From: Re-organisation of oesophago-gastric cancer care in England: progress and remaining challenges
Aspect of care | Peer Review results | Â |
---|---|---|
Referral pathways | 55% of the networks had referral guidelines agreed for diagnostic referral to secondary care | 49% of the networks had guidelines agreed for referrals from secondary to tertiary care. |
Network structure | There were significant gaps across all cancer sites in provision of oncologists, pathologists, radiologists, palliative medicine consultants and clinical nurse specialists. | 37% of networks had specialist surgical teams with a 24-hour on-call rota (i.e. contained a minimum of 3 surgeons). There was wide regional variation in this from 13% (East) to 60% (South). |
MDT structure | Units and centres had established their core MDTs in almost 100% of networks. Cover arrangements for core members (in case of annual leave etc) were in place overall in 58% of centres and 44% of units. | 46% of cancer centres and 33% of local units achieved the standard of core members attending half of the MDT meetings |
Clinical Nurse Specialist provision | The number of clinical nurse specialists per MDT was 1.4 for centres and 0.85 for units. | There was no clinical nurse specialist cover in 14% of cancer centres and 31% of local units, problems with workload and cover were reported in more than 20 centres and 30 units. |