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

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Chemotherapy MeasuresWhat’s New?

Anne Hines

Marie Brazil


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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


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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


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Nomenclature cont

  • Course – complete period of treatment for a particular regimen

  • Cycle – repeated pattern over which the drugs are given


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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


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1E’s – Functions of Network Chemotherapy group

  • Old 12 measures, new 13

  • Requires – annual review, work programme and annual report


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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)


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1E’s – Error Reporting

  • The NCG should review the reported errors of the CCS’s and agreed remedial actions.


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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


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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


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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


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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


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3S’s - 1 con’t

  • Chemotherapy dataset

  • - this measure will be included following implementation of the chemotherapy dataset in 2012


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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.


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3S’s - 1 con’t

  • 207 – 209 – Electronic prescribing

    • SOP, variations, validation

  • Vinca alkaloids – correction requested for childrens services


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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


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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


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