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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 measures what s new

Chemotherapy MeasuresWhat’s New?

Anne Hines

Marie Brazil

general draft still
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

nomenclature
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

nomenclature cont
Nomenclature cont
  • Course – complete period of treatment for a particular regimen
  • Cycle – repeated pattern over which the drugs are given
1a s network board
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
1e s functions of network chemotherapy group
1E’s – Functions of Network Chemotherapy group
  • Old 12 measures, new 13
  • Requires – annual review, work programme and annual report
1e s treatment algorithms
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)

1e s error reporting
1E’s – Error Reporting
  • The NCG should review the reported errors of the CCS’s and agreed remedial actions.
1e s training and assessment policy
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

3s s 1 s chemotherapy services
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

3s s 1 con t
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
3s s 1 con t12
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

3s s 1 con t13
3S’s - 1 con’t
  • Chemotherapy dataset
  • - this measure will be included following implementation of the chemotherapy dataset in 2012
3s 2 s oncology pharmacy
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.

3s s 1 con t15
3S’s - 1 con’t
  • 207 – 209 – Electronic prescribing
    • SOP, variations, validation
  • Vinca alkaloids – correction requested for childrens services
10 3s 3 intrathecal chemotherapy itc
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
don t forget acute oncology 3y s
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