West of Scotland Lung Cancer MCN 20022003

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West of ScotlandLung Cancer MCN 2002-2003

• Dr. Noelle ORourke
• Lead Clinician

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Challenges for WoS Lung Cancer MCN

• The scale of the enterprise 16 hospitals, 2700
  new patients per year,5 Health Boards
• Smoking rates, lung cancer incidence,
  socio-economic deprivation, co-morbidity levels,
  geographical access

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Network Objectives

• To improve quality of care and outcomes for
  patients
• To deliver access to specialist lung cancer MDT
  care throughout the WOS
• To ensure effective communication and minimise
  delays in the system
• To support and inform patients and carers
  throughout

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Evolution of WoS Lung MCN

• Lead Nurse, Clinician and Manager appointed by
  interviews March 2002
• Advisory Board established May 2002
• Mailing list of 300 and growing
• Five current active subgroups
• Subgroup meetings, Open meetings, Newsletters,
  Annual report
• Site visits to all hospitals

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Data and Audit

• Network dataset agreed to cover SCTN and CSBS
  requirements
• Software to collect the dataset offered to all 16
  hospitals
• Baseline data from CRAG audit broken down by
  hospital
• First call now out for data returns
• Guideline on data process in preparation

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Protocol Development

• Referral with suspected lung cancer
• Radiology and imaging
• Chemotherapy for lung cancer
• Referral to PAMs
• In development referral to palliative care,
  referral for surgery, oncology, systematic
  approach to records

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Information and Support

• Patient information booklet written for all new
  patients, piloted with feedback, general release
  next funded for 3 yrs
• Treatment information video just completed
• Communication skills training programme underway,
  with own video made for teaching
• Patient information needs surveyed

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Lung Cancer Awareness

• Group comprising reps from Roy Castle, MacMillan,
  Cancer BACUP, Maggies Centre, professional,
  management
• Collating information from all these sources on
  issues raised by patients and carers
• Developing a strategy for promoting public and
  professional awareness to combat nihilism in Lung
  Cancer

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Clinical Trials

• Aiming to promote access and uptake of clinical
  trials across WoS
• Survey of all ongoing research and audit in
  Network
• Plan to publish lists of trials and information
  on website

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Redesign

• Patient Pathway project and mapping exercise
• WoS meeting February 2003 with Action Plans set
  by each HB
• Development of MDTs AA/L, local Network Lung
  Group AC, fast track GP referral project G,
  surgical mapping

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MCNs a triumph of hope and commitment so
far..but will ultimately fail to deliver
without strategic support
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How do we deal with.

• 5 Health Boards each with their own Cancer Plan
  and separate priorities
• Major differences in equity of access
• HBs who wont fund lung data collection
• HB with funding for 2 Lung Cancer CNSs who wont
  advertise
• HB which doesnt think surgeons are necessary for
  an MDT
• Cancer Centre management inertia on implementing
  CHART

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With huge thanks to

• An indefatigable Network Manager, the Lead Nurse,
  Chairs of subgroups, patients, carers and
  professionals who have attended meetings, worked
  hard in the subgroups and shown enthusiasm and
  commitment.
• And to industry sponsorship without which many of
  our meetings could not have taken place.

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Cancer in ScotlandAction for Change

• A Focus on Lung Cancer

11th November 2003 Apex Hotel, Dundee