Event Summaries

Link to the PDF of the YCRBCIP Rectal Cancer Management Event 18 June 2025 Final Programme

This event was open to colorectal surgeons, clinical and medical oncologists and radiologists across the YCRBCIP region.

Topic/Themes covered during the event:

• Data on regional variation in the use of radiotherapy
• How radiology can support MDT decision making
• Update from the latest information and results available from ESTRO
• The management of early rectal cancers
• The management of intermediate rectal cancers
• The management of advanced rectal cancers

The event included presentations, case discussions and opportunities for round table discussions.

Outcomes:

• Agreement to update the regional pathways/ algorithms for early, intermediate and advance rectal cancers
• Include surgical, organ preservation (including contact radiotherapy) as well as oncology treatments in the updated pathways
• Develop a consensus statement on the use of MRI proforma requesting all radiologists use this method of reporting to support MDT decision making

On 18th March 2025 the Yorkshire Cancer Research Bowel Cancer Improvement Programme held the Update Event for 2025.  This event was held to share the progress of the programme over the past 12 months and the plans for 2025-2026.

The recording of the event can be viewed here (will open in a new window): Recording of YCRBCIP Annual Update Event 2025

The Programme of the event included:

• Summary of Achievements Over the Past 12-months
• Complexities and Opportunities of Accessing and Using Cancer Data to Support Clinical Teams
• Update on YCRBCIP Patient Reported Outcomes – Understanding bowel functioning following cancer treatment
• Implementing the Changes
• Future Plans for 2025-2026

Link to watch the recording of the lunch and learn session for action planning for opioid stewardship

This online event on the topic of developing effective action plans for the implementation of perioperative opioid stewardship.  This was offered to all those involved in perioperative opioid stewardship for colorectal cancer patients.

This event was offered as part of the perioperative opioid stewardship implementation toolkit.  The contents of the toolkit can be access on the resources page of this website Link to the Resource Page of the YCRBCIP website

This event was open to histopathologists and radiologists and trainees in these clinical disciplines with and interest in reporting colorectal cancer who work across the YCRBCIP region.

Link to the PDF of the programme for the 2024 Pathology and Radiology Event 19 Nov 2024

Topic/Themes covered during the event:

• What it is possible to do with cancer data and how this can impact outcomes
• Session on Large Polyps and Early rectal cancers
• Session on Neoadjuvant in colon cancer
• Session on Appendiceal tumours
• Speciality specific workshops

The event included presentations, case discussions and opportunities for round table discussions.

Outcomes:

Feedback from the event was overwhelmingly positive with many of the attendees finding it a useful opportunity to discuss the work of two different specialities of the MDT.  The clinicians were keen to take back to their clinical practice new knowledge on improving image sequencing and FOxTROT protocols in radiology and histopathology.

Link to the PDF of the final programme for the YCRBCIP Opioid Stewardship Event 11 Nov 2024

Attendance at this event included anaesthetists, members of acute pain teams, colorectal surgeons, clinical nurse specialists.

Topic/Themes covered during the event:

The purpose of the event was to formally launch the perioperative opioid stewardship toolkit.  The presentations covered:

• The background to the work
• The various aspects of the toolkit including;
  • The Functional Activity Score
  • Patient Information
  • The protocol
• The planned regional baseline audit

The afternoon of the event focused on supporting organisations in how to identify barriers to implementation and action planning.

Outcomes

Trusts are identifying the lead for implementation of perioperative opioid stewardship for colorectal cancer patients.  Follow up lunch and learn sessions are being planned for different aspects of the toolkit such as action plans, the functional activity score and the baseline audit.

This event was open to radiologists and radiology trainees reporting diagnostic imaging for colorectal cancer

Radiology Event 17 September 2024 - Final Programme

This event provided 6 CPD credits in accordance with the CPD Scheme of The Royal College of Radiologists for those delegates in attendance.

This full day educational event included sessions on:

• CTC Standards and learning
• CTC performance - included experience from gastroenterology and national audit
• Improving rectal cancer MRI
• The challenges in rectal cancer MRI

The event had presenters from international experts in colorectal radiology, implementation scientists, colleagues from oncology and gastroenterology sharing their experiences and the importance of accurate imaging in treatment decision-making.

The event was well attended and the key take home message from the feedback survey was around the complexity of oncology treatment options and the importance of accurate imaging to inform that treatment planning.

Link to the PDF of the final programme for the Large Polyp Event

This event was aimed at gastroenterologists and colorectal surgeons across the YCRBCIP region who manage patients with large and complex polyps.

Topic/Themes covered during the event:

The overarching theme of this event was to understand how these large and complex polyps are currently managed within the YCRBCIP region and identify strategies for improving the patient pathway.  The presenters included regional, national and international experts on the topic.

Presentations included:

• The results of regional survey about Polyp MDTs in the Yorkshire and Humber
• The benefits of Polyp MDTs
• When to leave a polyp and when they should be referred on or managed locally
• Methods for management of polyps including EMR, ESD, transanal surgery, contact radiotherapy
• How effectiveness can be measured
• Training and workforce requirements
• How to develop a regional response

Outcomes

The event concluded that there were gaps in services available and workforce.  The delegates requested the development of regional directory of services available to ensure that commissioned pathways can be put in place to ensure that patients can be referred to the most appropriate services.  The details for referral to contact radiotherapy in Hull were shared with all delegates.

In March, the Yorkshire Cancer Research Bowel Cancer Improvement Programme held the 2024 Update Event to share the progress of the programme over the past twelve months.  This event was held online on zoom.

Topics included:

• Utilising Implementation Methodologies within BCIP
• Frailty work across the workstreams and setting new metrics for the Programme
• Quality Performance Measures
• Ethnicity and Colorectal Cancer
• Understanding local and national variation in the use of radiotherapy
• Using new methods to understand radiologists' view of changing practice
• Update on molecular testing for bowel cancer

A copy of the programme for the event can be accessed here: 2024 YCRBCIP Update Event outline Programme

A recording of the event can be accessed here:Zoom recording of the 2024 YCRBCIP Update Event

The aim of this event was to progress the frailty work that applies across multiple YCRBCIP workstreams.  The event was aimed at anaesthetists with an interest in colorectal cancer, clinical nurse specialists and colorectal surgeons from across the YCRBCIP region.

Link to the PDF of the Final Programme of the The Needs of the Older Patient Event

Topic/Themes covered during the event:

The overall aim of the event was to complete the finalising of the metrics around frailty that would be implemented across the YCRBCIP.

Presentations at the event included:

• How are we currently treating the older colorectal cancer patient, what is the data telling us?
• Oncology and Onco-Geriatrics, new guidance and new models of care
• The management of surgical patients – a CNS perspective
• Implementation Science – what is it and what can it do for us?

In addition to case discussions and round table work.  The final section of the day was devoted to finalising the metrics that would be utilised across the YCRBCIP to implement the frailty work.

Outcomes

The final four frailty metrics were agreed and circulated across the region.  These metrics are:

1. Perform a frail screen on people aged 65 or over presenting with colorectal cancer
2. Use an accepted and validated tool to assess frailty
3. A positive frailty screen should be followed an elderly care assessment (CGA)
4. Education on prehabilitation should be provided, including physical, lifestyle, and psychological support

As part of the YCRBCIP, the Radiology workstream held two lunch and learn sessions in September 2023.  These  hour long sessions focused on the outcomes and findings from the BUSGAR audit on CTC and what we can learn from them for the CTC services in Yorkshire.  The learning objectives for the sessions were:

1. To understand the background and key priorities related to the RCR/BSGAR CT Colonography pathways guidance from 2023
2. To know the key performance requirements for services related to CTC quality assurance in RCR/BSGAR guidance from 2021
3. To know the current performance levels of CTC performance from national audit in 2019

Recording of the Radiology Lunch and Learn Event on 13th September 2023

Recording of the Radiology Lunch and Learn on 26th September 2023

The purpose of this online learning event run in conjunction with the LCRN was to provide research teams from recruiting sites to share issues they were having in relation to recruitment and to develop solutions to those issues.

The outcome of the event was linking up of some of research nurses with colorectal MDTs where those links had not already been established.  The sharing of good practice around remote recruitment and identification of suitable patients.

Zoom Recording of Pathology Event 21 April 2023

This two-hour online educational event was open to any histopathologists or trainees with an interest in reporting colorectal cancers. This event included presentations from Professor Phil Quirke and Dr Nick West on the following topics:

• An overview of the Pathology Workstream and the YCRBCIP and its achievements
• Changes to the new Royal College of Pathologists Colorectal Cancer Dataset
• The rationale for multigene panel testing and the testing of YCRBCIP consented patients

Zoom Recording of YCRBCIP Annual Update 2023

The Annual Update on the Yorkshire Cancer Research Bowel Cancer Improvement Programme (YCRBCIP) was held on 24th January 2023.  The purpose of this event was to give colleagues across the Yorkshire and Humber region an update on the progress and achievements of the YCRBCIP over the last twelve months.

The presentations for this event included:

• The latest key data metrics used by the YCRBCIP
• How the patient voice has been included in the work of YCRBCIP
• Results from surgical audits
• Updated results from the post colonoscopy completion rate audit
• How the YCRBCIP has developed the implementation workstream and demonstrated change
• The development of the frailty workstream

This event was aimed at gastroenterologist, nurse endoscopists, colorectal surgeon who undertake endoscopy, and primary care cancer leads.

The aim of the event was to provide information about the use of FIT as part of the diagnostic pathway for colorectal cancer in symptomatic patients.

Programme for YCRBCIP FIT Event 13 December 2022

The presentations for this event included:

• Local Diagnostic Accuracy – FIT in Higher Risk Symptoms Data on Patient Referred via NG12 Guidance
• Local Diagnostic Accuracy – FIT in Low Risk Symptoms Data on Patient Referred via DG30 Guidance
• Straight to Test and FIT
• Primary Care Perspective on FIT
• FIT: The National Perspective

The purpose of the event and discussions during the round table event was to increase understanding and ensure clinical teams were fully informed to support discussions within Cancer Alliances around the implementation of FIT in the diagnostic pathways for colorectal cancer.

Zoom recording of colonic cancer surgical event

This event was open to all colorectal cancer surgeons and surgical trainees in the Yorkshire and Humber region.

The event started out identifying the issues in relation to colonic cancers with presentations from;

• Nick West on the variation in outcomes based on the evidence in surgical specimens
• Jim Tiernan on the variation in surgical outcomes looking at post-operative CT.

The next section of the event focused on possible management solutions with presentations from the following;

• Thilo Wedel on Surgical anatomy revisited for right hemicolectomy with complete mesocolic excision
• Danilo Miskovic on Taking up the anatomical challenge for radical colonic resections using modern imaging and surgical techniques
• Damian Tolan on Appropriate selection of cases for pre-operative chemotherapy using CT imaging
• Dion Morton on Results from the FOxTROT study. Do surgeons need to be worried

Zoom Recording of Lynch Syndrome Education Event

There were some links that were suggested as part of the presentations;

Requesting genetic testing

NICE Guidance: Molecular testing strategies for Lynch syndrome in people with colorectal cancer

NICE Guidance: Testing strategies for Lynch syndrome in people with endometrial cancer

National Genomic Test Directory

UK Cancer Genetics Group Leaflets and Guidelines

Prospective Lynch Syndrome Database (PLSD) - cumulative risk for cancer by age, genetic variant, and gender in carriers subject to colonoscopy

This event was aimed at nursing teams across the Yorkshire and Humber region who care for cancer patients who should be tested for Lynch Syndrome and deficient mis-match repair (dMMR) status as part of their routine care; primarily those with colorectal cancer or endometrial cancer.

Presentations included;

• Patient Pathways for Lynch Syndrome from Referral to Results – Clinical Genetics
• Testing for Lynch Syndrome and dMMR before referral to Clinical Genetics Services
• Lynch Syndrome and dMMR the impact on treatment options
• Lynch Syndrome: the patient’s perspective

Lynch Syndrome – Hidden in Plain sight

This a patient editorial published alongside the paper Lynch Syndrome screening in colorectal cancer: results of a prospective two-year regional programme validating the NICE diagnostic guidance pathway across a 5.2 million population.
Authors – Katie McSweeney and Emily Boldison

Zoom recording of Anaesthetics/ Sprint Audit Results Event 20 May 2022

This event was open to all colorectal surgeons, anaesthetists involved in the care of colorectal cancer patients within the Yorkshire and Humber area.  Trainees who supported the audit and those interested in the results of the audit were also welcome to attend.

This event focused on sharing the results from the regional sprint audit from the surgical and anaesthetics workstreams. The audit focused on pre, intra and immediate post-operative care for patients with colorectal cancer.

Presentations at the event included;

• Overall results from the audit
• Key areas where significant variation has been identified for surgeons and anaesthetists
• Forthcoming frailty work
• Forthcoming work on multimodal analgesia and opioid stewardship
• Discussion about the audit results and actions to take place following the audit

Zoom Recording of Radiology Rectal MRI Event 18 May 2022

This event was open to radiologists and radiology trainees across the Yorkshire and Humber area.  Presentations at the event included;

• The outcome of the regional re-audit around rectal MRI
• Quality Assurance of MRI
• Lessons learned from the international TNM8 implementation work

At the event a number of key documents and papers were discussed.  These are available here;

Lambregts 2022 Current Controversies in TNM for the Radiology staging of rectal cancer

Schaap BJS 2021 Rectal cancer lateral lymph nodes

RCR National Rectal Cancer IMRT Guidance 2021

Colorectal Disease - 2021 - Hazen - Evaluation of the implementation of the sigmoid take‐off landmark in the Netherlands

Recording of Total Neoadjuvant Therapy Event

This was a multidisciplinary event across the oncology, surgery and radiology workstreams.  This event included presentations on:

• The evidence base for Total Neoadjuvant Treatment
• Selecting patients for TNT with imaging
• Agreeing the patient selection for TNT in the YCRBCIP region
• Pelvic Side Wall Nodal Dissection – who should receive this treatment

This event provided an opportunity to review the latest trial evidence for Total Neoadjuvant Treatment and Pelvic Side Wall Nodal Dissection.

Following a presentation of cases and polling of the event attendees the meeting developed a consensus of which patients should be managed with Total Neoadjuvant Treatment.  The outcome of the event will be a consensus treatment algorithm around TNT.  In addition, there was consensus about an approach to referring patients for review by a specialist panel of patients who may be suitable for pelvic side wall nodal dissection; the referral details and criteria will be circulated to teams across the region.

Zoom recording of 6th Pathology Event

This event was open to all histopathologists and trainees in the Yorkshire and Humber region with an interest in or reporting colorectal cancer.  Histopathologists with an interest in or who report on gynaecology cancers were welcome to attend the first half of the event to understand the results from the endometrial cancer Lynch testing

Topic/Themes covered during the event:

• YCRBCIP Update
• Final results from the endometrial Lynch screening testing undertaken via YCRBCIP
• Colon Cancer Surgery quality assessment
  • what have we learned from rectal cancer quality control?
  • what are the variables in colon cancer specimens?
  • what is the evidence that optimal colon cancer surgery matters
  • what is the current state of colon cancer surgery across the region
• Plans for YCRBCIP multigene panel testing and sharing of the results

Zoom recording of the Reducing Post Colonoscopy Colorectal Cancers

This event was open to all gastroenterologists, colorectal surgeons, nurse endoscopists, nurse practitioners, business managers, trainees, managers and endoscopy administration teams.

This was the inaugural event for the gastroenterology workstream that was formally launched in January 2021.

Speakers included Dr Roland Valori, Professor Matt Rutter, Dr Nick Burr, Dr James Turvill, Dr Chris Healey.  The programme for the event included;

• About the Yorkshire Cancer Research Bowel Cancer Improvement Programme
• National Audit of Post Colonoscopy Colorectal Cancers
• Outcomes from the PCCRC Pilot and Regional Data
• Quality standards in endoscopy and PCCRC
• National Endoscopy Database

A recording of the zoom event is available here:  YCRBCIP PCCRC Event Recording

Zoom Recording of YCRBCIP Update Event 31 January 2022

On 31st January 2022 we held an online event to provide an update on the Yorkshire Cancer Research Bowel Cancer Improvement Programme (YCRBCIP).   Presentations at the event included;

• The outcomes and work achieved to date by the YCRBCIP
• A tribute to our patient co-investigator, Barbara Hibbert
• Update from Yorkshire Cancer Research
• the impact of COVID on colorectal cancer services
• Results from the Lynch testing conducted by the YCRBCIP
• DPYD Testing in the YCRBCIP region
• The difference data can make to clinical teams
• Headline results from the 2021 anaesthetics and surgical audit
• Changes to MRI practice across the region
• Plans for the YCRBCIP for the next 12 months

This online event was aimed at Colorectal Clinical Nurse Specialists across the YCRBCIP region.

The purpose of the event was to allow the CNS teams to share experience and the impact of the COVID-19 pandemic on nursing services and share good practice and solutions that were being implemented to mitigate the impact.

In addition the event had presentations on:

• The early results from the Patient Reported Outcome Measures from the YCRBCIP
• Update on changes/ news from the YCRBCIP workstreams

This event was held via zoom and a recording of the event is available to view here; YCRBCIP Early Rectal Cancer Event Recording

Presentations from this event included:

• Setting the scene based on the Bradford Experience - Amarvir Bilkhu, Surgical Trainee,Bradford Teaching Hospitals NHS Foundation Trust
• Why we need endo-rectal ultrasound, Ragu Vinayagam and Naeem Jagirdar, Consultant Radiologists, Bradford Teaching Hospitals NHS Foundation Trust
• Why MRI is all that is needed, Damian Tolan, Consultant Radiologist,Leeds Teaching Hospitals NHS Trust
• Standardise/ Quality Assurance of Resection Specimens, Phil Quirke, Head of Pathology and Tumour Biology, University of Leeds
• Non-Surgical Oncology, Amandeep Dhadda, Consultant Clinical Oncologist, Hull University Teaching Hospitals NHS Trust
• YCRBCIP Early Rectal Cancer Minimum Dataset, John Taylor, Research Statistician, University of Leeds
• Videos of Resections/ Technical Aspects of Local Resections, Mark Steward/ Jon Robinson, Consultant Colorectal Surgeons, Bradford Teaching Hospitals NHS Foundation Trust

This event was provided to clinical and medical oncologists across Yorkshire and Humber who were managing colorectal cancer patients.

The purpose of the event was to share the evidence around the emerging new treatments for rectal cancer patients, discuss these results and the possible implications for the YCRBCIP region and develop a consensus on regional algorithm for use in the YCRBCIP region.

The programme included:

• Brief comparative presentation of RAPIDO and PRODIGE studies
• MDT style presentation of cases with live poll
• Management algorithm - reaching a consensus

This online event was held for anaesthetists who are involved in surgery for colorectal cancers across Yorkshire and the Humber.

Opiate Management Event Final Programme

A paper was circulated for consideration and discussion as part of the event: Levy-An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients

The programme included:

• Presentations on the consensus statement on opiate related harm in surgery
• Local analysis of PQIP data from Leeds  - what does it say about opiate management
• Reducing variation and developing consensus in quality of practice in the YCRBCIP region
• Proposal of a YCRBCIP consensus statement and identifying barriers to implementation
• Next steps for  opiate management in YCRBCIP region

Speakers included national experts on opiate management and regional expert on implementation science.

This event was open to histopathologists and trainees who were responsible for reporting colorectal cancer specimens.

Final Programme for Pathology Online Educational Event 12 January 2021

The programme for the event included:

• An update of YCRBCIP Workstreams
• The impact of COVID-19 on the regional pathology services
• Lynch Screening  - results from the YCRBCIP screening work
• The status of colorectal Lynch Syndrome testing across Yorkshire
• The future endometrial screening programme for Lynch Syndrome
• Plans for YCRBCIP2

The session included a Q& A session - Question and Answers from the Pathology event 12th January 2021

This event was aimed at clinical and medical oncologists who treated patients with colorectal cancer based in the Yorkshire and Humber region. Due to the online nature of the event the event was scheduled for two hours.

This online event included presentations on:

• The latest evidence from trials for rectal cancer presented at ASCO and ESMO
• Experience of using Short Course and Delay at Sheffield - sharing local data
• Toxicity Data for Short Course Radiotherapy with Delayed Surgery.
• Using adjuvant therapy for rectal cancers
• Update on the national Image Modulated Radiotherapy guidelines

Final Programme for Online Oncology Event on 11 December 2020

This event was provided to radiologists across the Yorkshire and Humber region who were responsible for reporting diagnostic imaging for colorectal cancers.

The event provided an opportunity for colleagues across the region to share the impact COVID-19 pandemic was having on their Trust's radiology services and share solutions being implemented locally.

The programme for the event included:

• Regional discussion about the impact of COVID-19 on radiology diagnostic services
• YCRBCIP plans for the next five years and plans for the radiology workstream over the next twelve months
• Key lesson for radiology from the FOxTROT trial

Radiology Online Event Programme on 25 November 2020

This online event was open to all clinical and medical oncologists in the YCRBCIP region who managed patients with colorectal cancer.

The purpose of the event was discuss the emerging guidance around how care should be altered for patients with colorectal cancer who are also receiving systemic therapy during the COVID-19 pandemic.

The event included:

• Discussion of guidance that has been released and how that is being implemented across YCRBCIP
• Understanding the impact on oncology services across the YCRBCIP
• Discussion about how Teams across YCRBCIP were adapting to the pandemic to maintain oncology service

This full day event was open to colorectal surgeons and surgical trainees across the YCRBCIP region.  The event was focused on the major surgical procedures used for low rectal cancers including APERs and TaTME

The event was accredited for 5 CPD points by the Association of Coloproctology of Great Britain and Northern Ireland (ACPGBI)

The event included sessions on:

• How Yorkshire compares to the rest of the UK in the management of low rectal cancer
• Pathological assessment of operative specimens.
• Anatomical aspects of total mesorectal excision (TME) and abdominoperineal excision of the rectum and anus
• Choice of appropriate surgical procedure for low rectal cancer based on MR imaging
• Relevance of lateral pelvic lymph nodes in low rectal cancer
• Proposed minimum dataset for rectal cancers treated by local excision
• Anatomical aspects of complete mesocolic excision for colonic cancer

This event included international, national and regional experts presenting in their fields of expertise.  This included Professor Wedel a Clinical Anatomist from Kiel University in Germany who presented on relevant anatomical principles for optimal planes of dissection and the safe dissection in the perineal phase of an APER.

Outcomes:

There was an agreement in principle to take forward a regional dataset for the collection of data on the local excision of early rectal cancers.  There was agreement to set up a working group to agree the fields and definitions for inclusion in the dataset.

This online event was aimed at clinical oncologists in the YCRBCIP who manage patients with colorectal cancer.

The event included presentations on:

• Background information including regional data
• Setting the clinical context
• DPYP testing availability across the YCRBCIP and the development of business cases for local implementation

The main session of the event was the discussion and development of a regional consensus position on the use of short course radiotherapy with delayed surgery for the management of rectal cancer.

Outcomes

Agreed consensus from clinical oncologists that short course radiotherapy with delayed surgery should be a treatment option.  Agreement to produce a slide set and briefing document for MDTs. Regional oncologist to present the information and evidence to their local MDT.

This event was open to all Colorectal CLinical Nurse Specialists, Stoma Nurse Specialists and Research Nurses supporting colorectal cancer trials across the YCRBCIP region.

The focus of the event was on living with and beyond cancer.

Presentations included:

• Presentations from each of the three Cancer Alliances in the region on their work on living with and beyond cancer
• Results of a CNS survey on living with and beyond cancer
• Update on the PROMs recruitment and analysis

This event was provided for the radiologists who report diagnostic imaging for colorectal cancer in the Yorkshire and Humber region. This event was accredited for 4 CPD points in accordance with the scheme of the Royal College of Radiologists.

The event included:

• Presentations on a user survey and an evaluation of current reporting standards in MRI
• Presentations on the limitations of Rectal MRI
• Workstation case reviews
• Question and answer session with Doenja Lambregts

This event was aimed at radiographers across the Yorkshire and Humber who take diagnostic MRI images for rectal cancer.

The event included sessions on :

• The importance of radiographers in the staging of rectal cancers
• Optimising scans
• Learning from the Dutch experience - how to improve MRI
• Results from a regional quality survey

Workstream - Pathology workstream

Date – 1st March 2019

Topic/Themes covered during the event:

• Low rectal cancers – including Mercury II results, assessment of specimens and group workshop using photographs from the YCRBCIP quality of surgery audit.
• Collection of tissue – sharing the progress with the YCRBCIP tissue block collection from the consented aspects of the study and the planned analyses.
• TNM8 and reporting issues
• Lynch screening and molecular pathology – including an update on the national genomics reconfiguration and practical guidance for dMMR and lynch testing for when the YCRBCIP funded testing ends.
• Feedback on the specimen quality audit – including some tips on how to improve specimen photography.

Outcomes:

In addition to topics for the next event, the clinicians in attendance determined the next steps and follow-up actions;

• Next pathology event should include a workshop session on colonic cancer including photographs from the specimen audit and assessment of mesocolic grading.
• Share the photography of specimens with the surgical workstream lead for inclusion in the surgical APE event.
• Discuss TNM8 implications with the oncology workstreams to understand what impact it is having on discussion of treatment options and feedback to pathology teams.
• Review the low rectal cancer in light of discussions and comments during the event; including review against screening data, rurality of patients and whether this has an effect on surgery.

Workstream - Radiology workstream

Event Title - MRI Training Event

Date – 21st January 2019

Topic/Themes covered during the event:

• Presentation of the results of the radiology reporting audit and the radiology users regional survey
• The limitations of rectal MRI
• Optimising the scans
• Learning from the Dutch experience

Outcomes:

Following discussions during the plenary session at the event the following next steps and follow-up actions are in development;

• Repeat the Radiology MRI Training event to allow for more radiologists and radiographers from across the region to attend.
• Revise a reporting template in response to comments made at the training event and circulate.
• The analysis of the templates completed in the training sessions of this event will be shared and discussed at the next event.

Workstream - Surgical Workstream - for anaesthetists with colorectal cancer interest

Event Title - Anaesthetics Educational Event

Date – 18th October 2028

Topic/Themes covered during the event:

• ERAS and Prehabilitation
• Perioperative Medicine at York
• Cancer Prehabilitation and Rehabilitation Exercise Referral Programme at Harrogate
• Perioperative Medicine Strategy to Implementation
• Peri-operative care of patients with colorectal cancer in Yorkshire the current status quo
• An introduction to the YCRBCIP
• How data is used in the YCRBCIP

Outcome:

A proposal to the YCRBCIP Project Group to develop an anaesthetic workstream within the YCRBCIP to support peri-operative care and risk stratification.

Workstream - Surgical workstream

Event Title - The Management of Early Rectal Cancers

Date – 10th October 2018

Topic/Themes covered during the event:

• Background to organ preservation including completed and planned trials
• Current regional picture using data from CORECT-R
• Radiological Staging of Early Rectal Cancers
• Pathology - Perspective on the nature of ‘early rectal cancer’ and quality issues around local excisions
• The Bradford experience on local treatment of early rectal cancer
• The rationale for considering non-surgical treatments based on experience of chemoradiotherapy for advanced rectal cancer
• An Endoscopist’s perspective on what to do if early rectal cancer is seen and what is the ‘scope’ of endoscopic management

Outcomes:

Some key areas for future discussions around the management of early rectal cancer forward were identified;

• Consideration of the development of a register for early rectal cancers to make sure the data is available for analysis
• Look at the pathways across the region and utilise the expertise,
• The development of a regional cohesive strategy for organ preservation
• The need to link with the other workstreams to support the initiatives in improving the quality of radiology and pathology reporting and data flows to ensure robust data.
• To focus on standardising high quality practice rather than changing existing patient flows

Workstream - Clinical Oncology workstream

Date – 3rd August 2018

Topic/Themes covered during the event:

• To develop a consensus view on the timing of surgery following radiotherapy for patients with rectal cancer.

Outcomes:

Following a review of evidence the workstream has confirmed that across the Yorkshire and Humber region the clinical oncology opinion is that intervals between radiotherapy and planned surgery for rectal cancer should be as follows;

• Short Course and Immediate Surgery – 7 days from the end of radiotherapy
• Short Course and Delayed Surgery – 6-8 weeks following the end of radiotherapy

Next Steps: Confirm these discussions with surgical colleagues and once agreed implement within the MDTs across the region.

This teleconference based event involved medical oncologists across the YCRBCIP region.

Topic/Themes covered during the event:

• The results of survey of YCRBCIP oncologists on the use of adjuvant chemotherapy
• The analysis and variation in the use of adjuvant chemotherapy across the YCRBCIP region
• The evidence base for adjuvant therapy to support decision making
• Proposed guidelines for the YCRBCIP on the use of adjuvant chemotherapy

Outcomes:

Agreement to develop a regional algorithm for adjuvant chemotherapy

Workstream - Pathology workstream

Date – 18th May 2018

Topic/Themes covered during the event:

• pT1 cancers
• Feedback from the Pathology Audits
• Lynch Screening and molecular pathology
• Lessons from the implementation of TNM8

Outcomes:

As part of the evaluation delegates were asked to identify what aspects from the day they would take back to their organisation or clinical practice. The most common items identified were:

• information around MMR testing and lynch screening.
• clarification of TNM8.
• macroscopic and integrated reporting.

Workstream - Medical Oncology workstream

Date – 26th January 2018

Topic/Themes covered during the event:

• Overview of the Yorkshire Cancer Research Bowel Cancer Improvement Programme
• MMR Testing Facilities in Leeds – Progress Update
• Recruitment Following Ethics Approval for PROMS and Tissue Collection
• Update on SACT and Other National Datasets
• Active trials including Add-Aspirin, Focus 4, e-RAPID, Early Phase Bio-marker Trials
• SCOT and IDEA Data
• NICE Guidance on MMR Testing
• SIRT
• SABR
• Potential Impact on Service if FOxTROT is Practise Changing
• Radiotherapy Studies

Outcomes: 

• Oncologists to review the SACT data presented at the meeting within their hospital teams and forward comments to develop the analysis to the Programme team
• Agree a consistent regional policy for the prescribing of 3/6 month chemotherapy in line with the outcomes highlighted by the SCOT and IDEA data.

Workstream - Clinical Nurse Specialist workstream

Date – 15th December 2017

Topic/Themes covered during the event:

• Introduction to the Yorkshire Cancer Research Bowel Cancer Improvement Programme
• PROMS and the YCR BCIP
• Good Clinical Practice
• Consent & the YCR BCIP Consent Process
• The YCR BCIP site set-up and recruitment

Outcomes:

• Circulating the capacity and capability documentation to research and development teams for completion
• Identifying suitable dates for site visits for team preparing to start recruitment

Workstream - Surgical workstream

Event Title - Peri-operative care, risk stratification and optimisation of patients for major surgery

Date – 24^th November 2017

Topic/Themes covered during the event:

• CPEX Testing and VE/VCO2 as Predictors of Survival
• Frailty in Surgical Patients
• Radiological Assessment of Sarcopenia in Surgical Patients and the Influence on Surgical Outcomes
• Post-Operative Care and Monitoring
• Routes to Diagnosis in Yorkshire & Humber
• Changing Management, and Influence on Outcomes in Colorectal Cancer- the Danish Experience
• CREST Trial Outcomes
• Post-Operative Care and Facilities across the region – outcome of the audit by ACPGBI.

Outcomes:
The event had two main outputs;

• A proposal to develop an anaesthetics workstream for the Bowel Cancer Improvement Programme.
• MDTs to confirm three priority areas of focus to develop new areas of analysis for the Programme

Workstream - Pathology workstream

Event Title - TNM8 and Tumour Deposits

Date – 10th October 2017

Topic/Themes covered during the event:

• TNM8 - working in practice
• Tumour deposits
• Optimising Lymph Node Yields
• Regional Audits:
  • Lymph Node Retrieval
  • Quality of Resection Reporting
  • Quality of Surgery via Specimen Photography

Outcomes:

Following the discussions during the event the following outputs were agreed by the regional pathologists;

• A Letter to commissioners to encourage regional funding of lynch immunohistochemistry for bowel cancer patients.
• The sharing of the methodologies in use across the region and in Denmark to enhance lymph node retrieval.
• The sharing of common issues encountered once TNM8 is implemented in January 2018 to enhance and improve reporting across the region.

Workstream - Clinical Oncology

Event Title - Timing of Radiotherapy and Surgery for Rectal Cancer: Regional Variation and Implications of Stockholm 3

Date – 7th July 2017

Topic/Themes covered during the event:

• Timing of Surgery following Radiotherapy  and the variation across the Yorkshire and Humber Region
• Stockholm 3 and the Implications for the Yorkshire and Humber Region
• Developing a Regional Consensus
• Harmonising Radiotherapy Protocols Across the Region
• Updating the Consent Process

Outcomes:

• The output of the event was to agree the expanded areas of analysis of the radiotherapy data to determine reasons underlying the regional variation in the timing of surgery following radiotherapy.
• A sub-group was developed with representatives from the three regional radiotherapy centres to take forward work in agreeing consistent information to be provided to patients at consent.

Workstream - Colorectal Clinical Nurse Specialist workstream

Date – 29th June 2017

Topic/Themes covered during the event:

• Remote Follow-up – The Approach in York
• Recovery Package - Regional Approaches, Challenges and Successes
• Update on PROMS work
• Rotherham Palliative Pathway

Outcomes:

Key gaps in knowledge of the new model were identified for cancer alliance across the region and determined this for a future topic for the next event.

Workstream - Surgery workstream

Date – 17th March 2017

Topic/Themes covered during the event:

• Outlining the Concept of the Bowel Cancer Improvement Programme
• Cancer Outcomes Services Dataset Local Reporting - where we are now
• Update on Regional Colorectal Surgical Data and Variation between Trusts
• Concept of Quality Performance Indicators

Outcomes:

The following workstream priorities were identified:

• Timely feedback of appropriate high quality data, to include quality performance indicators, to MDTs
• Reduction in perioperative 30 day and 90 day mortality
• Improvements in management of the elderly patient
• Standardised and enhanced treatment of early disease
• Improvement in the quality of surgery in both rectal and colonic surgery.

Workstream - Clinical Oncology workstream

Date – 17th March 2017

Topic/Themes covered during the event:

• Outlining the concept of the Bowel Cancer Improvement Programme
• Review of Current Radiotherapy Protocols
• Patient Consent – What do we do now and developing a consensus
• Variation in practice including radiotherapy data
• Developing IMRT Solutions for Rectal Cancer
• Round Table Discussion on Organ Preservation

Outcomes: 

The following workstream priorities were identified:

• Development and implementation of Yorkshire region standardised radiotherapy protocols
• Review and develop standardised patient information to support the consenting patients for radiotherapy.
• Understanding the impact of delay between short course radiotherapy and surgery and development of consensus approach across Yorkshire.
• Development of an IMRT protocol for rectal cancer

Workstream - Radiology workstream

Date – 28th February 2017

Topic/Themes covered during the event:

• An outline of the YCR BCIP
• The national perspective of radiology for colorectal cancer
• Setting the regional priorities and proforma reporting

Outcomes - 

The following workstream priorities were identified:

• Creation of a network of radiologists with an interest in colorectal cancer across Yorkshire and Humber
• Introduction of proforma reporting minimum dataset for rectal cancer reporting across Yorkshire
• Standardisation of frequency of post treatment CT follow-up scans for colon across Yorkshire
• Standardisation and improvement of radiographers scanning techniques for rectum and colon
• Development of uniform criteria for nodes
• Creation of a difficult case facility for continuing professional education

Workstream - Pathology workstream

Date – 28th February 2017

Topic/Themes covered during the event:

• Outlining the Concept of the Bowel Cancer Improvement Programme
• Where are we now in Pathology? – Regional and National Perspective
• Cancer Outcomes and Services Dataset Data Entry
• Specimen photography to Audit the Quality of Surgery
• Molecular Testing (Lynch syndrome and targeted therapies)
• TNM8 and Tumour Deposits
• Setting the Project Priorities

Outcomes - 

The following workstream priorities were identified:

• Enhancing full pathology staging across Yorkshire using COSD and additional datasets
• Photography of specimens to determine baseline quality of surgery across the region.
• Support for Lynch syndrome testing across the region until supported by Commissioners
• Support for pre-entry testing of patients into targeted therapy trials
• Enhanced pathology reporting across the Yorkshire Region

Workstream - Colorectal Clinical Nurse Specialist workstream

Date – 26th January 2017

Topic/Themes covered during the event:

• Re-establishing a colorectal CNS network
• The development of Projects and Priorities
• Introcution of the PROMS and Tissue consent aspects of the YCR BCIP
• Identifying the challenges in the PROMS and tissue consent process