Lucy Gladman General Manager BHRUT Lung MDT Large Acute Trust 1 - - PowerPoint PPT Presentation

Lung Cancer MDT Project BHRUT Lucy Gladman – General Manager

BHRUT



Large Acute Trust

–

Population ~ 750,000



Treat 10% of London's cancers; 50% of NEL’s cancers



Financially challenged



Special measures since January 2014

Lung MDT



1st April 2014 – 31st March 2015*

–

303 primary patients diagnosed

–

306 patients discussed at MDT

–

203 treatments

 37 monitoring  44 chemo  6 chemo radiotherapy  39 palliative care  50 surgery  27 radiotherapy 

Staging completeness Jan – Dec 2014 – 89%**

* Somerset, ** COSD

Project Objectives

 To establish baseline metrics;  To redesign and implement an MDT model that meets

the requirements of the London Cancer pathway specification;

 To devise a plan for monitoring and evaluating the

effectiveness of the redesigned MDT;

 To measure and evaluate the impact and effectiveness

• f the revised MDT model and ensure alignment with

national best practice;

 To use the intelligence gained to develop a “blue print”

model and recommendations for wider implementation.

Project Support

 Two partnered Trusts to pool expertise;  Supported by Medical and Educational Grant

from Pfizer;

 Project manager appointed from Quintiles;  Lead Clinician for Cancer;  Lung MDT Clinical Lead;  Service Manager for Respiratory;  General Manager for Cancer.

Baseline Data



Top priority KPIs:

–

Time from referral to DTT;

–

Number of patients who go on to treatment;

–

Number of patients who go on to be enrolled in clinical trials;



Additional KIPs

–

Number of new patients per MDT;

–

MDT attendance;

–

Time from referral to diagnosis;

–

Time from referral to staging;

–

Time from staging to DTT MDT;

–

Proportion of patients to:

 Surgery  Chemotherapy  Palliative intervention.

Project Timeline

Workshop

 7th January 2015;  23 attendees

– Physicians, Surgeon, CNS’s, MDT Coordinators,

Hisptopathologist, Oncologist, Palliative Care, Radiologist, Managers

 17 high level actions identified;  Three overarching themes:

 MDT  2WW  Surgery

Actions Identified

 Excessive workload of the lung cancer MDT

and need for lung nodule MDT;

 CT scan required prior to first OPA;  Optimise days for EBUS;  Increased lung function capacity required  PET scanner needed;  Communication between Trusts  Improved data

Actions Implemented

 Nodule MDT;

– Protocol written; – Budget identified for admin support; – Advertised and interviewed 27th May. – Start date TBA!

 To pilot nurse-led nodule service;

– Business case to be developed

Actions Implemented

 CT scan prior to first OPA;  Previous implementation put 2ww target at

risk;

 Audit undertaken of 2 weeks of 2ww referrals;

– Understand actual demand – Try to establish protocol for Cancer Referrals Office

 Meeting held with radiology for them to

understand MDT requirement;

 Need to identify area for CT hydration patients

Actions Implemented

 Excessive workload of MDT;  Audit undertaken of delayed patients due to

unavailability of notes at MDT;

 Nodule MDT will move some workload;  Inter-MDT process refined;  EBUS moved to Wednesday;

– Reduces number of patients not discussed at MDT;

 Review MDT Coordinator support;

– Pool work across site; – Band 3 support to coordinate MDT agenda

Actions Implemented

 Enabling works for PET scanner;

– Awaiting financial approval;

 Need business case to increase lung function

test capacity;

 Meeting with Bart’s Health – 4th June 2015, to

improve communications;

 MDT received training on how to improve data

quality for NLCA;

 Review MDT once all actions implemented.

Summary

 Identified short, medium and long term actions;  Brought team together;  Focused the actions needed;  Raised profile of cancer targets with the

clinicians;

 Identified audits to be undertaken;  Project overran;

– Restructure; – CQC re-visit

 Committed to keeping up the actions.

“If there is no struggle, there is no progress.” Frederick Douglass