Public BoD papers 26.5.22

BD noted that the cyclotron can be temperamental and that there is time each month for servicing to the cyclotron. Patients are managed to ensure they are not impacted by any downtime. The gantries are staffed up until 9pm where needed. KW asked about the limited number of indications that were commissioned for PBT and if this has changed in the 3 years since opening. ES noted that it has not changed, and that we are limited to radical treatments for paediatrics or for dose escalation for adults where radical treatment couldn’t be done with x-ray radiotherapy. ES noted that referrers are more aware of who can be referred as well as unwell patients now being able to use a service on UK soil. Numbers have increased year on year. The evidence base is building all the time to look to increase the patients that can be treated. The focus on research is very important and these developments will provide much more evidence base for other types of cancer. CO noted the constraints from NHSEI. ES noted that there is a process for discussing difficult cases so there is some flexibility. JA noted that growing the indication list is in our interest and we are looking at evaluative commissioning and growing our research studies as a priority. CH noted the MDT working is the core element of cancer care and this service exemplifies this. Referral pathways must connect across the country. Sally Corbett explained that referrals are sent to the national portal, the imaging is then requested as well as upload of all other information. The referral is then sent to a specific panel and the decision is made to treat or not. Most referrals are accepted and allocated. This then comes to us and is listed for an MDT where the information is discussed, and the decisions are made. It’s a complex system that works well and the process is quicker and works much better after 3 years. Everyone knows what is needed and the turnaround is quick from referral to acceptance of the patient. NB noted the responsibility to educate and train our future workforce in PBT and there’s an ambitious programme to do this. ES noted that there is a proton school to train staff nationally and internationally. We learned from others and are now supporting others through our School of Oncology. Observations and Fellowships are also in place and the ongoing relationships are helpful through this. Diagnostic and therapeutic radiographer hybrid working has been taking place that we have won an award for. We’ve used radiographers from the other Christie centres and given them opportunities to work in PBT. RF noted that regarding the PBT education programme, some of the work for undergraduates around coached/mentored activity is highly original and draws on contemporary education theory. Alison and team have been hugely successful and are working through evaluation and dissemination. This has fostered stronger links with Liverpool based colleagues too. https://www.christie.nhs.uk/about-us/news-at-the-christie/latest-news-stories/the-christie-wins-a- prestigious-healthcare-award

CO thanked the team for coming along and talking about their service. CO noted that we are hoping to move to face-to-face meetings soon. Item 15/22 Standard business a Apologies Apologies were received from Roger Spencer (RS), Chief Executive b Declarations of Interest No declarations of interest noted. c Minutes of the previous meeting – 31 st March 2022 The minutes were accepted as a correct record.

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