1. Peer Review of Cancer MDTs Presentation to Gynae Regional Group, 22nd May 2009

2. PEER REVIEW OF CANCER MDTS Service Framework Standard Peer review established in all other regions of UK Funding RMSG Appointed National Peer Review Team First round – lung, gynae, breast, colorectal; 50% of all new cancers diagnosed

3. Principles of PR Programme clinically led peer on peer review greater emphasis on outcomes developmental approach that builds on Trusts internal governance and risk management processes patient and carer involvement integration with other review systems

4. Aim of peer review Ensuring Services are as safe as possibleImproving the quality and effectiveness of careImproving the patient and carer experience Undertaking independent, fair reviews of servicesProviding development and learning for all involvedEncouraging the dissemination of good practice

5. Benefits / outcomes Enhanced multi-professional working Confirmation that cancer services are of approved quality and are consistent across the region Ability to benchmark

6. Benefits / outcomes Enhanced local system management processes to support governance and appropriate allocation of resources within cancer Embeds service improvement into practice Highlight any regional issues which require a Network intervention / response

7. Programme Structure Peer review reference group - lead planning and delivery - accountable to NICaN Board - provide direction to coordinating team - membership Zonal coordinating team – Mike Bellamy (Quality Director) – John Bolton (Clinical Director) –Angela Hoyes (Quality Manager)

8. Peer review visits – all teams in first year; targeted thereafter. Self-assessment +/- internal validation - all teams, annual Externally verified self-assessment - all teams, annually 3 STEP PROCESS

9. What is reviewed? 1. Performance against measures within Manual of Cancer Services –Membership –Attendance –Operational policies –Clinical trials –Audit –Patient feedback –Patient information

10. 2. A range of clinical issues highlighted as areas of for development in local & national audit

11. Operational PolicyAnnual Report Work Programme Describing how the team functions and how care is delivered across the patient pathway Outlining policies/processes that govern safe / high quality care Agreement to and demonstration of the clinical guidelines and treatment protocols for team. Summary assessment of achievements & challenges Demonstration that the team is using available information to assess its own service -MDT Workload & Activity Data (activity by modality, surgical workload by surgeon, numbers discussed at MDT, MDT attendance) -National Audits -Local Audits -Patient Feedback -Trial Recruitment -Work Programme Update How the team is planning to address weaknesses and further develop its service. Outline of the teams plans for service improvement & development over the coming year -Audit Programme -Patient feedback -Trial Recruitment -Actions from previous reviews

12. Support mechanisms 1.Trust familiarisation visits – end of June 2009* 2.Shadowing opportunities – 2 per trust (4 Belfast) 3.Handbook & evidence guides 4.Peer review preparation sub-groups of regional groups 5. Trust coordinating teams established 6.Pre-visits in September 2009

14. Process & Timescales Preparation of evidence Evidence uploaded onto CQuINs Pre-visits External verification (desk top review) July 2009 – Dec 2010 By 14 th Feb 2010 Last two weeks Feb 2010 First week March 2010 Self assessment Jan 2010

15. Last two weeks of April 2010 31st May 2010 11 th June 2010 30 th June 2010 Peer review visits* Feedback reports issued to Trusts Trusts to return factual corrections to zonal Quality Director Final feedback report issued to Network & Trusts Publication on CQuINs Resubmission of amended evidence / assessment By 31 st Mar 2010

16. PEER REVIEW REPORTS Final reports – Trust reports + summary network report 1.Published on CQuINs 2.Following notified Trust Chief Executives NICaN Board RHSCB cancer lead(s) RMSG RQIA Chief Medical Officer Chairs of LCGs Patient & Client Council

17. COMMENTS or QUESTIONS?

18. Mike Bellamy Director for Peer Review for London Zone since Dec. 2003 (covered 5 networks and 30 Trusts) Chaired London Cancer Services Reference Group 2000-02 Led review of cancer services across London 1996 Worked in NHS in London for 32 years with 18 years being as a CEO. Worked with cancer teams at Mount Vernon- 9 years, Charing Cross/ Hammersmith- 10 years, as well as at the Royal London and at St Thomas.

19. John Bolton Trained as a General Surgeon and worked as a Consultant in a DGH in North London for 22 years (specialty area OG surgery). Cancer Lead at Chase Farm Hospital Trust 4 years and following the merger with Barnet Hospital Trust, Cancer Lead for the merged trust for a further two years. Medical Director of Chase Farm for three years and following the merger Joint Medical Director of the merged trust for a further one year. Clinical advisor for the London & the South East Zone and has been involved in three rounds of visits to 7 networks with the 30 acute hospitals across London which have covered all the common tumour services. John has also undertaken reviews for Mike Richards and the Cancer Action Team of Oesophago gastric services in various parts of the country where the need for reconfiguration, as required by the IOG, has been contentious and restricted progress.