Peggy Turner Room, North Wing, St Bartholomew's Hospital
.
Renal Cancer Pathway Network Meeting
Monday 7th April 2014
17.30 – 18.30pm
Peggy Turner Room, North Wing, St Bartholomew's Hospital,
London EC1A 7BE
Action1. / Apologies ( see Appendix 1)
2 / Introduction and Agenda – Michael Aitchison (chair)
Follow up pathway (MA)
Patient Survey (feedback) (DC/MA)
MDT referral and outcome forms (NR)
Patient Information flow (DC)
3 / Follow up pathway
MA presented a revised version of the follow up pathway previously agreed at a pathway meeting. TP agreed that the current EU guidelines were not based on a systematic review of evidence and the debate is continuing at that level however there was a general feeling that 6 monthly review was too much.
Changes to the pathway were agreed and the revised version will be included with the revised MDT outcome form and also be included if possible on Cerner (shared drive).
It was agreed that the follow up pathway was important guidance for CNS' and junior doctors and the decision for follow up should be made based on this protocol once the patient's histology result is known and discussed at the MDT.
NR stated that the follow up pathway for patients following cryotherapy and radio frequency ablation was currently different as there was no histological examination of margins but this was a field for future research. NR to discuss with Rowland Illing and Miles Walkden to agree a follow up protocol for these patients.
DC stated that once the clinic moves all patients will receive a treatment summary. / GA to amend slide before circulation
MA/JC
NR
4 / Patient survey
MA and DC presented the current RFL patient survey based on a Scottish version which was research based and used 3 domains which had been identified as what patients wanted to know:
- communication
- information sharing
- shared decision making
The survey which includes specific questions for inpatient nephrectomy and ward experience would be run for 12 month and then the content reviewed.
It was agreed that a presentation of the survey and feedback received would be presented at the June Pathway meeting.
5 / MDT Referral and outcome form
NR presented the current HPB MDT referral form as an example of one which was too onerous for referrers to complete. Referral forms are required to provide sufficient information to ensure that the SMDT could make an informed decision and a version which was streamlined as suitable for renal cancer referrals to the MDT was presented to the meeting.
This version allows information to be cut and pasted into Infoflex, allowing a full history to be available if required. It does require referrers to be responsible for ensuring that the CT and report comes with the referral.
MA proposed that he would take responsibility with the MDT co-ordinator to go through the referrals, after screening by NR, and feed back on incomplete forms to educate referrers and advise them of the risks of sending incomplete referral requests.
TP agreed with the caveat that where patients were not 'refused' when referred by repeat offenders.
This process will start next week.
NR to talk to Infoflex re 'cut and paste' options.
It was agreed that the next Pathway meeting (Thursday 8th May) should be used for the annual meeting for the SMDT and could be used to discuss the progress made over the last year. (Plus patient satisfaction???) / MA/ Chinma
NR
ALL
6 / Patient Information flow
DC informed the meeting that he had been auditing clinic letters on a monthly basis and can now pick up when letters have not been dictated. There is now an ongoing audit to check the status of letters and this has improved since January. Where a patient is seen by more than one consultant, each is responsible for dictating a letter in clinic and currently this process is on track.
Following the MDT meeting the MDT co-ordinator sends an outcome form for each patient to their referring centre using their generic MDT email address.
7. / Date/Time and Venue of Next Meeting:
Thursday 8th May 2014 17.30 – 18.30pm MDT ANNUAL MEETING
Renal / Medical Library Royal Free London
Future meetings are as follows:
Monday 7th June / 5.30 – 6.30pmThursday 7th July / 5.30 – 6.30pm
Appendix 1 Attendees 07/04/14
Name / Initials / Role / BaseGillian Smith / GS / Consultant Surgeon & Service Line Lead / RFL
Michael Aitchison / Lead Renal Cancer Surgeon / RFL
Faiz Mumtaz / Consultant surgeon / RFL/BCF
Tom Powles / TP / Lead Renal Cancer Oncologist / Barts Health/RFL
M. Al Akraa / MAl / Consultant surgeon / RFL
Navin Ramachandaran / NR / Lead Renal Cancer Radiologist / UCLH/RFL
Katia Boleti / KB / Consultant Oncologist / RFL
Geraldine Alder / GA / Project Manager RCC / RFL
David Cullen / DC / Lead Renal Cancer CNS / RFL
Cliodhna O'sullivan / COS / Macmillan CNS / RFL
Apologies received
Name / Initials / Role / BaseAnju Sahdev / Barts Health
Rowland Illing / UCLH
Sandeep Gujral / BHRUT
Imran Syed / BHRUT
Guy Webster / RFL/BCF
Prakti Prasad / Barts Health
Harshawardhan Godbole / NMH