Quality statement 1: Specialist pancreatic cancer multidisciplinary teams

Quality statement

Adults with suspected pancreatic cancer have their diagnosis and care agreed by a specialist pancreatic cancer multidisciplinary team (MDT).

Rationale

Early input from a specialist pancreatic cancer MDT can minimise delays to diagnosis, optimise staging strategy and ensure that all management options are considered. A specialist MDT can also provide specific expertise, including knowledge of novel treatments and ongoing clinical trials, which may not be available within a local MDT. The care agreed by specialist pancreatic cancer MDTs should be delivered in partnership with local MDTs. This should ensure that people with pancreatic cancer have access to support for a broad range of needs associated with pancreatic cancer such as nutrition, pain management, and coping with anxiety and depression.

Quality measures

Structure

a) Evidence of specialist pancreatic cancer MDTs in the area.

Data source: Local data collection, for example service protocols, or local or regional network arrangements.

b) Evidence of clear care pathways between local cancer units and specialist pancreatic cancer MDTs.

Data source: Local data collection, for example local or regional network arrangements, documented local referral policies or agreed patient pathways.

Process

Proportion of adults with suspected pancreatic cancer who have their diagnosis and care agreed by a specialist pancreatic cancer MDT.

Numerator – the number in the denominator who have their diagnosis and care agreed by a specialist pancreatic cancer MDT.

Denominator – the number of adults with suspected pancreatic cancer.

Data source: Local data collection, for example patient records or local cancer unit reports.

Outcome

a) Proportion of adults with a pancreatic cancer diagnosis confirmed by a specialist pancreatic cancer MDT.

Data source:  National Cancer Registration and Analysis Service.

b) Proportion of adults with pancreatic cancer receiving pancreatic cancer treatment.

Data source:  National Cancer Registration and Analysis Service.

c) Proportion of adults with pancreatic cancer who agree they were given enough care and support from healthcare services.

Data source: Local data collection, for example surveys carried out with people with pancreatic cancer or their families.

What the quality statement means for different audiences

Service providers (local cancer networks, secondary care services, community imaging services and specialist cancer centres) ensure that pathways and systems are in place for specialist pancreatic cancer MDTs to review all cases of suspected pancreatic cancer. They also ensure that care agreed by the specialist pancreatic cancer MDTs is delivered in partnership with local MDTs, and that people have access to support for a broad range of needs associated with pancreatic cancer such as nutrition, pain management and coping with anxiety and depression.

Healthcare professionals (such as members of the local cancer network, clinical oncologists and radiologists) are aware of local pathways for pancreatic cancer and work in partnership with specialist pancreatic cancer MDTs to ensure accurate diagnosis. They also work with the specialist pancreatic cancer MDTs to plan treatment and provide care and support to meet a broad range of needs associated with pancreatic cancer such as nutrition, pain management and coping with anxiety and depression.

Commissioners (NHS England and clinical commissioning groups) ensure that they commission standardised pancreatic cancer care in which adults with suspected pancreatic cancer have their diagnosis and care agreed by a specialist pancreatic cancer MDT.

Adults who may have pancreatic cancer have their condition reviewed by a team of specialists called a pancreatic cancer multidisciplinary team. This team has special expertise in diagnosing and treating pancreatic cancer. They can also make sure that adults who are diagnosed with pancreatic cancer get pain relief, help with nutrition, and advice on where to find support for other problems such as anxiety or depression.

Source guidance

Pancreatic cancer in adults: diagnosis and management (2018) NICE guideline NG85, recommendation 1.2.1

Definitions of terms used in this quality statement

Suspected pancreatic cancer

Pancreatic cancer is suspected based on findings from a standard CT and/or a pancreatic protocol CT. Pancreatic cysts with high-risk features of pancreatic cancer are included.

[Expert opinion]