Background to the Programme
In 2021 the Scottish Government commissioned National Services Scotland to pilot a two year programme to establish a consensus process for the clinical management of cancer in Scotland. While there are existing regional, national and international guidelines in use there were challenges in maintaining some local guideline versions up to date and some differences between different areas in Scotland as to how treatments were offered. Consultation with the health-care professionals confirmed it would be helpful to get consensus from teams all across Scotland on which treatment options might be considered at points across the patient pathway from diagnosis right through to survivorship or end of life care.
Three tumour sites formed the basis for the pilot: breast cancer, lung cancer and adult brain tumours. For each we have drafted guidance for the health care professionals to cover the range of treatment options. This guidance was published on the Right Decision Service platform in September 2023 accessible to staff across Scotland, alongside other clinical guidelines with the RDS site overseen by Healthcare Improvement Scotland.
The initial two year programme has been approved for sustained funding and we shall in the coming year develop clinical management pathways (CMPs) for head and neck cancer and prostate cancer while continuing to update the existing three. In the longer term the aim is to provide consensus on management of all cancers in Scotland and to ensure these remain up to date and support the provision of equitable high quality care to all cancer patients in Scotland.
The professional consensus guides offer a concept of good practice but intending that the needs and wishes of the individual patient should be considered. The guides are not intended to be applied as rigid clinical protocols and there will be variation according to local services and individual patient factors.
The professional version CMP documents do not spell out detail on precise doses of chemotherapy or techniques for radiotherapy as these all sit within local departmental protocols. Similarly CMPs do not replicate all the existing guidelines on surgical techniques or pathology reporting standards. Instead the CMPs focus on which options for care should be considered at different points in the patient pathways. They are intended to support shared decision-making with patients and the aim of this accompanying patient facing resource is to empower patients and carers to participate in this process. We have attempted to distil the professionally tailored consensus guidance into a version which is accessible to all, without technical language.
We have deliberately not sought to duplicate the many valuable existing patient information resources on the principles of chemotherapy, radiation, staging of cancer etc., These are separately referenced as links from this website.
We recognise that this will be a dynamic process and that we shall need to learn from feedback as to what is helpful and what needs further clarity. We hope therefore that anyone accessing this information will send us feedback and let us know if they would be willing to contribute to further refine this resource.