Improving myeloma care together: spotlight on the myeloma Network Site-Specific Group (NSSG) professional information website, part of the Thames Valley Strategic Clinical Network, Regional Myeloma multidisciplinary team (MDT) and Oxford University Hospitals, Oxford.
Dr Sally Moore and Dr Karthik Ramasamy, Consultant Haematologists at the Churchill Hospital Oxford, told us how creating a Network Site-Specific Group (NSSG) website has proven an invaluable resource and positively impacted myeloma care both regionally and nationally.
What is the history of the NSSG website, and what prompted it to be initiated?
The NHS Cancer Plan published in 2000 and the subsequent Cancer Reform Strategy in 2007 set the tone and policy framework for cancer networks across England. Haematology network groups were created as part of this framework, focusing on developing regionally agreed policies and pathways to meet the quality outcomes in these plans.
NSSG – Haematology in Thames Valley is a collaborative with three groups dedicated to each haematological cancer information site: leukaemia, lymphoma, and myeloma. The NSSG developed diagnostic pathways and monitored cancer performance against agreed standards, regional MDT and protocols for diagnosis and treatment.
How are the resources and website developed and maintained?
We are fortunate to have in-house IT expertise, which enables us to build and maintain the website. This work is not outsourced or pharma-funded, so the resources are created for NHS use and driven by clinicians’ expertise, experience and needs.
The approach to building content is multidisciplinary, and the NSSG and regional MDT are intertwined.
We hold an all-day meeting annually, where 40 or so clinicians from across the region get together to review current protocols for relevance and accuracy and discuss any new resources required. This meeting also serves a useful educational purpose for keeping everyone up to date with current treatment strategies and helps to standardise myeloma management across the whole region.
Standardisation is further enabled because we share the same chemotherapy prescribing system across the region.
The protocols align with NHS England practice and guide the MDT discussions on individual patient management. The NSSG also contains regimens for use in the private sector to guide and support the appropriate management of patients treated outside the NHS.
What are the key success factors in the development of the NSSG?
A clear strength of the network is that it is genuinely collaborative, and there is mutual respect across all teams involved. This creates a valuable form of peer-to-peer education.
The group’s success relies on the time and expertise of a like-minded and committed group of clinicians. Having a dedicated team is essential for its ongoing success.
What impact has the NSSG had on myeloma treatment and care?
The fact that the NSSG website is widely used tells us that people trust it as a resource. It acts as a useful open-access reference tool, not just for doctors, pharmacists, and nurses locally but for clinicians working all around the UK.
As a resource, it is educational and provides support and reassurance to clinicians working in myeloma, underpinning the safe prescribing of chemotherapy with appropriate dose modification and toxicity prophylaxis.
The open nature of the protocol meetings empowers doctors to ask questions of the NSSG and MDT, with no issue too trivial or complex to raise. Hospitals which don’t sub-specialise can utilise the knowledge and experience of other clinicians to enhance their practice and grow everyone’s skill set.
The NSSG resource also supports other allied healthcare professionals to safely take on additional roles in prescribing and patient care. And most importantly, this can all lead to positive outcomes for patients: being able to stay on treatment longer; having more streamlined care; and getting the best possible results, including quality of life.
How do you see the NSSG developing in the future?
Time is a continual challenge and myeloma treatment is constantly changing, so we have to make sure the protocols are reviewed and updated in a timely way.
With this in mind, we would like to include more up-to-date information on the latest clinical trials available and the eligibility criteria.
There may also be scope to add specific content for other HCPs (nurses, primary care teams, pharmacists) and patients, possibly with digital content to include patients’ voices. Ultimately it is about improving the skill set of everyone involved in myeloma care – including the patients and carers themselves.