1. Regional Melanoma & Complex Skin Cancer Meeting
15th May 2008

2. 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

3. 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

4. Update on Current Arrangments
Dr Maureen Walsh

5. 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

6. 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

7. 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

8. 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 ; 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

9. 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

10. NICR Audit – Dr Anna Gavin
RACC Audit

11. 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

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