Lung Tumour Board
Dr Sara Lock, Consultant respiratory physician, Whittington Hospital
The Board has met three times to discuss business and has in addition had two half day research meetings. All are well attended. Changes to the structure will include Professor Spiro stepping down from the Lung Cancer MDT at UCLH and from the Chairmanship of the Board. The Board will be seeking an adequate successor to Chair it as soon as possible. The Network decision to use InfoFlex rather than Dendrite, for a number of reasons, was a disappointment to some, given the considerable development work undertaken by Professor Spiro. Time will tell as to whether InfoFlex can provide what is necessary and whether lung cancer, an extremely important tumour in its own right, is given due preference and status by the Network in general.
The entry to clinical trials is variable, particularly due to the closure of two trials run by the London Lung Cancer Group in small cell and non small cell lung cancer. However, other trials are in progress and new trials are about to start. Lack of an NCRI Nurse/Research Assistant has given considerable limitation to progress at UCLH. BCFH does not have NCRI support at all for lung cancer, which is another weakness.
There are still major concerns that surgical patients from RFH are still being sent outside the Network despite a uniformly excellent thoracic surgical service across the Network from the Heart Hospital. Such referrals outside the Network must cease forthwith. At the moment plans to link a joint thoracic surgical post between the Brompton and UCLH seem not to be going forward and this could be a major concern for the future.
| Hospital | Diagnosis | Surgery | Chemotherapy | Radiotherapy | |
| Simple | Complex | ||||
| BCFH | Y | N | N | N | N |
| NMUH | Y | N | Y | Y | Y |
| PAH | Y | N | Y | Y | N |
| RFH | Y | N | Y | Y | Y |
| UCLH | Y | Y | Y | y | Y |
| Whit | Y | N | Y | N | N |
The Board has agreed the following action plans in response to the Peer Review:
- Concern 1: Involve the PAH physicians and management representatives.
ACTION AGREED: Dr Newberry has been invited to and has attended the Board as do Gordon Read and Julian Singer. A lung CNS post at PAH has been advertised. - Concern 2: Clinical Governance, IOG non-compliance and reporting should be strengthened.
ACTION AGREED: Non-compliance/meeting targets to be a rolling item on the agenda. - Concern 3: Identify inequities in service across Network, eg. access to PET-CT, CT-guided biopsies and pathology.
ACTION AGREED: To update the list of personnel, highlighting gaps in service especially where there is non-compliance of targets. - Concern 4: Develop an agreed mechanism for obtaining user advice.
ACTION AGREED: To be actioned. - Concern 5: Data collection.
ACTION AGREED: Each Clinical Lead to determine local solution to data collection and ensure that minimum data for LUCADA is collected and uploaded. - Concern 6: Improve patient information.
ACTION AGREED: The Lung CNSs have looked at patient information and have completed the mapping process. The CNSs felt that each Trust had sufficient information, but the problem of leaflets in different languages was a national one and unlikely to be resolved at individual Trust or even Tumour Board level. - Concern 7: Strengthen involvement with palliative care services.
ACTION AGREED: To ensure each Trust has sufficient lung CNS support with palliative care connections. - Concern 8: Pursue innovative approaches, eg. diagnostic tests and PET-CT provision.
ACTION AGREED: Each Trust to ensure rapid access to CT scans, some of which will be preappointment. An audit was initiated on PET-CT waiting times. A business case has been put in for EBUS at UCLH. - Concern 9: Streamline service improvement initiatives.
ACTION AGREED: Each Trust to ensure rapid access to CTs, some of which will be pre-appointment. - Concern 10: Improve research infrastructure.
ACTION AGREED: To be actioned. -
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