Bristol Thoracic Surgery Unit

Update 2014

What we are doing well

• High resection rate

2012 UHBristol referral volumes

Other resection metrics

2009 2010 2011 2012 20130

5

10

15

20

25

30

Histologically confirmed NSCLC having surgery

AS+WEngland

What we are doing well

• High resection rate • Average mortality

UHBristol 2012 90-day mortality after lung cancer surger

What we are doing well

• High resection rate • Average mortality• Highest VATS lobectomy rate in UK (70%)• VATS lobectomy European training centre• ERAS• Group job plan• Research

Research portfolio

• NIHR– PulMiCC– VIOLET

• Other– ProVIOLET– SUMIPORT

• Potential (undergoing NIHR submission)– NUTS– ADELE

Issues

• Poor compliance with 62-day wait

Cancer performance 2013-14: surgically treated lung cancer

Q1 2013 Q2 2013 Q3 2013 Q4 2013 Q1 2014 Q2 20140

20

40

60

80

100

120

31 day62 daytarget 85

Issues

• Poor compliance with 62-day wait

• HDU bed capacity

• Staff surgeons/peripheral clinics?

Update

• New ward:– A700– 24 single side rooms

• New consultant(s):– Eveline Internullo– Rakesh Krishnadas - locum (…5th consultant)

• New CNS:– Lorraine Keepin

• More theatre capacity

Aims

• Cancer target compliance• Increase resection rate further (prehab, high

risk MDT)• Provide 52 week cover of peripheral

MDTs/clinics - rationalization• Nurse-led, protocol-driven CT surveillance of

lung cancer survivors• Post-MDT joint clinics (without dismantling pre-

op assessment process, e.g. Skype POAC)