1. Chemotherapy Measures What’s New? Anne Hines Marie Brazil

2. General – DRAFT still 1A’s – network board 1E’s – Network chemotherapy group 3’s – Cross cutting – 3S chemotherapy Numbering has changed 10 – 1E – 101s,102s etc 10 – 3S – 101,102 etc 100- chemotherapy service 200- oncology pharmacy 300 – intrathecal Note – no more stars – all important!! Pgs 11-13

3. Nomenclature Systemic chemotherapy im, oral, im,  Topical, intracavitary not included  Intrathecal – separate topic Regimen – defined by the drugs used Protocol – contains all the parameters specified in the measure Algorithm – acceptible regimen or range of regimens which may be used for a stated site specific situation Pgs 15 -16

4. Nomenclature cont Course – complete period of treatment for a particular regimen Cycle – repeated pattern over which the drugs are given

5. 1A’s – Network Board Old, 22 measures, New, 5 measures Covers leadership of chemotherapy services at network and board level Note that deliniation of chemotherapy services is now an acute onc measure

6. 1E’s – Functions of Network Chemotherapy group Old 12 measures, new 13 Requires – annual review, work programme and annual report

7. 1E’s -Treatment Algorithms Agree with NSSG a set of site specific chemotherapy algorithms – eg breast, haem, colorectal etc Network Algorithm Deviation Policy Network review of deviations Further clarity requested on definition of algorithm and how this fits with TYA measures – (no mention of algorithms)

8. 1E’s – Error Reporting The NCG should review the reported errors of the CCS’s and agreed remedial actions.

9. 1E’s Training and Assessment policy Network policy covering  Professional groups, activities needed to define process of chemotherapy, competency needed to work independently,  Network list of assessors  Named area of competence Networks appear to be being asked to maintain a current register of competent people – not feasible – should be done locally

10. 3S’s – 1’s chemotherapy services Old – 55 measures new- 35 measures 10-3S-103 – named wards 10-3S-104- specified room policy 107 – defining chemo MPT 111 – quality management system ? haematologist Not feasible in the time given if not already in place – no mention in NCAG or NCEPOD

11. 3S’s - 1 con’t 112 Error reporting – record and grade chemotherapy errors according to NPSA 113 Further pre-treatment consultation with “sufficient” time between the previous for pt to digest the information  Patient pathway  Department timetable

12. 3S’s - 1 con’t 118 – agreed list of treatment algorithms 119 – preventing regular deviation from the algorithm Still need protocols as well – 120 127 – patient experience exercise 128 – treatment plan to GP – regimen, startdate, planned duration, intent Protocols are not now network driven but locally driven

13. 3S’s - 1 con’t Chemotherapy dataset - this measure will be included following implementation of the chemotherapy dataset in 2012

14. 3S-2’s Oncology Pharmacy 201 Lead pharmacist – single designated lead only 204 But – also now need to list an aseptic lead 206 – computer generated prescriptions Note – no handwritten prescriptions is expected Further clarity on definitions of hand written etc requested as well as exceptions.

15. 3S’s - 1 con’t 207 – 209 – Electronic prescribing  SOP, variations, validation Vinca alkaloids – correction requested for childrens services

16. 10-3S-3 Intrathecal Chemotherapy (ITC) Old 50 measures – new 22 measures BUT A lot have just been condensed eg – no major changes to requirements for ITC. Lead, divisions, local protocol, register, risk assessment, hard copy of protocol, training competency assessors, who can administer, sequencing, labelling, prescription, collection, storage, room, normal working hours

17. Don’t forget acute oncology!! 3Y’s 1A – 302 – declaration of clinical chemotherapy services 1A- 303 – declaration of oncology pharmacy services 1A – 304 – review of services by network 3S-122 policies relating to acute oncology  Extrav, anaphylaxis, NS, emesis, stomatitis mucositis and diarrhoea  Cross refs to 10-1E110y and 1E-107y  Still not sure if need network policies for all of these as well