 62329 </p><p>Email: George.Tsavellas@ekht.nhs.uk </p><p>Addressee: Mr Samer Doughan </p><p>Telephone: 01843 225544 Ext 65300 </p><p>Email: Samer.Doughan@ekht.nhs.uk </p><p>Addressee: </p><p>Telephone: </p><p>Email: </p></li><li><p>MEASURES ADDRESSED BY THIS EVIDENCE ITEM </p><p>This item of evidence is submitted against the following measures: </p><p>MDT LEADERSHIP </p><p>10-2D-101 Single Named Lead Clinician </p><p>MDT STRUCTURE </p><p>10-2D-102 Named Core Team memebers </p><p>MDT SPECIALISING IN ANAL CANCER </p><p>10-2D-103 Named Consultant Surgical Core Member(s) for Anal Cancer </p><p>MDT SPECIALISING IN ANAL CANCER </p><p>10-2D-103 Named Consultant Surgical Core Member(s) for Anal Cancer </p><p>10-2D-104 Named Consultant Clinical Oncology Core Member(s) for Anal Cancer </p><p>10-2D-105 Named MDT for Anal Cancer </p><p>10-2D-106 Team Attendance at NSSG Meetings </p><p>MDT MEETINGS </p><p>10-2D-107 Meet Weekly and record Core Attendance and protocols for Referral to Next Scheduled Meeting </p><p>10-2D-108 MDT Agreed Cover Arrangements for Core Memebers </p><p>10-2D-109 Core Members (or cover) Present for at Least 2/3 of Meetings </p><p>OPERATIONAL POLICIES </p><p>10-2D-110 Annual Meeting to Discuss Operational Policy </p><p>10-2D-111 Policy for all New patients to be reviewed by MDT </p><p>10-2D-112 Policy for Communication of Diagnosis to GP </p><p>10-2D-113 Operational Policy for Named Key Worker </p><p>10-2D-114 Core Histopathology Member Taking Part in Histopathology EQA </p><p>Management of Surgical Emergencies Potentially Due to Colorectal Cancer </p><p>10-2D-115 MDT/NSSG Agreed Guidelines on Management of Surgical Emergencies </p><p>10-2D-116 MDT/NSSG Agreed Secondary to Tertiary Referral Policy </p><p>Colorectal Stenting </p><p>10-2D-117 MDT/NSSG Agreed List of Personnel Judged Competent for Colorectal Stenting </p><p>MDT NURSE SPECIALIST MEASURES </p><p>10-2D-118 MDT/NSSG Core Nurse Member Completed Specialist Study </p><p>10-2D-119 Agreed List of Responsibilities for Core Nurse Members </p><p>10-2D-120 Agreed List of Additional Responsibilities for One Core Nurse Members </p><p> 10-2D-121 Attendance at National Advanced Communication Skills Training Programme </p></li><li><p>Extended Membership of MDT </p><p>10-2D-122 Extended Membership of MDT </p><p>10-2D-123 Patients Permanent Consultation Record </p><p>10-2D-124 Patient Experience Excercise </p><p>10-2D-125 Presentation and Discussion of Patient Experience Survey </p><p>10-2D-126 Provision of Written Patient Information </p><p>TREATMENT PLANNING DECISION </p><p>10-2D-127 Agree and Record Individual Treatment Plans </p><p> CLINICAL GUIDELINES </p><p>10-2D-128 MDT/NSSG Agreed Network Clinical Guidelines for Colorectal Cancer </p><p>10-2D-129 MDT/NSSG Agreed Network Guidelines for the Clinical Management of Anal Cancer </p><p>10-2D-130 MDT/NSSG Agreed Network Guidelines on the Resection of Liver Metastasis </p><p>10-2D-131 MDT/NSSG Agreed Network Referral Guidelines between Teams for Anal Cancer </p><p>10-2D-132 MDT/NSSG Agreed Network Referral Guidelines between Teams for the Resection of Liver Metastasis </p><p>10-2D-133 MDT/NSSG Agreed Network Investigation Protocol for Colorectal Cancer </p><p>10-2D-134 MDT/Network Agreed Collection of Minimum Dataset </p><p>10-2D-135 MDT/NSSG Agreed Policy for the Electronic Collection of Specific Portion of MDS </p><p>10-2D-136 MDT/NSSG Agreed Participation in Network Audit </p><p>10-2D-137 MDT Present Results from Participation in Audit to NSSG </p><p>CANCER RESEARCH NETWORK </p><p>10-2D-138 MDT/NSSG Agreed List of Approved Trials </p><p>10-2D-139 MDT/NSSG remedial Action from MDTs Recruitment Results </p><p>MDT WORKLOAD </p><p>10-2D-140 MDT to Discuss 60 or more New Cases per Year </p><p>10-2D-141 20 or more Operative Procedures per Core Individual Surgical Member per Year </p><p>OPERATIONAL POLICY SPECIFIC TO ANAL CANCER MDTs </p><p>10-2D-142 No more than 2 Clinical Oncologists Practising Radiology in Radiology Department and they should be Core Members </p><p>LAPAROSCOPIC COLORECTAL CANCER SURGERY MEASURES </p><p>10-2D-143 Policy on the choice of Laparoscopic Colorectal Cancer Surgery (Applicable to all colorectal MDTs) </p><p>10-2D-144 Training in Laparoscopic Colorectal Cancer Surgery (Applicable to all colorectal MDTs) </p><p>10-2D-145 Referral Guidelines for Laparoscopic Colorectal Cancer Surgery (Applicable to Colorectal MDTs without trained or exempt members) </p></li><li><p>MDT LEADERSHIP </p><p>10-2D-101 Single Named Lead Clinician </p><p> The single named lead clinician for the WHH Colorectal MDT is Mr Pradeep S Basnyat. The responsibilities of the position, agreed with Dr Brett Pereira (Trust Cancer Lead Clinician) are listed below: Updated Roles and Responsibilities of MDT Lead Clinicians : August 2010 Role in MDT: </p><p> Chair Lead and chair the MDT and ensure membership is appropriate (IOG and Quality Measure compliant) and objectives as laid out in the Manual of Cancer Measures and in the national Cancer Action Team document characteristics of an Effective MDT are met </p><p> Policies Be responsible for ensuring that the team has policies and protocols in place which are IOG, Cancer Quality Measure, DOG and Trust compliant </p><p> Annual Operational Policy Ensure that the team has a robust operational policy relating to the delivery of Cancer Services and that the policy is reviewed at least on an annual basis with appropriate changes to process agreed to ensure best practice </p><p> MDT membership Ensure that MDT members function in line with the operational policy and specialists work together in teams such that all decisions are multidisciplinary and effective regarding the patients pathway in cancer management </p><p> Training ensure appropriate skills and training of MDT members such as Advanced Communication Skills Training as appropriate </p><p> Cancer Pathways Ensure that all patients with Cancer are managed in line with the operational policy and disease site specific pathways of care agreed with the relevant DOG </p><p> Clinical Trials Support entry of eligible patients into clinical trials where appropriate and with full informed consent in partnership with the research team </p><p> MDT Attendance Ensure the MDT meets regularly and that attendance is documented and core members attendance is maintained in line with Quality Measures. </p><p> MDT Documentation: Be responsible for ensuring that MDM discussions are appropriately documented, validated and circulated to all team members. </p><p> MDT Data Collection and Audit: Be responsible for ensuring that the MDM collects validated data to support. </p><p> - The collection of the cancer minimum data set </p><p> - Cancer registration </p><p> - Relevant DOG agreed clinical audit data sets </p><p> - National Cancer Databases as required </p><p> Meetings: Ensure that besides the regular meetings to discuss patients the MDT meets at least twice a year and that: </p><p> - The outcomes of audit programmes are discussed and appropriate action plans agreed </p><p> - The meeting takes the opportunity for teaching </p><p> - Analysis of breach reports and embed process to ensure best practice delivery of cancer pathway to achieve National Cancer targets </p><p> Role in Peer Review Process: </p><p> Lead the MDT through the annual self (and as appropriate external) assessment process for Peer Review </p><p> Ensure Operational Policy is up to date and reviewed with the team </p><p> Ensure appropriate audits and patient surveys completed and action points </p><p>MDT STRUCTURE </p><p>10-2D-102 Named Core Team memebers </p><p>WHH Core Team Members </p><p>Name Title/Responsibility Mr Pradeep S Basnyat Lead Clinician of the MDT Mr Gandrasuppalli Harinath Colorectal Surgeon Mr Nebil Behar Locum Colorectal Surgeon Dr Julia Hall Clinical Oncologist (responsible for radiotherapy for Rectal Cancer) Dr Catherine Harper-Wynne Medical Oncologist (responsible for chemotherapy) Dr A Santhakumaran Radiologists </p></li><li><p>Dr David Rand Radiologists Dr George Vittay Histopathologists Dr Nipin Bagla Histopathologists Dr Arun Dhiman Gastroenterologists and Lead Colonoscopists Dr Christopher Fox Gastroenterologists and Colonoscopists Dr David Austin Gastroenterologists and Colonoscopists Extended Members Mr Parthi Srinivasan Liver Surgeon Dr Mark Downs Interventional Radiologists (provides Colorectal Stent Services) Dr Louise Izzatt Clinical Geneticist Dr Jeff Summers Lead Consultant Clinical Oncologists for Anal Cancer Ruth Burns Colorectal Nurse Specialist (CNS) Maggie Moore CNS Julie Bell Stoma Nurse Specialist Philippa Everard MDT Co-ordinator Dr Declan Cawley Palliative Consultant Julie Jones Palliative Care CNS Terri Oliver Palliative Care CNS </p><p>Weekly MDT Meeting Thursday 1200 to 1400 hours </p><p>Clinic Schedule: Mr PS Basnyat Tuesday Morning and Friday Morning Mr G Harinath Monday Mornings and Friday Morning Mr N Behar Monday Afternoon and Friday Afternoon Dr C Harper-Wynne Thursday Morning and Afternoon at WHH Dr J Hall Tuesday afternoon Friday Morning at KCH </p><p>Thursday Morning and Afternoon at WHH </p><p>Position Name Telephone Secretary Tel No/Bleep </p><p>Colorectal Consultant Surgeon Mr PS Basnyat 01233616677 01233616677 </p><p>Colorectal Consultant Surgeon Mr G Harinath 01233616676 01233616676 </p><p>Colorectal Consultant Surgeon Mr N Behar 01233616693 01233616693 </p><p>Clinical Oncologist Dr J Hall 01227783012 Ext 74986 </p><p>Medical Oncologist Dr C harper-Wynne 01622225321 </p><p>Gastroenterologists Dr A Dhiman </p><p>Gastroenterologists Dr C Fox </p><p>Gastroenterologists Dr D Austin </p><p>Imaging Specialist Dr A Santhakumaran </p><p>Imaging Specialist Dr D Rand </p><p>Histopathologists Dr G Vittay </p><p>Histopathologists Dr N Bagla </p><p>Liver Surgeon Mr Parthi Srinivasan 02032995188 02032995188 </p><p>CNS Ruth Burns 01233651831 01233633331 Ext 81831 </p><p>CNS Maggie Moore 01233651831 01233633331 Ext 81831 </p></li><li><p>Stoma Nurse Specialist Julie Bell 01233633331 Ext 86646 01233633331 Ext 86646 </p><p>Stoma Nurse Specialist Ross Marshall 01233 616646 01233 616646 </p><p>MDT Co-ordinator Philippa Everard 01233633331 Ext 84100 01233633331 Ext 84100 </p><p> Other supportive resources:- </p><p> Cancer BACUP free Phone: 0808 800 1234 Website: www.cancerbacup.org.uk </p><p>For all queries relating to Rapid Access Appointments call Cancer Services 01227 783089 Ext 74848 </p><p>Rapid Access Fax Number: 01227 866300 MDT SPECIALISING IN ANAL CANCER </p><p>10-2D-103 Named Consultant Surgical Core Member(s) for Anal Cancer </p><p>Mr Gandrasuppalli Harinath Colorectal Surgeon and Lead Surgeon for Anal Cancer Liaise with Lead Clinical Oncologists for treatment of Anal Cancers. </p><p> MDT SPECIALISING IN ANAL CANCER </p><p>10-2D-103 Named Consultant Surgical Core Member(s) for Anal Cancer </p><p>Mr Gandrasuppalli Harinath Colorectal Surgeon and Lead Surgeon for Anal Cancer Liaise with Lead Clinical Oncologists for treatment of Anal Cancers. </p><p>10-2D-104 Named Consultant Clinical Oncology Core Member(s) for Anal Cancer </p><p>Dr Jeff Summers Lead Consultant Clinical Oncologists for Anal Cancer. Julie Hall provides cover. </p><p>10-2D-105 Named MDT for Anal Cancer </p><p> All patients who are being investigated and treated for anal cancer will follow a pathway agreed by the Kent &amp; Medway cancer network. http://www.kentmedwaycancernetwork.nhs.uk/home-page/for-professionals/colorectal-dog/ After completion of diagnostic and staging investigations, patients with confirmed anal cancer are referred to the Maidstone Anal Cancer MDM for discussion and treatment. Follow-up of anal cancer (including counselling, Radiological investigations, EUAs, biopsies &amp; diversion stomas) are done at local hospitals (WHH &amp; QEQM). Salvage surgery for recurrent, relapse or residual anal cancers are offered salvage surgery to these selected patients by Mr. G Harinath who has teamed up with Mr Mark Pacifico, Consultant Plastic Surgeon, Royal Victoria Hospital, East Grinstead. </p></li><li><p>10-2D-106 Team Attendance at NSSG Meetings </p><p>Attendance at Colorectal DOG </p><p>Name Role 19/05/2009 12/11/2009 30/03/2010 Attendance PS Basnyat Consultant Colorectal Surgeon YES YES YES 100% </p><p>G Harinath Consultant Colorectal Surgeon YES YES NO 67% </p><p>C Harper-Wynne Medical Oncologist NO NO YES 33% </p><p>J Hall Clinical Oncologist NO NO YES 33% </p><p>Fox Chris Gastro Physician YES NO NO 33% </p><p>Ruth Burns CNS NO NO YES 33% </p><p>Maggie Moore CNS NO NO YES 33% </p><p> http://www.kentmedwaycancernetwork.nhs.uk/home-page/for-professionals/colorectal-dog/ </p><p>MDT MEETINGS </p><p>10-2D-107 Meet Weekly and record Core Attendance and protocols for Referral to Next Scheduled Meeting </p><p> WHH MDT is scheduled on every Thursday between 1200 to 1400 hours. All patients either suspicious on clinical or radiological investigations and those with confirmed Colorectal Cancers are referred to MDT co-ordinator by clinicians and CNS. It is agreed that the Colorectal MDT will accept referrals from any source on patients suspected or confirmed colorectal cancers. List is discussed and confirmed with Lead Clinician. The list for discussion is sent to all members of the colorectal MDT at least 48 hours prior. However, any patients who needs to be ad...</p></li></ul>