Collaborative and Compassionate Cancer Care: cancer strategy for children and young people 2021–2026

Section 1 - Our Story so Far

The MSN CYPC was officially launched in 2011 to ensure a single sustainable model of service delivery for children, teenagers and young adults with cancer. It was recognised that adopting a network approach could support services to further improve outcomes. The creation of a pan Scotland co-ordinated network supported all relevant clinicians operating across the NHS Scotland children and young people's main cancer centres to work collectively in accordance with national standards and guidelines. Cancer plans were published in 2012 and 2016 and have driven the development of a single service and fostered national collaboration, aiming to deliver a world class service for our children and young people.

MSN CYPC Foundations

• Develop a single, sustainable and cohesive service for Scotland providing guidance on service development, supported by robust shared care arrangements and multidisciplinary ways of working on treatment and beyond
• Develop and embed governance frameworks that support the work of the MSN CYPC to ensure the safety of children and young people
• Ensure that all children and young people in Scotland have had the opportunity to be included in an appropriate clinical trial
• Develop and monitor patient pathways, standards and supporting systems to ensure consistent data standards, collection and management
• Ensure patient involvement at all levels including network activities and monitor patient satisfaction
• Develop sub-specialisation, agreeing referral guidelines and advising on strategic workforce issues including key appointments
• Lead on the establishment of a robust eHealth strategy, supporting the functioning of multidisciplinary teams and the delivery of services
• Facilitate mutual support arrangements between units when required
• Lead on national education and training issues, research and the establishment of a national academic resource
• Promote the early detection of cancer in children and young people
• Ensure that the work of the MSN CYPC is widely communicated to all stakeholders
• Develop and implement best practice frameworks for multidisciplinary teams

Governance and Structure

The MSN CYPC works in partnership with the 14 territorial Health Boards and frontline clinical staff. National multidisciplinary working is pivotal to delivering our vision, promoting consistency and equity of care. The MSN CYPC, while not a legal entity, holds accountability for the delivery of the NHS Scotland Children and Young People's Cancer plans, and this new strategy, with the operational delivery of services lying directly with each territorial Health Board. Key to delivering a single national service is collaboration, networking and communication; this is supported by the MSN CYPC's organisational operating structure (Appendix 1).

National Multidisciplinary Teams

Multidisciplinary working with regards to treatment is widely accepted as the 'gold standard' of cancer care delivery across the world. Throughout the UK, health departments have obligated multidisciplinary team (MDT) working in order to ensure reliable and equitable delivery of safe and high quality care that is necessary to improve patient outcomes. In addition to delivering safe management plans for patients, the national MDTs maximise expertise, facilitate data collection, support cancer registration and audit, provide educational value, guide patient pathways and provide reassurance to patients and families that high quality care is being delivered.

Cancer multidisciplinary teams meet regularly in multidisciplinary meetings (MDMs) to discuss and agree treatment recommendations for individual patients. Members include oncologists, surgeons, radiologists, pathologists, palliative care clinicians, pharmacists, specialist cancer nurses, social workers,^[1] clinical psychologists, clinical geneticists, dietitians, occupational therapists and physiotherapists. They also have a governance role to ensure the quality and safety of care, by overseeing and monitoring the impact of treatment decisions. Table 1 demonstrates the current MDTs that exist within Scotland for children and young people's cancer services to ensure joint assessment of all new cases of children and young people with a diagnosis of cancer and agreement upon their ongoing treatment and management. For teenagers and young adults, all patients are discussed at a national TYA MDT that works alongside the traditional site specific MDTs which have responsibility for treatment recommendations.