Cancer Networks: Moving forward Pat Higgins Director of Merseyside and Cheshire Cancer Network
Jan 12, 2016
Cancer Networks: Moving forward
Pat Higgins
Director of Merseyside and Cheshire Cancer Network
Summary
• The future role of cancer networks
• Driving improvement
• Improving service delivery
• Integrated working
• Planning for Reform in M&C and our priorities
What are the characteristics of networks
• Collaborative
• Partnership
• Patient centred
• Consensus
• Pathways
• Seamless care
Network Structure
• Taskforce (Board)
• Managers Forum
• Management team
• Cancer Commissioning Group
• Lead Clinicians
• Lead Nurses Forum
• Clinical Network Groups (CNGs)
NETWORK TASKFORCE
Network Team
Lead Clinician
Network Managers Forum
Liverpool PCT RLBUH & LWH FT /Trusts
Sefton Sefton PCT, UHA FT, S&O and WCNN Trusts
Eastern Warrington, St Helens & Halton and Knowsley PCTs NCH and St H&K Trusts
Wirral Wirral PCT and Wirral Trust and CCO
ICN
ICN
ICN ICN
ICN
Cancer Commissioning Group
West Cheshire Countess of Chester FT and Western Cheshire
Urology
Breast
Colorectal
OG
HPB
CAYP Gynae Lung Path Rad Sarcoma Neuro
Primary Care
Haem
Chemo Pharm Health Inequalities
Paed Palliative
Head & Neck
SPC Chemo
Lead Nurses
Kathy DoranNetwork Chair
Pat HigginsNetwork Director
Jon HayesDeputy Network Director
Carol CottrellBusiness Support Co-ordinator
Pat Sneddon Nurse Director
Ian ConnollyPerformance Improvement Manager
Ged CorcoranMedical Director
Kathy CollinsNetwork Manager
Linda DevereuxNetwork Manager
Alison WilliamsNetwork Manager
Paul MackenzieHealth Inequalities Manager
Tracie KeatsICCP/LD Project Manager
Sandra RowlandsPatient Information Manager
Chris BarkerWeb Manager
Marie CoughlinBowel Cancer Screening Manager
Anne HinesLead Pharmacist
Sarah GriffithsBusiness Support Manager
Debbie MooresBusiness Support Co-ordinator
Senior ManagementTeam Improvement Team Information Team
Business SupportTeam
Claire MacLeanPublic Health Analyst
Simon PearceInformation Analyst
Mandy SneeNetwork Manager
Gloria PaynePatient & Carer Facilitator
Katherine WebbTrainee Public Health Analyst
Outline indicates externallyfunded or temporary post
Key
Dan SeddonPublic Health Consultant
Prevention and Early Detection Strategy
Cheshire and MerseysideBowel Cancer Screening Programme
(11 members of staff)
Anita Corrigan Network Manager
Lead Team
VacancyICCP Lead Nurse
Adrienne BrownriggClinical Lead, End of Life Programme
Pauline Webster Business Support Co-ordinator
Penny RobinsonBusiness Support Coordinator
Eleri Philps Patient Dependency Manager
Jackie SandersBusiness Support Manager
1
2
3
4
Locality Leads
1. Sefton: Kathy Collins
2. Liverpool: Linda Devereux
3. Wirral & West Cheshire: Alison Williams
4. Eastern: Anita Corrigan
Type of Network
• Governed partnership
• Funded by and accountable to PCTs
• Core roles defined
• PCTs sign off objectives and review 6/12
• Report to PCT Networks Board via Taskforce
Network challenges
• 2nd highest incidence rates in the country
• Ditto for mortality rates
• Trust configuration - high number of specialist trusts
• Cancer centre without surgical oncology
• Lack of academic research leadership
• 5 out of 7 PCTs are Spearhead PCTs
Cancer Mortality RatesBest of Europe
European Average
English Average
Merseyside & Cheshire Average
North Liverpool
20% Gap
14% Gap
126% female lung Ca
Excess deaths from cancer PCT All
cancers
LungCancer
Deaths[1]
all Ca2005
Deaths allall Ca2006
Male Female Total
Male Female Total
Halton & St Helens 66 64 130 23 24 48 883 796
Knowsley 50 45 95 26 33 59 413 449
Liverpool 181 174 355 99 100 199 1398 1330
Sefton 40 29 69 15 27 42 930 834
Warrington 6 -6 0 2 3 5 460 475
West Cheshire 2 9 11 -6 -1 -7 651 693
Wirral 33 49 82 18 24 41 971 1031
Total excess deaths 378 364 742 177 210 387 5706 5612
[1] Source NCHOD mortality all ages all cancers
Key Priorities
• Health Inequalities
• Better Treatment
• Living with and beyond cancer
• Care in appropriate settings
• Ensuring delivery
• Building capability and capacity
Health Inequalities Better Treatment
Living with and Beyond Cancer
Care in Appropriate Settings
Building Capacity and Capability
Ensuring Delivery
Social marketing
CPED Strategy
Primary Care Strategy
Commissioning toolkit
LD/ACC
ICCP
CRS screening extension
BCSP 2WR clinics fit for purpose?
Peer Review• Self Assessment – working group•RAP monitoring
Support•Locality Groups•CNGs
Workforce planning
E-learning
NDP / NDP Next Steps
Anatomy & oncology
PH Analyst Trainee
CRS waiting times
SCR & Data Warehousing
Research Strategy & CRUK Centre
Satellite Radiotherapy
M&C response to NW Cancer Plan
Support ICNs
Inpatient redesign
Palliative Care Strategy
Follow-ups project
Patient information strategy
website
Ward dependency project
IOG Delivery•Supportive Care•HMDS•CYP•Skin•Sarcoma•Neuro
CPORT
NCAGHPB
Supportive Care•Key worker•Holistic assessment•24/7 7/7•Psychology•Rehabilitation•Adv Care Planning
Adv Comms Skills
Succession planning / AfC
AHP Strategy
Nursing Strategy
Pt Involvement Strategy
CRS NICE uptake audit
Map of Medicine
Pharmacy protocols
Development of Lead Clinicians’ role
Genetics & Fertility – access issues?
CPIs
ACC training DVD
Key Issues facing networks• Survival!
• Improving Outcomes Guidance
• Peer review
• Influencing the commissioning of cancer services
• Service Improvement and re-design
• Responding to Cancer Reform Strategy
Oesophago-gastric
Original configuration:
8 units all delivering full range of services
Southport and Ormskirk
Aintree
St Helens and Knowsley
North Cheshire
Royal Liverpool and Broadgreen
Wirral Hospitals
Countess of Chester
Cardiothoracic Centre
Oesophago-gastric
By 2007
3 centres delivering complex care
Aintree
Cardiothoracic Centre
Wrexham
Partnership with North Wales Network
Peer review
• Self assessment
• Self Improving
• Validation
• Exception visits
• Performance monitoring
• Using the process to drive up quality and improve services
What the CRS says about Networks
……………………..to recommend that cancer
commissioning is coordinated across a
network of care, based on patient care
pathways into these services, rather than
formal organisational boundaries
Commissioning
• strengthen the support available to commissioners, including publishing a cancer commissioning guide and planning toolkit; and
• Commissioners should also use existing national guidance and standards and the process of peer review to assist them in making commissioning decisions for cancer.
World class commissioning
• Providing information and support to promote informed choice in treatment and care;
• Delivering safe and effective radiotherapy in accordance with the recommendations of the National Radiotherapy Advisory Group;
What levers do networks have?
2.42 PCTs will also need to ensure that providers of cancer services collect datasets as set out in national contracts.
2.65 End of Life Care – building on baseline reviews improve access to high quality services close their homes with rapid response services and coordination centres.
Important quotes
• Networks teams should act as agents for
commissioners, supporting them to
coordinate their activities and providing
shared expertise, maintaining the
dialogue with clinical teams and users,
agreeing clinical guidelines and pathways and driving forward innovative, high quality care;
What does that look and feel like?
A bit like this!
Or if the technology fails - this!
• Herding cats!
• Knitting fog
Why do we need a North West plan?• Cancer in the North West - challenges to health
services and wider community
• Future demand for cancer services
• Improve preventive programmes
• Work with local communities
• An opportunity in to address some of these issues collectively & individually.
PREVENTION
Pledge 2: We will implement the tobacco control plan.
To help prevent cancer we will:
Pledge 6: The North West will campaign for greater regulation of sun beds to protect children and young people.
Pledge 5 : The North West will strive towards reducing obesity especially in children and young people.
To improve and extend breast screening services:
SCREENING
Pledge 6: Unacceptable variations in screening uptake will be investigated and appropriate action will be taken to target the population never screened. PCTs leads will examine the coverage and uptake rates for all screening programmes to improve and maintain uptake by their populations.
TREATMENT
Pledge 10: We will ensure that all patients in the North West will meet extended standards for waiting times. For second or subsequent surgery and chemotherapy this will mean that patients will wait no longer than 31 days by December 08. All women referred by their GP with breast symptoms will be seen within two weeks by December 2009. All patients with a suspected cancer detected through screening programmes will be treated within 62 days by 2009.
To improve waiting times for cancer treatments:
To improve the quality of capture of cancer staging at presentationwe will:
Action: By December 2009 we will have completed the collection of retrospective staging data for cancers diagnosed in 2006. During 2008/09 all data will be collected prospectively through MDTs to capture this in real time, and be used as a basis for treatment decisions
TREATMENTTo improve access to radiotherapy
Pledge 11: Networks, working with their cancer centres and PCTs will develop radiotherapy satellite facilities to meet the expectations within the CRS and NRAG which will guarantee that patients have a maximum travel time of 45 mins for the more common cancers and for those requiring palliative treatment. PCTs will commission any additional capacity that cannot be met from better utilisation of existing equipment..
To deliver local, consistent and safe chemotherapy:
Pledge 16: By 2012 Chemotherapy and other systemic therapies will be delivered as close to home as possible where this is safe to do so.
QUALITY To reduce cancer inequalities:
Pledge 26: By the end of 2008 all networks will have developed rigorous plans that are aimed at reducing the health inequalities experienced by their populations. The inequalities in cancer mortality rates will then be rigorously monitored by the SHA.
To commission world class cancer services:
Pledge 27: PCTs in the North West commit to the DH world class commissioning programme and the use of the cancer
commissioning toolkit when available, through which standardised care across the North West can be monitored.
Network Objectives 2008 - 2012
• Early Detection and Prevention
• Ensuring better treatment
• Living with and beyond cancer
• Reducing health inequalities
Network Objectives 2008 - 2012
• Delivering care in the most appropriate setting
• Ensuring delivery and maintaining progress
• Building capability and capacity