The cancer clinical advisory groups (CAGs) are the clinical arm of the Wessex Cancer Alliance, supporting the delivery of high quality services and the cancer elements of the NHS Long Term Plan in each cancer pathway across Wessex.

These groups act as the source of expert clinical opinion for a wide range of clinical service issues including best practice clinical guidelines, optimum treatment pathways and patient focused care.

Some CAGs are based across the whole of Wessex, while others are separate Dorset Site Specific Groups (SSG).

Terms of reference

updated May 2024

These terms of reference are written to summarise the core approach of CAGs, and to reduce variation and effort in CAGs producing separate documents. In some exceptional cases e.g. cross-cutting groups with a specific service development mandate may wish to develop separate Terms of Reference which will be presented for review to the WCA Clinical Reference Group for approval.

Purpose

To bring together Clinical Advisory Group membership to:

• Advise the Wessex Cancer Alliance and Commissioners by providing clinical opinion and expertise
• Facilitate collaboration between teams and across their member organisations to reduce unwarranted treatment variation and deliver high quality care to all patients in Wessex
• Ensure annual work plans are produced, delivered and reviewed
• Monitor progress on meeting national standards and guidelines across Wessex
• Consult with other CAGs on relevant issues and to seek the advice of other subject experts

Specifically, the responsibility of the CAG is to:

• Agree referral and clinical guidelines and review these on a regular
• Consider the impact of national guidelines/standards published by NICE, Department of Health, Royal Colleges and other professional bodies/committees setting out best
• Review clinical outcome, performance and patient experience data identifying and addressing
• Review approved clinical trials and other research & development initiatives and encourage patient entry with its constituent MDTs
• Provide a forum for the presentation of local audits and project initiatives as part of its role in education
• Where appropriate undertake Wessex-wide audit of service and quality
• Ensure patient and carer involvement in service issues and in the development of
• Develop MDT function across the CAG, including introduction of MDT streamlining (using agreed Alliance-wide standards of care where appropriate)
• Supporting the future development of cancer pathways across primary, secondary and tertiary care to ensure sustainable and high quality clinical services
• Identifying workforce recommendations in response to service developments, recruitment difficulties and emergent technologies
• For cancer site-specific CAGs – to focus creative energy on delivering the ambition to diagnose 75% of all cancers at an early stage (stage 1 or 2) by 2028

Structure

CAG Membership will be multidisciplinary with representation from professionals across the care pathway, and will actively engage all multidisciplinary teams (MDT) from the relevant constituent organisations in the Network.

Each Trust/MDT should aim to have one medical/surgical representative and one Nurse/AHP representative. Each Group will have a named WCA GP/Primary Care Group member and a WCA Leadership Team member, to provide continuity of communication and support. Other MDT colleagues and/or key stakeholders can be established as core CAG members by mutual agreement, co-opted to attend a meeting or task and finish groups as required according to their expertise or experience.

An up-to-date list of Core Membership of the group including Trust/MDT representatives and other agreed key stakeholders will be maintained and held by the WCA CAG business administrator.

Meetings will be considered quorate when 50% of the member Trust MDTs are represented by a Consultant and/or CNS or Lead Nurse. If a Trust/MDT representative member of the group is unable to attend a meeting, it is their responsibility to nominate a deputy who has the authority to make decisions and recommendations on their behalf, and who will report back to the local team they represent.

In exceptional circumstances where this cannot be achieved, key decisions can still be provisionally made and later finalised by written confirmation from the absentee.

Where there are currently some separate HIOW and Dorset groups, joint working and collaboration across Wessex is encouraged. At least an annual unified Wessex-wide meeting is strongly recommended to ensure local initiatives, education/training, and research best practice are shared.

Function and Process

Wessex Cancer Alliance expects that Clinical Advisory Groups will:

• Meet regularly and record attendance (usually three meetings a year, two on MS Teams, and one face to face meeting for education and networking). The minimum expectation is for two meetings a year
• Record and agree accurate and up to date minutes, key decisions and actions at each meeting. Establish sub-groups or time-limited ‘task-and finish’ project working groups where required

A formal agenda will reflect the CAG work programme and may feature the following items:

• Clinical Guidelines for optimum treatment
• Referral Guidelines
• Best practice timed diagnostic pathways
• Site-specific MDT functionality/streamlining
• Review of data (national audits and Wessex (Diis) data pack) and agree actions
• Pathways for personalised patient care
• Audit, Research and Clinical Trials
• Involvement of Users/Patient Voice
• Service Improvement and Workforce Development
• Wessex Cancer Alliance ambitions
• CAG clinical priorities and current issues/concerns