1. NHS England Service Specification for Thoracic Surgery (Adult)
Richard Page
Chair, Thoracic Surgery
Clinical Reference Group

2. Organisation of services - 1
24/7 emergency cover
Thoracic consultants ± support from mixed practice CT surgeons
No more frequent than 1 in 3
Referring Trusts should have the same level of support as those attending the Centre
Centres must undertake > 70 resections for primary lung cancer per annum, rising to 150 by end of

3. Resections for primary lung cancer 2015 (English Centres LLCOP data)
150/year
70/year

4. Organisation of services - 2
Lung cancer MDT cover to allow quorum of core members > 95%
Protocols in place to facilitate the provision of a second opinion for patients with early stage disease turned down for surgery

5. Exclusions Oesophagogastric cancer
Diseases of the heart and great vessels
Children's thoracic surgical services
(Rare thoracic surgical conditions e.g. radical surgery for mesothelioma, tracheal surgery)

6. Essential alliances/co-locations
Respiratory medicine
Thoracic physiotherapy
Specialist thoracic pathology
Frozen section within 1 hour
Interventional radiology and bronchoscopy

7. Consultant Surgical Staffing
Move towards at least 3 full-time thoracic surgeons in all units ASAP
Minimum thoracic practice within job plans for current CT surgeons:-
1 all-day thoracic list per week. No mixed CT lists
1 lung cancer MDT per week
Take part in emergency on-call rota
Specific appraisal on thoracic activity and outcomes
No mixed CT practices beyond 2020

8. Rationale/Evidence for splitting UK consultant CT practices
Range of diseases treated and the knowledge and therapies available are more diverse than ever before
More MDT work needed
Need to fit work within PA job plan
Volume effect of specialisation
Training limitations

9. Primary Lung Cancer Resection Rate (by Cancer Network)

10. Questions?

11. CRG Membership Chair (Page) Thoracic Surgeons - 10
Batchelor, Black/Belcher, Hunt, Jordan, Scarci, Shah, Stamenkovic, Steyn, Waller, Woo
Cardiothoracic Surgeons - 2
Mike Cowen, Martin Hayward
Respiratory Physician -1
Chris Warburton, Merseyside
Medical Oncologist - 1
Riyaz Shah, South East Coast

12. Membership Affiliated Professional Organisations
SCTS
Simon Kendall
BTS
David Baldwin, Respiratory Physician, Nottingham
BTOG
Richard Booton, Respiratory Physician, South Manchester
RCRadiol
Michael Snee, Clinical Oncologist, Leeds
X3 patient / carer reps