Department considering cancer surgery centralisation plan

The NCCP submitted the first draft to the Department last year but was asked to make a number of amendments.

It is understood the document focuses on the centralisation of surgery for colorectal, prostate, and head and neck cancers.

At a meeting of the NCCP’s executive committee in February, Surgical Programme Manager Ms Maeve Cusack noted that a lot of surgical centralisation had happened in respect of breast, pancreas and lung cancers.

“More challenging tumour types are rectal and colon cancer,” stated the minutes seen by MI through Freedom of Information legislation.

“Agreed that surgeons doing low rectal numbers is a real risk and it is a priority to transfer rectal into designated cancer centres.”

At the committee’s meeting in September, NCCP Director Dr Jerome Coffey confirmed the surgical centralisation report had been submitted to the Department and that the NCCP would share the “salient points” with Prof Arnold Hill, Chair of Surgery at RCSI.

Prof Hill stated it would be “important for trainees to know that on-call” will be in eight specialist cancer centres.

Meanwhile, Prof Hill also enquired about the multidisciplinary team meeting (MDM) co-ordinating capacity of the National Cancer Information System (NCIS) and when it will be live in all eight centres. The Medical Oncology Clinical Management System, which was rebranded as the NCIS earlier this year, has faced delays in being rolled-out.

The meeting heard that University Hospital Galway would be the first to roll-out the system, followed by St James’s Hospital, Dublin.

“Once live, it would be rolled-out, depending on resources,” according to the minutes.

The NCIS will include recording referral for cancer MDMs; recording of the MDM recommendations; prescribing of systemic anti-cancer therapy (SACT); verification of prescription, support for pharmacy department aseptic preparation of chemotherapy and other medication for non-cancer patients; and recording of clinical assessments and administration of SACT.

The National Cancer Strategy 2017-2026 outlines the main requirements for completion of surgical centralisation. The number of designated centres for the management of common adult cancers remains at eight. “These centres need to plan for the projected increase in cancer incidence in the medium to longer term,” an NCCP spokesperson told MI.