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Cancer Networks: Moving forward Pat Higgins Director of Merseyside and Cheshire Cancer Network

Cancer Networks: Moving forward

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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. - PowerPoint PPT Presentation

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Page 1: Cancer Networks:  Moving forward

Cancer Networks: Moving forward

Pat Higgins

Director of Merseyside and Cheshire Cancer Network

Page 2: Cancer Networks:  Moving forward

Summary

• The future role of cancer networks

• Driving improvement

• Improving service delivery

• Integrated working

• Planning for Reform in M&C and our priorities

Page 3: Cancer Networks:  Moving forward

What are the characteristics of networks

• Collaborative

• Partnership

• Patient centred

• Consensus

• Pathways

• Seamless care

Page 4: Cancer Networks:  Moving forward

Network Structure

• Taskforce (Board)

• Managers Forum

• Management team

• Cancer Commissioning Group

• Lead Clinicians

• Lead Nurses Forum

• Clinical Network Groups (CNGs)

Page 5: Cancer Networks:  Moving forward

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

Page 6: Cancer Networks:  Moving forward

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

Page 7: Cancer Networks:  Moving forward

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

Page 8: Cancer Networks:  Moving forward

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

Page 9: Cancer Networks:  Moving forward

Cancer Mortality RatesBest of Europe

European Average

English Average

Merseyside & Cheshire Average

North Liverpool

20% Gap

14% Gap

126% female lung Ca

Page 10: Cancer Networks:  Moving forward

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

Page 11: Cancer Networks:  Moving forward

Key Priorities

• Health Inequalities

• Better Treatment

• Living with and beyond cancer

• Care in appropriate settings

• Ensuring delivery

• Building capability and capacity

Page 12: Cancer Networks:  Moving forward

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

Page 13: Cancer Networks:  Moving forward

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

Page 14: Cancer Networks:  Moving forward

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

Page 15: Cancer Networks:  Moving forward

Oesophago-gastric

By 2007

3 centres delivering complex care

Aintree

Cardiothoracic Centre

Wrexham

Partnership with North Wales Network

Page 16: Cancer Networks:  Moving forward

Peer review

• Self assessment

• Self Improving

• Validation

• Exception visits

• Performance monitoring

• Using the process to drive up quality and improve services

Page 17: Cancer Networks:  Moving forward

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

Page 18: Cancer Networks:  Moving forward

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.

Page 19: Cancer Networks:  Moving forward

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;

Page 20: Cancer Networks:  Moving forward

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.

Page 21: Cancer Networks:  Moving forward

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;

Page 22: Cancer Networks:  Moving forward

What does that look and feel like?

Page 23: Cancer Networks:  Moving forward

A bit like this!

Page 24: Cancer Networks:  Moving forward

Or if the technology fails - this!

• Herding cats!

• Knitting fog

Page 25: Cancer Networks:  Moving forward

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.

Page 26: Cancer Networks:  Moving forward

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.

Page 27: Cancer Networks:  Moving forward

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.

Page 28: Cancer Networks:  Moving forward

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

Page 29: Cancer Networks:  Moving forward

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.

Page 30: Cancer Networks:  Moving forward

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.

Page 31: Cancer Networks:  Moving forward

Network Objectives 2008 - 2012

• Early Detection and Prevention

• Ensuring better treatment

• Living with and beyond cancer

• Reducing health inequalities

Page 32: Cancer Networks:  Moving forward

Network Objectives 2008 - 2012

• Delivering care in the most appropriate setting

• Ensuring delivery and maintaining progress

• Building capability and capacity