Metastatic Spinal Cord Compression Project Clodagh O'Brien Regional Macmillan MSCC Project Manager

Starting point Progress to date Future

Starting Point Guidance – NICE guidance MSCC and AOS peer review measures Regional Steering Group A lot of good will

Variable Standard Audit result 2011 Commence definitive treatment within 24 hours 100% 64.2% Emergency RT for appropriate patients within 24 hours 72.7% Post-operative RT for appropriate patients Appropriate documentation of mobility/stability ? Prescription of thromboprophylaxis

Progress to date Referral Pathways Treatment pathways Spinal surgery rota Improved MRI access Patient information Rehab guidance

Impact of progress Variable Standard Audit result 2011 Audit result 2013 Commence definitive treatment within 24 hours 100% 64.2% 80% Emergency RT for appropriate patients within 24 hours 72.7% 91% Post-operative RT for appropriate patients Appropriate documentation of mobility/stability ? 60% Prescription of thromboprophylaxis 96%

Impact of Progress Mobility -able to walk unaided at diagnosis CRAG (2001) 18% SCAN – (2012) 25% Northern Ireland (2013) 38%

Future Health professional education MSCC co-ordinator role essential Who do I phone when I have a patient with suspect MSCC? How do I get an MRI? MSCC co-ordinator role essential Educate Triage Audit

Key messages Positive developments to date Work still needs to be done To progress MSCC co-ordinators are needed