National Cancer Action Team

There are two programmes to improve treatment for colorectal cancer patients which are described below.

Laparoscopic Colorectal Surgery Training (LAPCO)

In August 2006, NICE issued a technology appraisal recommending laparoscopic resection as an alternative to open surgery for people with colorectal cancer in whom both procedures were suitable. NICE estimated that the surgery would result in shorter bed stays and significantly improve the patient experience. On 31 October 2006, the Department of Health waived the 3-month funding direction to implement this appraisal as it was recognised that there were insufficient surgeons trained in the procedure. 

NICE made it clear that laparoscopic colorectal surgery should only be performed by surgeons who had completed appropriate training in the technique and performed the technique often enough to maintain competence.  The national training programme (Lapco) was established by the National Cancer Action Team and the Department of Health during 2008 to accelerate the adoption of laparoscopic surgery amongst experienced consultant surgeons with the aim of training sufficient surgeons in this technique to allow access to this treatment for all colorectal cancer patients across the country. There are now 11 training centres around the country, based in 18 trusts.   

The National Clinical Lead for Lapco is Mark Coleman who has established the coordination office for the national programme in Plymouth.

The waiver was reviewed in 2009 by the Department, and it was decided to continue the waiver until October 2010.  From October 2010 all colorectal MDTs have had to ensure that every patient suitable for laparoscopic resection is given this choice of treatment. If laparoscopic surgery is not available suitable onward referral arrangements will need to be in place.  In March 2010 the colorectal measures for peer review were updated and now include five measures related to laparoscopic colorectal surgery.

Contacts for further information

For further details of the training programme please contact the national programme manager, Laura Langsford, Tel: 01752 439 845, Email: laura.langsford@nhs.net , or the National Clinical Lead, Mark Coleman, Email: mcoleman1@nhs.net

Full details of the programme are on the website http://www.lapco.nhs.uk/

Low Rectal Cancer Development Programme (LOREC)

The National Cancer Action Team and the Department of Health are developing a pilot training programme to improve patient care in low rectal cancer. 

The training programme will improve care for patients through a number of strands within the programme. 

• To tackle the variations in decision making we want to establish expert faculty workshops.  The workshops will be an opportunity to learn from the recognised experts in radiology, oncology, pathology and surgery to improve decision making on treatment for patients. 
• To tackle variations in surgery the training programme will include surgical training in ELAPE (extra levator abdominoperineal excision)
• In order to understand variations across the country we will work with NBOCAP (National Bowel Cancer Audit) to audit the quality of low rectal cancer care

Brendan Moran has been appointed to be the national clinical lead in order to provide leadership and to coordinate all aspects of the programme.  This is being undertaken with the support of the Association of Coloproctology of Great Britain and Ireland (ACPGBI).

For further details of the LOREC pilot programme please contact the programme manager, tel: 01256 314 746 Email: lorec@pelicancancer.org.

Full details of the programme are on the website, www.lorec.nhs.uk

Contacts for further information

For more information please contact, Andy McMeeking in the National Cancer Action Team, Tel: 0208 282 6317 or email: andy.mcmeeking@ncat.nhs.uk