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National Chemotherapy Advisory Group - an update . Elaine Lennan Consultant Nurse. NCAG. History Established 2004 and Co chaired by Professor Mike Richards & Dr Peter Clark Representation from all disciplines Medical, Clinical Oncology and Haematology Paediatrics
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National Chemotherapy Advisory Group - an update Elaine Lennan Consultant Nurse
NCAG • History • Established 2004 and Co chaired by Professor Mike Richards & Dr Peter Clark • Representation from all disciplines • Medical, Clinical Oncology and Haematology • Paediatrics • Network and PCT Colleagues • Learned lessons from NRAG • Aim To provide advice to the National Cancer Director on: • Safe & Effective Service Delivery • Equity of access to treatments • Commissioning Guidance
Cancer Reform Strategy • Chapter 4 of the Cancer Reform Strategy (Dec 07)covered areas around Chemotherapy: • Drug treatments • NICE Appraisals • Reduced Variation in drug usage • Better local Planning • NCAG • Ensuring safe Delivery of Chemotherapy (Peer review)
Linked very closely to • Darzi review • NRAG • NPSA oral chemo • NCEPOD SACT • Electronic prescribing • Updated national guidance on IT chemotherapy
NCAG would Cover: • Capacity and demand – year on year increases • Potential new service models • Out of hours management • Governance Structures • Workforce requirements • Specific safety issues • The management of febrile neutropenia • Guidance for Commissioners
4 main sections • 1. Deliver safe and effective care • 2. High Quality Information • 3. Access to new treatments • 4. Commissioning
1.Deliver safe and effective careService Models • Service Models are currently based on historical arrangements • May focus more on nurse led services • Delivering chemotherapy in different settings • Levels of care • Patient friendly services • Workforce implications • Governance structures to ensure safe services
1.Deliver safe and effective care Febrile neutropenia • Service guidance not detail of which antibiotic • Minimum safe practice • Timeframes -fever to antibiotic • Advice to patients
1.Deliver safe and effective care 24 hour emergency care OOH • Equitable access for everyone • ?network based • Staffed by chemo nurses on rota basis • Electronic records • Linked to e prescribing • Local Triage
2. High quality information • Good quality information lacking • Minimum data set • Horizon scanning • CPORT • E prescribing • Workforce planning
3.Access to new drugs • Horizon scanning advice • Linked to NICE changes • Informed by 3rd review of NICE uptake
4. Commissioning • Toolkit - guidance for commissioners • Framework • What facilities – different levels • What policies • What hours etc • ? Clinical pathways
Implications for nurses • First real driver for system change • Work streams led by nurses • Extension of nurse led services • More collaborative work within networks
Next steps post NCAG • Services will need to respond locally probably led by network • Existing work streams may need to develop further work • Interested in being involved? - speak to Network nurse director
NCAG • Possible Publication date October