The NUH Recovery Package Journey so far.
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- Shanna McKinney
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1 The NUH Recovery Package Journey so far. Implementing the Recovery Package in Greater Manchester Event 2 nd November 2017 Lisa Janiec - Macmillan Cancer Pathways Programme Manager Stephanie Day - Macmillan Recovery Package CNS
2 #TakeAwayMessages Background of the NUH cancer pathways redesign programme Implementation approach Lessons learnt to date
3 Overview of Cancer in Nottinghamshire Incidence and mortality is higher than the national average for some tumour sites Every day 16 people will hear that they have cancer Every day 8 people die from the illness In 2016/ people were diagnosed with cancer By 2030 over 69,000 people will be living with cancer NB: Data does not included non-melanoma cancers
4 One size fits all approach to follow up care Care closer to home agenda Need to improve communication between primary and secondary care Need for integrated care pathways Cancer Pathway Programme Journey
5 What we did Inclusive Steering Group Leadership support from Cancer Lead Clinician Task & finish groups to take work forward Expansion of implementation team PPI engagement to understand local needs
6 1. Information and Support 2. Managing my condition 4. Work 3. Professionals working with me
7 What we have achieved to date NUH seen as national leader for this work Treatment Summaries Being developed/in place as part of each follow up pathway for Breast, Colorectal, Gynaecology, Lung, Oncology, Upper GI and Urology Electronic Holistic Needs Assessment (ehna) Project Rolled out to all tumour sites Evaluation completed Impact mapping tool developed to inform local service developments Four stratified follow up pathways in place (Colorectal, Breast, Gynaecology & Prostate) Four to be developed by 31/03/2020 (Lung, Upper GI, Urology & Ovarian) Health & Wellbeing Events Nottingham patient/carer conference Apr 17 HOPE courses running throughout the year Moving Forward Programme for Breast & Prostate Cancer patients Maggie's Centre Cancer Care Reviews Working alongside Macmillan GP Cancer Leads to support testing of the newly developed template linked to the recovery package
8 Treatment Summary Approach 1. Vital part of the stratified follow up pathways 2. Team have to meet up and agree it and then review it regularly 3. Developed a report with IT to monitor implementation 4. Can help reduce work but its getting that message across that s the hard part Challenge = getting all consultants on board What's in it for me?
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10 Value for GPs? Straightforward with clear instructions for monitoring and documentation by both GP and patients & earlier identification of patients needs Everything in one place Contact telephone numbers and Alert symptoms "clear summary of diagnosis and treatment and section on GP actions" Treatment aim i.e. curative/palliative is excellent as often this isn't clear on GP letters/discharges
11 Value for Patients 80% of endometrial cancer patients surveyed recalled receiving the treatment summary All of these patients rated it as helpful, with most reporting it is very helpful Patient Quote: Received after discharge most helpful thing was that the treatment aim was defined as curative
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13 Benefits / The Good Provides information and support for patients symptoms and/or concerns that they may have Helps prioritise what s important to them Supports referrals to other services that may be closer to their home Helps them plan ahead from diagnosis to life after treatment
14 The Bad HNA not needed we already do it Opening the can of worms Reliant upon key people Lone worker CNS Sickness Ipad's maintenance
15 The Ugly / Challenging Sustainability Scope Creep Its not a fad ICT Migration Time
16 Count of concerns raised Patients Concerns 5% 4% 2% 10% 21% I have questions about my diagnosis/treatment that I would like to discuss Emotional/Psychological Concerns Physical Concerns Spiritual Concerns Practical Concems Relationships/family 58%
17 Severity score of concerns raised
18 Cancer Impact Maps in Nottinghamshire
19 Health & Wellbeing events
20 Cancer Care Review & Primary Care Engagement
21 Lessons learnt System wide steering group to support development of integrated care approaches Clinical Leadership as part of the implementation team to influence peers Engage staff to work alongside them to understand and develop their patient pathways e.g. where to offer ehna Partnership working is key to develop pathways, new models of care and support for onward referrals
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23 Contact Details Lisa Janiec Macmillan Cancer Pathways Programme Manager Mobile: Stephanie Day Macmillan Recovery Package CNS Mobile: Macmillan Cancer Partnership in Nottinghamshire webpage acmillansprogrammesandservices/macmillancancerpartnershipinnottingh am.aspx
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