New Drug Implementation Tool - Northern Cancer Alliance

New Drug Implementation Tool - Northern Cancer Alliance

This tool was developed by the NECN and GSK on behalf of the Pharmaceutical Industry Partnership Group (PIPG) New Drug Capacity Calculator An Excel-based tool for estimating the resource required to deliver newly approved chemotherapy drugs. Instruction Manual ZINC Code : UK/ONC/0013/13d(1) Date of Preparation: February 2015 Sheet 1 - Cover New Drug Capacity Calculator This tool was developed by the NECN and GSK on behalf of the Pharmaceutical Industry Partnership Group (PIPG) ZINC Code: UK/ONC/0013/13c(1) Date of Preparation :February 2015 Enter the model Click on the Enter the model button or use the tab at the bottom of the worksheet to go to the Introduction sheet. Sheet 2 - Introduction New Drug Capacity Calculator The New Drug Capacity Calculator is an Excel-based tool for estimating the resource required to deliver newly approved chemotherapy drugs. The pharmacy resource, nurse resource, chair time and activity tariffcan be estimated using this tool. The New Drug Capacity Calculator may assist with planning but it is not intended as a resource scheduling tool. NEXT PREVIOUS Click on the blue buttons below to navigate to the specific page of the New Drug Capacity Calculator. Chemotherapy Pathway Treatment Plan Pharmacy Capacity Nurse Capacity Chair Capacity Activity Tariffs The draftNHS standard specification template for adult systemic anti-cancer therapy services (December 2012) 1 specifies that the pathway of care for any chemotherapy patient will need to ensure that the provider services have capacity (in terms of oncology pharmacists and technical pharmacy staffand chairs) for checking prescriptions, reconstitution, and deliver of chemotherapy drugs. 1 DraftNHS Standard specification template for adult systemic anti-cancer therapy services, December 2012 https://www.engage.england.nhs.uk/consultation/ssc-area-b/supporting_documents/b3lservicespec.pdf Accessed January 2015 Costs and savings figures used in the model are for illustrative purposes only and the user's attention is drawn to the fact that outputs from the model are subject to a) the assumptions described within the model and b) the data that the user selects or decides to input into the model. GSK and NHS England accept no liability for losses arising, directly or indirectly, from the use of the model or its output. GSK and NHS England make no representation or warranty as to the suitability of the output of the model for any particular purpose. This worksheet has been designed to introduce the user to the New Drug Capacity Calculator and allows the user to navigate directly to specific sheets in the tool using the blue buttons. Sheet 2 - Introduction Functionality New Drug Capacity Calculator The New Drug Capacity Calculator is an Excel-based tool for estimating the resource required to deliver newly approved chemotherapy drugs. The pharmacy resource, nurse resource, chair time and activity tariffcan be estimated using this tool. The New Drug Capacity Calculator may assist with planning but it is not intended as a resource scheduling tool. NEXT PREVIOUS Click on the blue buttons below to navigate to the specific page of the New Drug Capacity Calculator. Chemotherapy Pathway Treatment Plan Pharmacy Capacity Nurse Capacity Chair Capacity Activity Tariffs Use arrows or blue navigation buttons to move to next page. The draftNHS standard specification template for adult systemic anti-cancer therapy services (December 2012) 1 specifies that the pathway of care for any chemotherapy patient will need to ensure that the provider services have capacity (in terms of oncology pharmacists and technical pharmacy staffand chairs) for checking prescriptions, reconstitution, and deliver of chemotherapy drugs. 1 DraftNHS Standard specification template for adult systemic anti-cancer therapy services, December 2012

https://www.engage.england.nhs.uk/consultation/ssc-area-b/supporting_documents/b3lservicespec.pdf Accessed January 2015 Costs and savings figures used in the model are for illustrative purposes only and the user's attention is drawn to the fact that outputs from the model are subject to a) the assumptions described within the model and b) the data that the user selects or decides to input into the model. GSK and NHS England accept no liability for losses arising, directly or indirectly, from the use of the model or its output. GSK and NHS England make no representation or warranty as to the suitability of the output of the model for any particular purpose. No data input is required on this sheet. Please read the disclaimer. Sheet 3 Chemotherapy Pathway CHEMOTHERAPY PATHWAY* For information only, no data input required on this sheet The New Drug Capacity Calculator estimates pharmacy capacity (staff and isolator time), oncology nurse capacity and oncology chair time associated with treating a cohort of patients with a new regimen of cancer drugs Chemotherapy booked for patient Chemotherapy prescribed for patient Prescription verified by oncology pharmacist Check blood tests Patient arrives for chemotherapy Chemotherapy organised Additional monitoring Nurse to administer chemotherapy Clinical review by nurse Discharge Prepare patients for chemotherapy Prepare chemotherapy in advance or on day Schedule patients for chemotherapy Synchronise booking with radiotherapy Calculate pharmacy capacity (isolator time and WTE) Initiate reconstitution & handling of chemotherapy Calculate oncology nurse capacity Calculate oncology chair time WTE = Whole Time Equivalent Key Areas of the pathway where capacity will be calculated Areas of the pathway that will NOT be included in the capacity calculations * Sample pathway as described in the draftNHS standard specification template for adult systemic anti-cancer therapy services, December 2012. https://www.engage.england.nhs.uk/consultation/ssc-area-b/supporting_documents/b3lservicespec.pdf Accessed January 2015 For current service specification refer to NHS England Chemotherapy CRG webpage. http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-b/b15/ Acessed January 2015 NEXT PREVIOUS This sheet has been designed to introduce the user to the Chemotherapy Pathway, as described in the draft NHS Standard specification template for adult systemic anti-cancer therapy services (December 2012). Although the pathway may vary slightly according to local practice, the general flow of the patient through this pathway should be similar in different parts of the country. Sheet 3 Chemotherapy Pathway Functionality Green boxes represent areas of the pathway where capacity is being calculated. CHEMOTHERAPY PATHWAY* For information only, no data input required on this sheet The New Drug Capacity Calculator estimates pharmacy capacity (staff and isolator time), oncology nurse capacity and oncology chair time associated with treating a cohort of patients with a new regimen of cancer drugs Chemotherapy booked for patient Chemotherapy prescribed for patient Prescription verified by oncology pharmacist Check blood tests Patient arrives

for chemotherapy Chemotherapy organised Additional monitoring Nurse to administer chemotherapy Clinical review by nurse Discharge Prepare patients for chemotherapy Prepare chemotherapy in advance or on day Schedule patients for chemotherapy Synchronise booking with radiotherapy Initiate reconstitution & handling of chemotherapy Calculate oncology nurse capacity Calculate pharmacy capacity (isolator time and WTE) Calculate oncology chair time WTE = Whole Time Equivalent Key Areas of the pathway where capacity will be calculated Areas of the pathway that will NOT be included in the capacity calculations * Sample pathway as described in the draftNHS standard specification template for adult systemic anti-cancer therapy services, December 2012. https://www.engage.england.nhs.uk/consultation/ssc-area-b/supporting_documents/b3lservicespec.pdf Accessed January 2015 For current service specification refer to NHS England Chemotherapy CRG webpage. http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-b/b15/ Acessed January 2015 Reference for document that describes the pathway. Describes the service area where capacity calculation will be shown in the summary. NEXT PREVIOUS Click home button to return to the Introduction sheet. Sheet 4 Treatment Plan (1) CALCULATE CHEMOTHERAPY DELIVERY TIME FOR COHORT OF PATIENTS FOR ONE YEAR Detailed treatment plan (per patient) NEXT PREVIOUS Step 1: Select, drug type, route, infusion type and times using the drop-down buttons Drug type Route Infusion type Infusion time (mins) Observation time (mins) Administrations per cycle Oral Oral Not Applicable 0 15 1 Drug 2 IV IV Infusion Ready made infusion bag 60 60 2 Drug 3 IV IV Bolus Infusion bag 60

0 1 Drug 4 IV Sub-cut Syringe 10 0 1 Drug 5 MAB IV Infusion Infusion bag 60 180 1 Drug 6 None None None 0 0 1 250 315 Table 1a Drug 1 First Cycle If Cycle 1 is different from subsequent cycles select "Yes" and complete Tables 1a and 1b. If Cycle 1 is the same as subsequent cycles select "No" and complete Table 1b only. Select "No" to set the totals in Table 1a to zero. Yes Is Cycle 1 different? Time for first cycle Manually input data into the white boxes that do not have drop-down buttons. Select "None'"for drug type, route and infusion type to blank out rows when less than 6 drugs are used in the regimen. All or Subsequent Cycles Table 1b Drug 1 Oral Oral Not Applicable 0 0 1 Drug 2 IV IV Infusion Ready made infusion bag 60 60 1 Infusion timInfusion es are ignored drugs for timesfor areoral ignored Drug 3 IV IV Infusion Infusion bag

60 0 1 Drug 4 IV Sub-cut Syringe 10 0 1 Drug 5 IV IV Infusion Infusion bag 60 180 1 Drug 6 None None None 0 0 1 oral drugs. Observation times can be included by selecting "Not Applicable" in the "Infusion type" column and selecting an observation time. 190 240 Time per cycle for all/ subsequent cycles Sum the values in table 1b? Yes Select "No" to set the totals in Table 1b to zero. This sheet allows the user to put together a treatment plan for a cohort of patients. The delivery time for delivering a new drug regimen to a cohort of patients is calculated on the basis of the input data. Sheet 4 Treatment Plan (2) Step 2: Individualise treatment plan for one patient Table 2 Enter planned number of cycles Total time per patient (hours) 10 For clinical trials enter the average number of cycles in the trial. 74 Step 3. Chemotherapy delivery time for cohort Table 3 Enter number of patients to be treated per year 15 Total time for cohort 1,109 hours 148 days NEXT PREVIOUS Input the number of treatment cycles and the number of patients in this section of the treatment plan worksheet. Sheet 4 Treatment Plan Functionality CALCULATE CHEMOTHERAPY DELIVERY TIME FOR COHORT OF PATIENTS FOR ONE YEAR Detailed treatment plan (per patient) NEXT PREVIOUS Step 1: Select, drug type, route, infusion type and times using the drop-down buttons If Cycle 1 is diffe rent from subsequent cycles select "Yes" and complete Tables 1a and 1b. If Cycle 1 is the same as subsequent cycles select "No" and complete Table 1b only. Select "No" to set the totals in Table 1a to zero. Yes

Is Cycle 1 different? Drug type Route Infusion type Infusion time (mins) Observation time (mins) Administrations per cycle Oral Oral Not Applicable 15 1 Drug 2 IV IV Infusion Ready made infusion bag 0 60 60 2 Drug 3 IV IV Bolus Infusion bag 60 0 1 Drug 4 IV Sub-cut Syringe 10 0 1 Drug 5 MAB IV Infusion Infusion bag 60 180 1 Drug 6 None None None 0 250 0 315 1 First Cycle Table 1a Drug 1 Time for first cycle Manually input data into the white boxes that do not have drop-down buttons. Select "None'"for drug type, route and infusion type to blank out rows when less than 6 drugs are used in the regimen. All or Subsequent Cycles Table 1b

Sum the values in table 1b? Drug 1 Oral Oral Not Applicable 0 0 1 Drug 2 IV IV Infusion Ready made infusion bag 60 60 1 Infusion timInfusion es are ignored drugs for timesfor areoral ignored Drug 3 IV IV Infusion Infusion bag 60 0 1 Drug 4 IV Sub-cut Syringe 10 0 1 Drug 5 IV IV Infusion Infusion bag 60 180 1 None 0 190 0 240 1 oral drugs. Observation times can be included by selecting "Not Applicable" in the "Infusion type" column and selecting an observation time. None None Time per cycle for all/ subsequent cycles Drug 6 Follow the instructions in Steps 1, 2 and 3. The headers for tables 1a and 1b contain information in the comments boxes. Use drop-down buttons to input details of the regimen. Input data manually in the white boxes that do not contain drop-down lists. Yes Select "No" to set the totals in Table 1b to zero. Step 2: Individualise treatment plan for one patient Table 2 Total time per patie nt (hours) Enter planned number of cycles 10

For clinical trials enter the average number of cycles in the trial. 74 Select None in Drug type Route or infusion type to blank out rows. Step 3. Chemotherapy delivery time for cohort Table 3 Enter number of patie nts to be treated per year 15 Total time for cohort 1,109 148 hours NEXT days PREVIOUS Throughout the tool some cells contain additional information in the comments box (as denoted by a red triangle). Hover your mouse over the red triangle in the corner of the cell to view the information. Sum of infusion and observation times for specified number of cycles for the whole cohort of patients. Sheet 5 Pharmacy Capacity CALCULATE PHARMACY CAPACITY Time in the white box for isolator cleaning time can be changed by overtyping, times in the "Variable time" column can be changed using the drop-down buttons. Fixed times and Whole Time Equivalent (WTE) times can be modified by clicking on the hyperlinks below. No other figures should be changed on this sheet. NEXT PREVIOUS Type of Item/activity Number of cycles Quantity for cohort PRESCRIPTION VERIFICATION/REVIEW Cycle 1 prescription verification/review Subsequent cycles prescription verification/review Fixed time/ item (min) Variable time /item (min) Total time (hours) Stafftime (WTE days) Isolator time (days) 2.5 0.5 N/A N/A Step 1 - Select times for prescription verification/review 1 9 15 135 N/A N/A 10 5 TOTAL TIME FOR PRESCRIPTION VERIFICATION/ REVIEW FOR THE COHORT ADDITIONAL CHECKS 11.3 2.1 13.8 2.5 Step 2 - Select time for additional checks Check blood tests 10 150 N/A 10 25.0 4.6 N/A

Other checks 10 150 N/A 5 12.5 2.3 N/A 37.5 6.9 TOTAL TIME FOR ADDITIONAL CHECKS FOR COHORT MANUFACTURING - CYCLE 1 Step 3 - Select time for manufacturing each item - Cycle 1 Infusion bag 1 30 34 60 47.0 8.7 6.3 Syringe 1 15 24 30 13.5 2.5 1.8 Ready made syringe 1 0 15 0 0.0 0.0 0.0 Ready made infusion bag 1 30 0 7.5 1.4 1.0 Oral 1 15 15 10 0 2.5 0.5 N/A 70.5 13.1 9.1 TOTAL MANUFACTURING TIME FOR CYCLE 1 MANUFACTURING - ALL/SUBSEQUENT CYCLES Step 4 - Select time for manufacturing each item - all/subsequent cycles) Infusion bag 9 270 34

30 288.0 53.3 38.4 Syringe 9 135 24 30 121.5 22.5 16.2 Ready made syringe 9 0 15 0 0.0 0.0 0.0 Ready made infusion bag 9 135 0 33.8 6.3 4.5 Oral 9 135 15 10 0 TOTAL MANUFACTURING TIME FOR ALL/SUBSEQUENT CYCLES ISOLATOR CLEANING Isolator cleaning time Isolator time in days is calculated on the basis of 7.5 hours. Stafftime in days is based on Whole Time Equivalent (WTE). 22.5 4.2 N/A 465.8 86.3 59.1 0.9 N/A N/A 588 109 68 Click here to change the number of hours that constitute WTE. Step 5 - Review time assigned for cleaning isolator(s)* N/A TOTAL PHARMACY RESOURCE REQUIREMENTS FOR THE COHORT 1 52 N/A *Isolator cleaning time is applied to infusion bags and syringes only. N/A = Not Applicable WTE = Whole Time Equivalent Click here to change fixed times. Click here to change the number of hours that constitiute WTE NEXT PREVIOUS

This sheet allows the user to calculate the pharmacy capacity needed to deliver the newly approved medications. It calculates the time needed for items that require aseptic preparation and those that are pre-filled items. The output is expressed in Whole Time Equivalents (WTE) days for pharmacy staff and the isolator time needed to deliver the regimen to a cohort of patients. Sheet 5 Pharmacy Capacity Functionality CALCULATE PHARMACY CAPACITY Time in the white box for isolator cleaning time can be changed by overtyping, times in the "Variable time" column can be changed using the drop-down buttons. Fixed times and Whole Time Equivalent (WTE) times can be modified by clicking on the hyperlinks below. No other figures should be changed on this sheet. NEXT PREVIOUS Type of Item/activity Number of cycles Quantity for cohort 1 15 PRESCRIPTION VERIFICATION/REVIEW Cycle 1 prescription verification/review Subsequent cycles prescription verification/review Fixed time/ item (min) Variable time /item (min) Total time (hours) Stafftime (WTE days) Isolator time (days) 2.5 0.5 N/A N/A Step 1 - Select times for prescription verification/review 9 N/A 135 N/A 10 5 TOTAL TIME FOR PRESCRIPTION VERIFICATION/ REVIEW FOR THE COHORT ADDITIONAL CHECKS 11.3 2.1 13.8 2.5 Step 2 - Select time for additional checks Check blood tests 10 150 N/A 10 25.0 4.6 N/A Other checks 10 150 N/A 5 12.5 2.3 N/A 37.5 6.9 TOTAL TIME FOR ADDITIONAL CHECKS FOR COHORT MANUFACTURING - CYCLE 1 Step 3 - Select time for manufacturing each item - Cycle 1

Infusion bag 1 30 34 60 47.0 8.7 6.3 Syringe 1 15 24 30 13.5 2.5 1.8 Ready made syringe 1 0 15 0 0.0 0.0 0.0 Ready made infusion bag 1 30 0 7.5 1.4 1.0 Oral 1 15 15 10 0 2.5 0.5 N/A 70.5 13.1 9.1 TOTAL MANUFACTURING TIME FOR CYCLE 1 MANUFACTURING - ALL/SUBSEQUENT CYCLES Isolator time in days is calculated on the basis of 7.5 hours. Stafftime in days is based on Whole Time Equivalent (WTE). Step 4 - Select time for manufacturing each item - all/subsequent cycles) Infusion bag 9 270 34 30 288.0 53.3 38.4 Syringe 9 135 24 30 121.5

22.5 16.2 Ready made syringe 9 0 15 0 0.0 0.0 0.0 Ready made infusion bag 9 135 0 33.8 6.3 4.5 Oral 9 135 15 10 0 TOTAL MANUFACTURING TIME FOR ALL/SUBSEQUENT CYCLES ISOLATOR CLEANING Isolator cleaning time Use the drop-down buttons to input data on the variable time activities. 22.5 4.2 N/A 465.8 86.3 59.1 0.9 N/A N/A 588 109 68 Click here to change the number of hours that constitute WTE. Data on the number of patients, cycles and items is drawn from the Treatment plan sheet. Step 5 - Review time assigned for cleaning isolator(s)* N/A 1 52 TOTAL PHARMACY RESOURCE REQUIREMENTS FOR THE COHORT N/A *Isolator cleaning time is applied to infusion bags and syringes only. N/A = Not Applicable WTE = Whole Time Equivalent Click here to change fixed times. Click here to change the number of hours that constitiute WTE Input data manually in the white box for isolator cleaning time multiplier. Select hyperlink to Pharmacy References sheet to change or review fixed times. NEXT PREVIOUS Select hyperlink to local Assumptions sheet to whole time equivalent (WTE) figure which is set at a default figure of 5.4 hours.

Sheet 6 Nurse Capacity CALCULATE NURSE CAPACITY Times in the "Time/cycle/patie nt" column can be changed using the drop-down buttons. Whole Time Equivalent (WTE) times can be modified by clicking on the hyperlink below. No other figures should be changed on this sheet. NEXT PREVIOUS Type of Item/activity Quantity/patient CLINICAL REVIEW (NOT INCLUDED IN CHAIR TIME) Check blood tests Administrative tasks Pre-chemo assessment Other clinical assessments Total times for clinical review N/A N/A N/A N/A Time /cycle/patie nt for regimen (min) Total time for cohort (hours) Step 1 - Select times for the following clinical review activities 50.0 9.3 20 50.0 9.3 20 37.5 6.9 15 12.5 2.3 5 150.0 27.8 ADDITIONAL CHECKS/PREPARATION (NOT INCLUDED IN CHAIR TIME) Cycle 1 N/A Subsequent cycles N/A Total times for additional checks/preparations that do not use chair time Step 2 - Select combined time for activitie s 5.0 20 45.0 20 50.0 PATIENT & EQUIPMENT CHECKS/PREPARATION (INCLUDED IN CHAIR TIME) Step 3 - Select combined time for this type of activity Cycle 1 N/A Subsequent cycles N/A Total times for patient & equipment checks/preparation that use chair time Staffresource (WTE days) 60 60 15.0 135.0 150.0 0.9 8.3 9.3 2.8 25.0 27.8 CHEMOTHERAPY DRUG ADMINISTRATION (INCLUDED IN CHAIR TIME) Oral 1 Sub-cut 1 Intramuscular 0 IV bolus 0 3 IV infusion Intrathecal 0 Total times for chemotherapy drug administration Step 4 - Select times for drug administration 12.5 5 12.5 5 0.0 5 0.0 5 37.5 5 0.0 5 62.5 2.3 2.3 0.0 0.0 6.9 0.0

11.6 TIME SPENT MONITORING PATIENT (INCLUDED IN CHAIR TIME) Cycle 1 Subsequent cycles Total time spent monitoring patients Step 5 - Select time the nurse spends with patie nt 5.0 20 45.0 20 50.0 0.9 8.3 9.3 TOTALS FOR ACTIVITIES THAT REQUIRE CHAIR TIME TOTAL NURSE RESOURCE REQUIREMENT FOR THE COHORT N/A N/A 263 463 The assumption in Steps 1 & 4 is that the activites will take similar lengths of time for cycle 1 and subsequent cycles. In Steps 2, 3 & 5 different times may be selected for cycle 1 and subsequent cycles. Click here to change the number of hours that constitute WTE. 49 86 NEXT PREVIOUS This sheet allows the user to calculate the nurse capacity needed to deliver the newly approved regimen. It calculates the time needed for the nurses to deliver the specified regimen for a cohort of patients. The output is expressed in WTE days of nurse staff resource needed for delivery of the regimen. Sheet 6 Nurse Capacity Functionality CALCULATE NURSE CAPACITY Times in the "Time/cycle/patient" column can be changed using the drop-down buttons. Whole Time Equivalent (WTE) times can be modified by clicking on the hyperlink below. No other figures should be changed on this sheet. NEXT PREVIOUS Type of Item/activity Quantity/patient CLINICAL REVIEW (NOT INCLUDED IN CHAIR TIME) Check blood tests Administrative tasks Pre-chemo assessment Other clinical assessments Total times for clinical review N/A N/A N/A N/A Time /cycle/patient for regimen (min) Total time for cohort (hours) Step 1 - Select times for the following clinical review activities 50.0 9.3 20 50.0 9.3 20 37.5 6.9 15 12.5 2.3 5 150.0 27.8 ADDITIONAL CHECKS/PREPARATION (NOT INCLUDED IN CHAIR TIME) Cycle 1 N/A Subsequent cycles N/A Total times for additional checks/preparations that do not use chair time Step 2 - Select combined time for activities 5.0 20 45.0 20 50.0 PATIENT & EQUIPMENT CHECKS/PREPARATION (INCLUDED IN CHAIR TIME) Step 3 - Select combined time for this type of activity Cycle 1 N/A Subsequent cycles N/A Total times for patient & equipment checks/preparation that use chair time Staffresource (WTE days)

60 60 15.0 135.0 150.0 0.9 8.3 9.3 2.8 25.0 27.8 CHEMOTHERAPY DRUG ADMINISTRATION (INCLUDED IN CHAIR TIME) Oral 1 Sub-cut 1 Intramuscular 0 IV bolus 0 3 IV infusion Intrathecal 0 Total times for chemotherapy drug administration Step 4 - Select times for drug administration 12.5 5 12.5 5 0.0 5 0.0 5 37.5 5 0.0 5 62.5 2.3 2.3 0.0 0.0 6.9 0.0 11.6 TIME SPENT MONITORING PATIENT (INCLUDED IN CHAIR TIME) Cycle 1 Subsequent cycles Total time spent monitoring patie nts Step 5 - Select time the nurse spends with patient 5.0 20 45.0 20 50.0 0.9 8.3 9.3 N/A N/A TOTALS FOR ACTIVITIES THAT REQUIRE CHAIR TIME TOTAL NURSE RESOURCE REQUIREMENT FOR THE COHORT 263 463 The assumption in Steps 1 & 4 is that the activites will take similar lengths of time for cycle 1 and subsequent cycles. In Steps 2, 3 & 5 different times may be selected for cycle 1 and subsequent cycles. Click here to change the number of hours that constitute WTE. 49 86 NEXT PREVIOUS Nurse resource that requires chair time and total nurse resource is calculated. Use the drop-down buttons to input data. Nurse activities that require chair time and those that do not, need to be entered in different sections of the table. Input the total time per patient for the activities described in steps 2, 3 and 5. Cycle 1 data may be entered separately from that of subsequent cycles. Sheet 7 Chair Capacity ESTIMATE OF CHAIR CAPACITY NEXT Summary of treatment plan Drug Type Oral Sub-cut

Intramuscular IV bolus IV infusion Intrathecal Number of patients Total time from treatment plan (hours) Nurse led activities (hours)* Items to administer 1 1 0 0 3 0 PREVIOUS 15 1,109 213 Total chair occupation time in chemotherapy delivery unit TOTAL CHAIR TIME REQUIRED FOR THE COHORT (days) 176 * The nurse monitoring time is omitted from the calculation of chair time. It is covered within the observation time recorded on the 'Treatment Plan' worksheet and hence is already captured in the "Total time from treatment plan" figure shown on this worksheet. This sheet shows the chair capacity needed to deliver the newly approved regimen for a cohort of patients. Sheet 7 Chair Capacity Functionality ESTIMATE OF CHAIR CAPACITY NEXT Summary of treatment plan Drug Type Oral Sub-cut Intramuscular IV bolus IV infusion Intrathecal Items to administer 1 1 0 0 3 0 Number of patients Total time from treatment plan (hours) Nurse led activities (hours)* 15 1,109 213 PREVIOUS Shows the different drug types that need to be delivered for the new regimen in the chemotherapy unit. Data is drawn from the Treatment plan and Nurse Capacity sheets. Total chair occupation time in chemotherapy delivery unit TOTAL CHAIR TIME REQUIRED FOR THE COHORT (days) 176 * The nurse monitoring time is omitted from the calculation of chair time. It is covered within the observation time recorded on the 'Treatment Plan' worksheet and hence is already captured in the "Total time from treatment plan" figure shown on this worksheet. No data input is required on this sheet. The default setting is that each chair is bookable for 7.5 hours/day Sheet 8 Pathway Results CHEMOTHERAPY PATHWAY - CAPACITY REQUIRED* This page presents the results of this capacity estimate (pharmacy capacity (WTE and isolator time), oncology nurse capacity and oncology chair time associated with delivery of the regimen you have detailed for the cohort of interest). Chemotherapy booked for Chemotherapy prescribed for patient Check blood tests Additional monitoring Prescription verified by oncology Patient arrives for chemotherapy Chemotherapy organised Nurse to administer chemotherapy

Clinical review by nurse Discharge Prepare patients for chemotherapy Prepare chemotherapy in advance or on day Schedule patients for chemotherapy Calculate pharmacy capacity (Isolator time and WTE) StaffResource (WTE days) Isolator time (days) 109 68 Synchronise booking with radiotherapy Initiate reconstitution & handling of chemotherapy Calculate oncology nurse capacity StaffResource (WTE days) 86 Calculate oncology chair time Chair time (days) 176 WTE = Whole Time Equivalent Key Areas of the pathway where capacity will be calculated Click here for Results Table. Areas of the pathway that will NOT be included in the capacity calculations * Sample pathway as described in the draftNHS standard specification template for adult systemic anti-cancer therapy services, December 2012. https://www.engage.england.nhs.uk/consultation/ssc-area-b/supporting_documents/b3lservicespec.pdf Accessed January 2015 For current service specification refer to NHS England Chemotherapy CRG webpage. http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-b/b15/ Acessed January 2015 NEXT PREVIOUS This sheet collates the capacity information on resources needed to deliver the newly approved regimen. It is designed to act as a snap-shot of the collated resources and may be used to provide an overview of the overall capacity needed for delivery of a newly approved drug regimen. As it draws on the inputs from previous sections, the previous worksheets have to be completed before the overview can be generated. Sheet 8 Pathway Results Functionality CHEMOTHERAPY PATHWAY - CAPACITY REQUIRED* This page presents the results of this capacity estimate (pharmacy capacity (WTE and isolator time), oncology nurse capacity and oncology chair time associated with delivery of the regimen you have detailed for the cohort of interest). Chemotherapy booked for Chemotherapy prescribed for patient Check blood tests Additional monitoring Prescription verified by oncology Patient arrives for chemotherapy Chemotherapy organised Nurse to administer chemotherapy Clinical review by nurse Discharge Prepare patients for chemotherapy Prepare chemotherapy in advance or on day Schedule patients for chemotherapy Calculate pharmacy capacity (Isolator time and WTE) StaffResource (WTE days) Isolator time (days)

109 68 Synchronise booking with radiotherapy Initiate reconstitution & handling of chemotherapy Calculate oncology nurse capacity StaffResource (WTE days) 86 Calculate oncology chair time Chair time (days) 176 WTE = Whole Time Equivalent Key Areas of the pathway where capacity will be calculated Click here for Results Table. Areas of the pathway that will NOT be included in the capacity calculations * Sample pathway as described in the draftNHS standard specification template for adult systemic anti-cancer therapy services, December 2012. https://www.engage.england.nhs.uk/consultation/ssc-area-b/supporting_documents/b3lservicespec.pdf Accessed January 2015 For current service specification refer to NHS England Chemotherapy CRG webpage. http://www.england.nhs.uk/commissioning/spec-services/npc-crg/group-b/b15/ Acessed January 2015 NEXT PREVIOUS Grey boxes indicate which capacities have been calculated. The totals on the Pharmacy , Nurse and Chair Capacity worksheets are summarised here. Sheet 9 Results Table RESULTS TABLE NEXT PREVIOUS Enter the Title of the New Chemotherapy Regimen StaffResource (WTE days) Isolator Time (days) Chair Time (days) PHARMACY 109 68 N/A NURSE 86 N/A N/A FACILITIES N/A N/A 176 TOTAL 194 68 176 WTE = Whole Time Equivalent The results are tabulated on this worksheet. No inputs are required. Isolator and chair time in days is calculated on the basis of 7.5 hours per day. Stafftime in days is based on WTE Click here to change the number of hours that constitute WTE Sheet 10 Local Assumptions Functionality LOCAL ASSUMPTIONS NEXT PREVIOUS Average opening time for chemotherapy unit Average opening time for pharmacy unit

Fixed time for pharmacy staff Assistants Pharmacists Technicians Available time (hours) 7.5 7.5 27.3 27.3 27.3 Fixed time for chemotherapy nursing staff Chemotherapy-trained nurse 27.3 Fixed time for oncology clinic staff Nurses Oncologists 27.3 27.3 To change how long the chemotherapy unit is open or the WTE enter the new values in the appropriate white box. Time available for performing fixed time tasks. For details of the actual times used in the fixed time calculations, refer to the Pharmacy References page. WTE calculations 1 whole time equivalent is 37.5 hours per week (or 2250 mins per week) Deduct 40 mins per day (2X20 min breaks) (-200 mins/week) Deduct 20% for holidays, sickness, training etc. 1 WTE =27.3 hrs/week or 5.4 hours per day Change hours worked / day To change the number of hours that the chemotherapy unit is open, input the number of hours manually into the white box. 5.4 Whole Time Equivalent (WTE) To change the WTE, input the number of hours/day manually into the white box. This sheet shows the information on the local assumptions that are used in the Capacity Calculator tool. The assumptions currently used are derived from the data that has been provided by the Newcastle Cancer Centre. Sheet 11 Pharmacy references GUIDANCE ON FIXED TIMES FOR PHARMACY* Time taken per infusion (mins) Task Clinical Check Workhseet & labels Setti ng Up Checking Ingredients Transfer Labelling, Final Check, Release Delivery TOTAL (mins) Time taken per syringe (mins) Task Clinical Check Worksheet & labels Setti ng Up Checking Ingredients Transfer Labelling, Final Check, Release Delivery TOTAL (mins) NEXT Assistant Pharmacist 5 10 5 2 5 5 2 12 12 10 Assistant Technician Pharmacist 4 6 4 2 4 2 2 10 Time taken per ready made item (mins) Task Assistant Release

Dispensing & labelling 5 Final Check TOTAL (mins) 5 Time taken per oral drug (mins) Task Dispensing & Labelling Final Check TOTAL (mins) Technician 8 6 Technician Pharmacist 5 0 Assistant Technician 7 0 7 5 10 Pharmacist 3 3 Total 5 10 5 2 5 5 2 34 Total 4 6 4 2 4 2 2 24 PREVIOUS Input numbers into the white boxes to change the fixed times used in the pharmacy capacity calculations. Total 5 5 5 15 Total 7 3 10 Isolator cleaning time (mins) Task Assistant Technician Pharmacist Total Initial Clean of Isolator 15 15 Final Clean of Isolator 22 22 Environmental Monitoring 15 15 TOTAL (mins) 15 37 0 52 *The data shown above has been collated by Steve Williamson, Consultant Cancer Pharmacist , Northumbria Healthcare / Cumbria, Northumberland, Tyne & Wear Area Team, NHS England This sheet gives details of the aseptic preparation fixed times used in the pharmacy capacity calculations. The times that are currently in the tool are derived from the data that has been provided by the Newcastle Cancer Centre. If local data needs to be used, the data in the white boxes can be changed manually. Sheet 12 Activity Tariffs UNBUNDLED HRGs FOR CHEMOTHERAPY DELIVERY FOR REGIMENS ON THE NATIONAL LIST* This sheet generates the likely tariffcosts for delivering unbundled HRGs for chemotherapy delivery for regimens on the national list. If the chemotherapy regimen being delivered is not on the national list, this sheet will not apply and please use code SB17Z and local tariffinformation. NEXT PREVIOUS All oral regimen - Tarifffor cohort Step 1 Is the regimen exclusively oral chemotherapy? HRG4 Code Total tarifffor cohort () Go to Step 2 Go to Step 2 No If yes, the following steps do not apply PREVIOUS

No Parenteral -Tarifffor Cycle 1 cohort Please select only one Yes Step 2 Is Cycle 1 simple parenteral chemotherapy? Yes SB12Z Tarifffor cycle one for cohort () 2,385 Step 3 Is Cycle 1 complex parenteral chemotherapy? No Go to Step 4 Tarifffor cycle one for cohort () Go to Step 4 Tarifffor cycle one for cohort () Step 4 Is Cycle 1 complex parenteral chemotherapy, including prolonged infusion treatment at first attendance? Select "Yes" or "No" using the drop-down buttons Click here for details of HRG costs No Go to Results Go to Results Parenteral -Tarifffor subsequent cycles for cohort Results Cost for delivering subsequent cycles of chemotherapy (SB15Z) 42,660 Total national activity tarifffor cohort (all cycles) 45,045 *National tariffpayment system 2014/15, Annex 5A national prices. https://www.gov.uk/government/publications/national-tariff-payment-system-2014-to-2015 Accessed January 2015 VARIABLE TARIFF CALCULATOR Total cycles of chemotherapy for cohort 150 Chemotherapy preparation tariff 0 NEXT NEXT Total variable tarifffor the cohort () 0 PREVIOUS This sheet shows the likely tariff costs for delivery of the new chemotherapy regimen. Sheet 12 Activity Tariffs Functionality UNBUNDLED HRGs FOR CHEMOTHERAPY DELIVERY FOR REGIMENS ON THE NATIONAL LIST* This sheet generates the likely tariffcosts for delivering unbundled HRGs for chemotherapy delivery for regimens on the national list. If the chemotherapy regimen being delivered is not on the national list, this sheet will not apply and please use code SB17Z and local tariffinformation. NEXT PREVIOUS All oral regimen - Tarifffor cohort Step 1 Is the regimen exclusively oral chemotherapy? HRG4 Code Total tarifffor cohort () Go to Step 2 Go to Step 2 No If yes, the following steps do not apply PREVIOUS No Parenteral -Tarifffor Cycle 1 cohort Please select only one Yes Step 2 Is Cycle 1 simple parenteral chemotherapy? Yes SB12Z Tarifffor cycle one for cohort () 2,385 Step 3 Is Cycle 1 complex parenteral chemotherapy?

No Go to Step 4 Tarifffor cycle one for cohort () Go to Step 4 Tarifffor cycle one for cohort () Step 4 Is Cycle 1 complex parenteral chemotherapy, including prolonged infusion treatment at first attendance? Select "Yes" or "No" using the drop-down buttons Click here for details of HRG costs No Go to Results Cost for delivering subsequent cycles of chemotherapy (SB15Z) 42,660 Total national activity tarifffor cohort (all cycles) For parenteral drugs select Yes once in this section. 45,045 *National tariffpayment system 2014/15, Annex 5A national prices. https://www.gov.uk/government/publications/national-tariff-payment-system-2014-to-2015 Accessed January 2015 VARIABLE TARIFF CALCULATOR Total cycles of chemotherapy for cohort Use hyperlink to review national tariff Information. Go to Results Parenteral -Tarifffor subsequent cycles for cohort Results Select Yes in Step 1 if the new regimen is comprised totally of oral drugs. 150 Chemotherapy preparation tariff 0 NEXT NEXT Total variable tarifffor the cohort () 0 PREVIOUS Use this section of the worksheet for activities that are not on the national tariff list. Manually input the tariff in the white box. Sheet 13 Tariff Information DETAILS OF CHEMOTHERAPY COSTS (from the National tariffpayment system 2014/15 - Annex 5A Spreadsheet) PREVIOUS HRG code SB11Z SB12Z SB13Z SB14Z SB15Z SB17Z HRG name Deliver Exclusively Oral Chemotherapy Deliver Simple Parenteral Chemotherapy at first attendance Deliver more Complex Parenteral Chemotherapy at first attendance Deliver Complex Chemotherapy, including Prolonged Infusion Treatment at first attendance Deliver Subsequent Elements of a Chemotherapy Cycle Deliver Chemotherapy for Regimens not on the National List Tariff() 126 159 316 475 316 - National tariffpayment system 2014/15, Annex 5A national prices. https://www.gov.uk/government/publications/national-tariff-payment-system-2014-to-2015 Accessed January 2015 The 2014-15 national tariffs for chemotherapy delivery are on the Excel worksheet labelled 04. Unbundled Services and are in table 2 Unbundled chemotherapy delivery Details of the HRG codes and tariff costs used in the calculation of the activity tariffs are given on this sheet. The reference is also provided.

Recently Viewed Presentations

  • CHAPTER OVERVIEW - Ed W. Clark High School

    CHAPTER OVERVIEW - Ed W. Clark High School

    Discuss Hagia Sophia, Corpus JurisCivilis, and his absolute power. Describe Christianity under the Byzantine Empire . What caused the fall of the Byzantine Empire? What were the effects? ... What is the Quran? What are it's basic teachings? Describe the...
  • SUPERLATIVE ADJECTIVES - İngilizce Dersi Yazılı Soruları ...

    SUPERLATIVE ADJECTIVES - İngilizce Dersi Yazılı Soruları ...

    SUPERLATIVE ADJECTIVES Boxing is interesting. Baseball is interesting Football is the most interesting sport in Turkey. Adjectives with one syllable (tek hece) Hot hotter the hottest Example :Antalya is a hot city.
  • Historians have disagreed about the extent to which

    Historians have disagreed about the extent to which

    Assignment. The assignment has taken account of a range of views, and these are compared and contrasted in a discussion of relevant issues. The decision to write one overall response, rather than divide it into sections, has resulted in a...
  • Incorporating CCSSE and SENSE Into the Accreditation Process

    Incorporating CCSSE and SENSE Into the Accreditation Process

    data in QEP. Reaffirmed by SACS-COC in 2010. SACS-COC Principles of Accreditation. Section I: The Principle of Integrity. ... The institution identifies college-level general education competencies and the extent to which graduates have attained them.
  • The characteristics, objectives and benefits of Leisure ...

    The characteristics, objectives and benefits of Leisure ...

    Leisure time Play, physical recreation and sport. Characteristics 'Spare time' during which you choose what to do- Personal Choice. Available once all other commitments are completed. E.g. Going to school ,part-time job, homework etc. Various ways to spend it. Some...
  • Emily Anne Espinosa - Murrieta Valley Unified School District

    Emily Anne Espinosa - Murrieta Valley Unified School District

    In 1815, Austria, Russia, and Prussia embarked on a crusade against the ideas and politics of dual revolution. September 1815 - Tsar Alexander I proposed the "Holy Alliance" (Austria, Russia, Prussia) Alliance became the symbol of "repression of liberal and...
  • THE SYNTHESIS ESSAY - Bloomfield College

    THE SYNTHESIS ESSAY - Bloomfield College

    THE SYNTHESIS ESSAY Mary Ellen Haley Center for Academic Development What is "synthesis"? Definition: "Synthesis" is the combining of separate elements or substances to form a coherent whole. What is a synthesis essay? Definition: A synthesis essay brings together your...
  • Slajd 1 - KDPW_CCP

    Slajd 1 - KDPW_CCP

    CCP12 Working Group 2 - Review of CPSS-IOSCO Standards and key recent regulatory publications . CCP12 Working Group 3 - Default Contact List and Information Sharing. 4 August 2012 - entry into force of new provisions of the Act on...