Regional Melanoma & Complex Skin Cancer Meeting 15th May 2008

Focus of today’s meeting Melanoma & Complex Skin Cancer MDM Agenda Focus of today’s meeting Melanoma & Complex Skin Cancer MDM Care Pathway, Referral & Audit Practice Elsewhere – draft Manual of Cancer Services Standards For Skin Cancer Services

Melanoma & Complex Skin Cancer MDM Update on Current Arrangments Discussion Criteria (copies provided) Proposed move to Regional MDM NICE Guidance for Specialist Skin Ca MDM Timetable Enablers / Inhibiters Clinical Minimum Dataset – Informed by NICR Dataset

Update on Current Arrangments Dr Maureen Walsh

NICE Guidance on Specialist Skin MDM Defined as : MDM for discussion of patients with invasive skin cancer associated with greater risk or rarity. Minimum Population served: 750,000 Frequency: least fortnightly Belfast Trust 340,000 + regional service Northern Trust 440,000 South Eastern Trust Southern Trust 290,000 Western Trust

Core Members Dermatologists (at least two- one with a major interest in skin cancer and/or skin cancer surgery; another ideally with a major interest in cutaneous lymphoma) Surgeons (at least two who perform at least 15 block dissections each per year) Skin Cancer Clinical Nurse Specialist(s) Histopathologist (at least two dermatopathologists or histopathologists with an interest in dermatopathology) Radiologist Medical Oncologist Clinical Oncologist Palliative Care Specialist Co-ordinator Liz to provide update on Board and Network Development Plan Martin Eatock or Fionnuala to provide update on D&T

Additional Members Trained Counsellors Psychologist / Liaison Psychiatrist Pharmacist Cosmetic camouflage service advisers Clinical Geneticist/ Genetic Counsellors Lymphoedema Therapists Occupational Therapists Prosthetics and Orthotics staff Physiotherapists Radiographers Speech and Language Therapists

Assigned Plastics and Oncology representation Timetable: Autumn 2008 Enablers: Assigned Plastics and Oncology representation Resources – room, equipment Job Plans Inhibitors: Incomplete core membership Time and Date Liz to provide update on self assessment against service standards Guidelines for patients who become sick - currently being disseminated by the Boards and are being highlighted at the Primary Care meetings being held across the Region Management of chemotherapy hypersensitivity – final draft forwarded with email; Propose final 2 week consultation – no comments received then will be signed off. Don’t propose going through it. Management of Neutropenic Sepsis – Draft 2 circulated and a draft highlighting comments. Propose a subgroup be convened to incorporate the proposed changes and come to some agreement on outstanding points e.g. temperature

Care Pathway Development SDU Request for pathway to be developed NICE Guidance states that main skin cancer groups require separate pathways Sample Pathways provided Generic Benign Cancer Access Pathway – Yorkshire Melanoma Pathway Non Melanoma, Malignant Pathway Need multidisciplinary subgroup to work up regional pathways Will project initial draft for some discussion To be submitted to project team by 12th December 07

NICR Audit – Dr Anna Gavin RACC Audit

Practice Elsewhere Draft Manual of Cancer Services Standards for Skin Cancer (closed for consultation) Sign off July 08 Peer Review against measures to commence in England in Oct / November 2008 Includes Measures for: Network Skin Group Local Skin MDTs Specialist MDTs Supranetwork T- Cell Lymphoma MDT

Download from http://www. dh. gov Link can be forwarded after meeting Cancer Services Collaborative Service Improvement Guide