Tayside Breast Cancer Independent Advisory Group: final report

The report on how best to implement changes to breast cancer management in NHS Tayside.

Annex C


General Background

Clinical management of breast cancer in NHS Tayside (HIS Report) published 1 April 2019


Clinical management of breast cancer in NHS Tayside: risk assessment of the Healthcare Improvement Scotland report, published 16 April 2019


MEL 1999/10- 9 Feb 1999 - Introduction Of Managed Clinical Networks Within The NHS In Scotland– see Annex C1 for extract


CEL 30 2012- July 2012 - [Revised] Guidance For the Safe Delivery of Systemic Anti-Cancer Therapy– See Annex C2 for extract


Patient consent

The full Supreme Court judgement on Montgomery vs Lanarkshire Health Board (11 March 2015)


GMC guidance on consent (2 June 2008, currently under review)


Occupational Development documents

Values Based Recruitment


Compassionate Leadership


NHS Scotland Staff Governance Standard


NHS Scotland iMatter process


Annex C1

Extract from MEL 1999/10- 9 Feb 1999 - Introduction Of Managed Clinical Networks Within The NHS In Scotland.

(Note- Paragraph numbering is as appears in original document)

8. In considering whether or not to confer such recognition, Boards, Trusts and the ME must take into account the degree to which the arrangements proposed satisfy the following core principles and are consistent with the policies in Designed to Care and the report of the Acute Services Review:

8.1 each Network must have clarity about Network management arrangements, including the appointment of a person who is recognised as having overall responsibility for the operation of the Network, whether a lead clinician, a clinical manager or otherwise. Each Network should produce a written annual report to the appropriate Health Board or Trust, which would also be available to the public;

8.2 each Network must have a defined structure which sets out the points at which the service is to be delivered, and the connections between them;

8.3 each Network must have a clear statement of the specific clinical and service improvements which patients could expect as a result of the establishment of the Network;

8.4 each Network must use a documented evidence base, such as SIGN guidelines where these are available, and must be committed to expansion of the evidence base through appropriate R & D;

8.5 each Network must be truly multi-disciplinary/multi-professional and should include representation from patients' organisations in its management arrangements;

8.6 each Network must have a clear policy on the dissemination of information to patients, and the nature of that information, bearing in mind the role of primary care in helping to lead the patient through the system;

8.7 all the health professionals who would make up the Network must indicate their willingness to practice in accordance with the evidence base and with the general principles governing Networks;

8.8 an integral part of each Network must be a quality assurance programme acceptable to the Clinical Standards Board for Scotland, which also has a role in ensuring consistency of standards and quality of treatment across all Managed Clinical Networks;

8.9 the educational and training potential for Networks should be used to the full, through exchanges between those working in the community and primary care and those working in hospitals/specialist centres. Networks' potential to contribute to the development of the intermediate specialist concept should also be kept in mind, and Networks should develop appropriate affiliations to universities, the Colleges and SCPMDE;

8.10 all health professionals in the Network must produce audit data to required standards and participate in open review of results;

8.11 all Networks must include arrangements to circulate staff in ways which improve patient access, and enable professional skills to be maintained. Each Network should have an appropriate programme of continuous professional development in place for every member of the Network, as well as a mechanism for ensuring the programme is being followed;

8.12 there must be evidence that the potential for Networks to generate better value for money has been explored.

Annex C2

Extract from CEL 30 2012- July 2012 - [Revised] Guidance For the Safe Delivery of Systemic Anti-Cancer Therapy

(Note- Paragraph numbering is as appears in original document)

1.4 Clinical Management Guidelines

1.4.1 A Clinical Management Guideline (CMG), as defined in the glossary, is in place for all common cancers. In paediatric cancer care, an approved clinical trial protocol may replace a CMG.

1.4.2 In rarer cancers, where there is no CMG, a SACT protocol is in place.

1.4.3 All CMGs or SACT protocols are approved by the appropriate, disease specific Managed Clinical Network (MCN) and local or regional governance arrangements.

1.4.4 An approved clinical trial protocol may be used in the absence of a SACT protocol.

1.4.5 Policies and procedures are in place to manage off-protocol requests for SACT, ensuring compliance with CEL (17) 2010.


Email: marianne.barker@gov.scot

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