1000 Lives Annual Report North of England Cancer Network Annual Conference 20 th September 2013.

1000 Lives

Annual Report

North of England Cancer Network Annual Conference

20th September 2013

NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l2

Plan• Geography

• Matrix working and team structure

• 1000 lives – 2011 to 2013

• Interactive model

• Preparing for 2014 - 2017

North of England Cancer Network Annual Conference

20th September 2013

Clinical Networks & Senates

3

North East, North Cumbria, and the Hambleton & Richmondshire districts of

North Yorks

Greater Manchester, Lancashire and south

Cumbria

Cheshire & Mersey

West Midlands

East Midlands

South West

Thames Valley

East of England

Wessex

Yorkshire & The Humber

South East Coast

London

NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

Associate Director, Clinical Director for Networks, Senate Chair

Prevention, early

diagnosis and

primary care

Treatment and Patient Experience

Long term conditions,

Living with… and End of Life

Care

Business and

Information Support

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1000 Lives – 2011 to 20132011 Finding 1000 people, Saving 1000 livesCAM survey Race for Life partnership Shopping centre campaign Cancer in Community group

2012 GP education sessions with CVD networkBCOC – bowel campaign

5 NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

1000 Lives – 2011 to 20132012 Fast focus events (FFEs) – lung and bowel OG local campaign BCOC lung and bowel refresh Regional blood in pee campaign

2013 4 x FFEs – prostate, skin, breast, acute

oncology Direct access to diagnosticsDecision support tools pilot

6NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

The Model - Background• Interactive Tool developed based on available data

relating to key factors that influence cancer outcomes – smoking prevalence, lifestyle, stage of disease, mode of presentation

• Prototypes developed – used in Fast Focus Events and presented here last year – feedback good:

• Excellent ‘starting’ tool for discussions.

• Very good for baseline data.

• Breakdown at ? PCT/Trust level would be useful

• The tool looks simple to use and results easily seen when factors are changed is useful

7 NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

Interactive model – current position

• Updated version of the Model available now - developed in collaboration with the NECN Pharmacy Industry Group

• Further development of data to reflect NHS changes

• Enhancements include:• Drill down to CCG level data• Inclusion of demographic data • Reporting facility to document results

• Small user event held at the end of August – feedback positive

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Summary Data Baseline

9

Demographics CCG NetworkRegistered patients 3,125,868 Factors affecting incidenceRegistered cancer cases 16,759 16,759 % Male 50% 50% Attributes CCG Network% Female 50% 50% Smoking 24% 24%% Age above 65 18% 18% Alcohol 29% 29%Deprivation level 18% 18% Obesity / Overweight 27% 27%

Inactivity 88% 88%Colorectal Statistics Male Female All Red Meat Consumption 97% 97%Incidence 1404 1022 2426 Low Fibre Intake 80% 80%Survival Rate - Year 1 78 78 78Survival Rate - Year 5 61 61 61 Factors affecting survivalMortality 471 339 810

Screening CCG Network% Screening rates 59% 59%

Cancer stagesDukes A 13%Dukes B 27%

0.10181 Dukes C 29%0.12416 Dukes D 31%0.270650.00546 Routes to diagnosis CCG Network0.02763 Screen detected 4% 4%

Two Week Wait 32% 32%GP referral 16% 16%Other Outpatient 9% 9%Inpatient Elective 11% 11%Emergency presentation 25% 25%Death Certificate Only 0% 0%Unknown 3% 3%

0

500

1000

1500

2000

2500

3000

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Colorectal Cancer Trend - Cases - Persons

Incidence - Persons Survivors - 1 Year Survivors - 5 Year Deaths - Persons

NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

Summary Data - Outputs

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Change in Survival

Screening Male Female

2013Baseline

Indicative change

based on trend

2014Forecast

Modelled Change

Revised Forecast No patients surviving 1 year 0 0

Incidence 2426 32 2458 0 2458 No patients surviving 5 years 0 01 Year Survivors 1883 1 1883 0 18835 Years Survivors 1487 1 1489 0 1489 Cancer stagesDeaths 810 -11 799 0 799 Dukes A 0

Dukes B 0Dukes C 0

Change in Incidence Dukes D 0

Attributes Male FemaleRoutes to diagnosis

Change in 1 year survival

Smoking 0 0 Male FemaleAlcohol 0 0 Screen detected 0 0Obesity / Overweight 0 0 Two Week Wait 0 0Inactivity 0 0 GP referral 0 0Low Fruit and Vegetable consumption 0 0 Other Outpatient 0 0

Inpatient Elective 0 0Emergency presentation 0 0Death Certificate Only 0 0Unknown 0 0

North East Network

Warning - modelled data is not linked and should be analysed in isolation

Change in 5 year survival

Generate report

NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

Effect of Interventions - Network

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Males Females Persons Males Persons Females Males Females Persons1404 1022 2426 471 810 793 861 626 1487

-12 -7 -18 -4 -6 5 7 4 111393 1015 2408 467 804 798 868 631 1499

Baseline Change Baseline Change Baseline Change

24% 23% 24% 23% 24% 23%

29% 28% 29% 28% 29% 28%

27% 27% 27% 27% 27% 27%

88% 88% 88% 88% 88% 88%

97% 97% 97% 97% 97% 97%

80% 80% 80% 80% 80% 80%

SAVI

NG

100

0 LI

VES

- M

OD

ELLI

NG

CO

LORE

CTA

L CA

NCE

R

North East Network

1090Males

9

Males

Smoking

Routes to Diagnosis

Change

Baseline

Incidence

Females

DeathsSurvivors - 5 Year

SurvivorsSurvivors - 1 Year

-2337

Persons1883

141099 1897

339

Attributable Factors Screening

Low Fibre Intake

Persons

Red Meat Consumption

Staging

Obesity / Overweight

Inactivity

New

Alcohol

Females

-4

-8

0 0 0 0

-4

-3

0 0 0 0

-8

-10

0 0 0 0

-12

-10

-8

-6

-4

-2

0Smoking Alcohol Obesity / Overweight Inactivity Red Meat Consumption Low Fibre Intake

Male Change in Incidence Female Change in Incidence All Change in Incidence

Reset

NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

The Model – Version 3

• Model available over lunch for you to look at

• Feedback welcomed – on increased functionality, how it looks etc.

• But also some specific questions to consider:

• Is the model user friendly

• Does it have the right data/format

• Would this model (in the correct format) influence the decisions you are making

• Who would use a model like this?

12 NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

Next Steps

• Further refining of data and methodology

• Consider how to expand across all tumour groups and/or clinical networks – with linkages

• Incorporation of cost data – even if only indicative

• Develop mechanism to maintain currency of data and incorporate emerging evidence/priorities

• Consider roll out – how and where

• Respond to feedback of users to maintain usability

13 NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

Preparing for 2014-17

• OG regional campaign – Spring

• National Strategies

• Linkages

• Themes

14 NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l

• • Any questions?

NHS | Presentation to North of England Cancer Network Annual Conference - 20 September 2013l15