A Strategic Vision For Cancer

Transcription

1 A Strategic Vision For Cancer Wessex Cancer Strategic Clinical Network Matthew Hayes Clinical Director, Cancer Strategic Clinical Network

2 Cancer today Half of people with cancer survive at least 10 years 50% increase in suspected cancer referrals since 2009/10 In million people were living with cancer; 4 million by 2030 The NHS has a 30bn funding gap between 2013/14 and 2020

3 Cancer survival

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5 The strategic vision for cancer In 2014, the 9 Wessex Clinical Commissioning Groups proposed that the SCN be tasked with describing a strategic vision for cancer services over the next five years. The vision is based entirely on views of the local population and its needs, collected through meetings, on line surveys and direct consultation. The vision sets down a series of ambitions for cancer care in Wessex, designed to stretch services to improve outcome and experience.

6 Ambition 1 - cancer survival Over the next five years cancer survival in Wessex will continue to exceed the England average, and will improve by 5% across all cancers.

7 Ambition 2 - cancer prevention Mary O Brien Consultant in Healthcare Public Health

8 Ambition 2 - cancer prevention By 2020 in Wessex: Smoking prevalence at age 15 will be below the national average Smoking prevalence in adults will be below the national average Parity of smoking cessation between the wider population and people with a serious mental illness Aggregate % of all adults achieving at leave 150 minutes exercise per week above the national average (currently 55%) Aggregate % of adults classified as overweight below national average (currently 64%) All healthcare settings to endorse European Code Against Cancer All practices will achieve at least the national minimum uptake for screening programmes, currently: 60% for bowel cancer 70% for breast cancer 80% for cervical cancer Every practice will achieve at least the 90% HPV vaccine target

9 Ambition 2 - cancer prevention Tobacco single largest avoidable risk factor for cancer mortality Many areas in Wessex below national average smoking rate BUT we still have 400,000 adult smokers Multiple health & cost benefits for smoking cessation Diet, Obesity, Alcohol, Physical Activity associated with increased risk of certain cancers Over 600,000 people in Wessex physically inactive Outliers for alcohol-specific hospital admissions & mortality Infections: HPV, HepB, HepC Sun exposure Unequal burden for most cancers

10 Ambition 2 - cancer prevention Simple, consistent messages Smoking, diet, exercise, alcohol, symptoms, screening programmes NHS and CCG roles? Making every contact count (MECC) Role as employers Prevention in commissioning plans Cross sector engagement??

11 Ambition 3 - cancer detection Dr Richard Roope RCGP and CRUK Clinical Lead for Cancer Formerly Wessex SCN Cancer GP Lead The proportion of patients presenting as an emergency with a new cancer diagnosis will be below the England average across all nine CCGs in Wessex, aiming for an aggregate figure of 15% by 2020.

12 Ambition 3 - cancer detection Where is cancer in 2015?

13 Ambition 3 - cancer detection Where is cancer in 2015? The perfect storm:

14 Ambition 3 - cancer detection Where is cancer in 2015? The perfect storm:

15 Ambition 3 - cancer detection Where is cancer in 2015? The perfect storm: Aging population

16 Ambition 3 - cancer detection Where is cancer in 2015? The perfect storm: Aging population Lifestyles less healthy: Smoking Diet Alcohol Exercise Sun exposure

17 Ambition 3 - cancer detection Where is cancer in 2015? The perfect storm: Aging population Lifestyles less healthy: from womb to tomb Smoking Diet Alcohol Exercise Sun exposure

18 Ambition 3 - cancer detection Where is cancer in 2015? Addressing non-communicable diseases (NCDs) is critical for global public health, but it will also be good for the economy; for the environment; for the global public good in the broadest sense. If we come together to tackle NCDs, we can do more than heal individuals we can safeguard our very future. UN Secretary General Ban Ki-moon

19 Ambition 3 - cancer detection Where is cancer in 2015? After Cancer Prevention the next most effective intervention:

20 Ambition 3 - cancer detection Where is cancer in 2015? After Cancer Prevention the next most effective intervention: Early Diagnosis: Stage Shift

21 Ambition 3 - cancer detection Where is cancer in 2015? After Cancer Prevention the next most effective intervention: Early Diagnosis: Stage Shift Site Earliest Stage Five Year Survival Latest Stage Five Year Survival Colorectal 93.2% 6.6% Lung 35.3% 6.3%*

22 Ambition 3 - cancer detection Where is cancer in 2015? Early Diagnosis: New NICE Guidance Uses Primary Care Research Data 3% PPV across all cancers More direct access to diagnostics More symptom focused

23 Ambition 3 - cancer detection Where is cancer in 2015? Early Diagnosis: How? Education Education Education

24 Ambition 3 - cancer detection Where is cancer in 2015? Early Diagnosis: How? Education - public Education - patients Education - professionals

25 Ambition 3 - cancer detection Where is cancer in 2015? Early Diagnosis: How? Education - public Education - patients Education professionals Education policy makers

26 Ambition 3 - cancer detection Where is cancer in 2015? Early Diagnosis: How? Education - public Education - patients Education professionals Education policy makers Education - politicians

27 Ambition 3 - cancer detection Where is cancer in 2015? The key to cancer:

28 Ambition 3 - cancer detection Where is cancer in 2015? The key to cancer: EDUCATION

29 Treatments for the best outcomes Dr Richard Osborne Consultant in Medical Oncology at Dorset Cancer Centre

30 Treatments for the best outcomes

31 Treatments for the best outcomes Begs the questions: Definition of treatments everything in the cancer journey Best for whom? recommendations weighted towards quality not cost What outcomes? everything from satisfaction to survival Plans should reflect: the stakeholder comments during the consultation process the right treatment i.e. delivered by specialists, and tailored.support.accessibility modern, evidence-based - i.e. cutting edge

32 Essential Considerations Facts: Increasing cancer incidence Increasing desire for quality, holistic, end-to-end care Increasing sophistication of treatment Compliance with mandatory requirements, national and local context: CWT, IoG, NICE guidelines Wessex-specific factors Plans must be internally consistent with, and support other Ambitions Awareness of imminent and near-future innovations / developments Identification and understanding of inequalities Identification and eradication of ineffective and inefficient practice Understanding how the introduction of new cancer treatment occurs Proactive, nimble, clinician- and science-led, considerable central leadership

33 Some key priorities Workforce development Ambition 4 is only deliverable if more specialists are employed IMRT, SRS providing technology is only part of the answer Increased workload, increased quality needs people Development of Oncogeriatric specialism in Wessex to support an aging population Improved working between Primary and Secondary Care e.g. Advice and Guidance, re-engineered pathways Precision Medicine Joined-up approach to molecular diagnostics in Wessex Designated, authoritative planning and guidance group Effective, responsive commissioning links

34 Patient experience Dr Tim Billington

35 Ambition 4 patient experience Within 5 years all patients will receive cancer care in Wessex on the basis of a personalised, evidence based treatment pathway designed to optimise outcome and experience. No patient requiring cancer treatment using modern radiotherapy technologies need travel outside Wessex.

36 Ambition 5 Rehabilitation and recovery June Davis National Cancer Rehabilitation Lead Macmillan Cancer Support Within 5 years all Wessex patients with a new cancer diagnosis will be offered a holistic needs assessment, a primary care cancer review and a detailed treatment summary, as a consequence of the implementation of the recovery package.

37 National context: Five Year Forward View Local context: Wessex Rehabilitation, Reablement and Recovery Quality Guidance Document

38 Recovery package Prevention of comorbidities Rehabilitation and recovery Education, training and development of the health and care workforce Health and Wellbeing

39 Ambition 6 clinical trials Dr Andrew Bateman Clinical Lead Cancer, Wessex Clinical Research Network All cancer patients who are eligible will be offered recruitment into a clinical trial.

40 Posted by Target Ovarian Cancer on Wednesday 4 March 2015 There is an unacceptable variation in accessing ovarian cancer clinical trials, Target Ovarian Cancer is warning today. Eight-fold difference in recruitment rates A new analysis by the charity has shown that there is an eight-fold difference in recruitment rates to FOxTROT clinical trials between Current the best performing regions and the worst performing regions, across the UK. Status The Eastern NIHR Clinical Research Network (CRN) came out top, with 65 per cent of women with ovarian cancer recruited to a trial. In stark comparison Wessex CRN is the one of the worst performing regions, with only seven per cent of women with ovarian cancer recruited to a clinical trial.

41 Ambition 6 clinical trials Challenges Figurative Portfolio depiction of the studies: landscape 187 of somatic mutations present in a single cancer genome. Studies recruiting <5: 95 MR Stratton et al. Nature 458, (2009) doi: /nature07943

42 The Research Infrastructure Wessex Clinical Research Network Clinical Director (lead) Prof John Primrose Clinical Co-Director 1 Prof Robert Peveler COO Industry Operations Manager Rebecca McKay Sally Albon Division 1 Clinical Lead Division 1 RDM Research Portfolio Manager Portsmouth Cancer Centre Research Lead Poole Cancer Centre Research Lead Dr Andrew Bateman Jocelyn Walters Ann Nicholls Dr Ann O'Callaghan Dr Jo Davies

43 The Research Infrastructure Wessex Clinical Research Network Cancer Subspecialty Leads

44 The Research Infrastructure Wessex Clinical Research Network Cancer Subspecialty Leads Brain Cancer Dr Omar Alsalihi Clinical Oncologist Breast Cancer Dr Ellen Copson Medical Oncologist Children & Young People Dr Juliet Gray Paediatric Oncologist Colorectal Cancer Dr Tim Iveson Medical Oncologist Gynaecological Cancer Haematological & Lymphoma Mr Simon Crawford Dr Andy Davies Head & Neck Cancer Ms Emma King Gynae Surgeon Medical Oncologist ENT Surgeon Lung Cancer Dr Luke Nolan Medical Oncologist

45 The Research Infrastructure Wessex Clinical Research Network Cancer Subspecialty Leads Brain Cancer Dr Omar Alsalihi Clinical Oncologist Breast Cancer Supp. & Pall. Dr Care; Ellen Copson Medical Oncologist Children & Young Psychosocial Prof Alison Richardson Cancer Nursing Dr Juliet Gray Paediatric Oncologist People Sarcoma Dr Peter Simmonds Medical Oncologist Colorectal Cancer Dr Tim Iveson Medical Oncologist Skin Cancer Dr Matthew Wheater Medical Oncologist Gynaecological Mr Simon Crawford Gynae Surgeon Cancer Upper GI Cancer Dr Andrew Bateman Clinical Oncologist Haematological & Urological Cancer Dr Andy Davies Dr Simon Crabb Medical Oncologist Medical Oncologist Lymphoma Radiotherapy Research Head & Neck Lead Cancer Ms Emma King Dr Andrew Jackson ENT Surgeon Clinical Oncologist Lung Cancer Haematology Dr Luke Nolan Dr Matthew Medical Jenner Oncologist Haematology TYA Sr Louise Hooker Cancer Nursing

46 The Research Infrastructure Wessex Clinical Research Network Cancer Subspecialty Leads Trust R&D Departments Cancer Clinical Teams Clinical Trial Practitioners + administrators

47 Ambitions for year 1 Matthew Hayes Clinical Director, Cancer Strategic Clinical Network

48 Scale of ambition for year one Discussion - for each ambition: What would you prioritise for action first and why?

49 Action plan By this time next year we will:

50 How do we achieve our plan? What will you personally do to support change for cancer patients this year? How could organisations contribute? Should there be a board to provide focus and leadership?

51 Our plan Item Action Deadline Lead 1 Confirm support for action plan and scale of achievement by July Identify baseline data set for each ambition. 3 First meeting of strategy Alliance 4 Resources and ambition action plans finalised 31 st July 2015 Cancer SCN August 2015 September 2015??? October 2015 Ambition leads 5 Review and report progress December 2015 Cancer SCN 6 Review achievement against plan and agree action for year 2. July 2015 All

52 Contact details: Matt Hayes, Clinical Director, Cancer Strategic Clinical Network Sally Rickard, Manager, Cancer Strategic Clinical Network Website