Cancer Delivery Plan. Interim Progress Report

Transcription

1 Cancer Delivery Plan Interim Progress Report Ref: ABMUHB Reporting Period: November 2012 March 2013 Highlights / Key Achievements PC1 PC2 - PC2.4 Director of Public Health (SH) agreed to become member of Cancer Executive Board and attended last meeting on January 29 th At meeting SH requested that maybe future CDP s could address inequalities. Public Health Strategic Framework In November 2012, the Chief Executive stated at his monthly team briefings for Managers that future team briefings would include and highlight progress against the priority areas in the Public Health Strategic COPD and pneumonia care bundles being implemented within respiratory medicine. Pilot area defined for introduction of bundles and 5 high impact actions to ensure the best clinical outcome for patients includes the assessment and offer of referral for smoking cessation with the aim of reducing smoking prevalence in this high risk group. Rehabilitation Leads annual report and Rehabilitation standards progress report embedded below See Appendix 1 - NETWORK CANCER REHABILITATION LEADS ANNUAL REPORT (DRAFT) See Appendix 2 - CANCER REHABILITATION STANDARDS PROGRESS REPORT FOR THE SOUTH WALES CANCER NETWORK MARCH

2 The Sharing Good Practice Day was held on Friday 19th April 2013; over 100 delegates enrolled with 26 from ABMUHB. The programme included 12 presentations from ABMUHB staff. See Appendix 3 - SHARING GOOD PRACTICE IN CANCER REHABILITATION LEARNING EVENT AGENDA Education is ongoing. The living well project and all the lymphoedema education is being accredited by AGORED. South Wales Cancer Network Directory has been updated. GP Learning event held at Swansea on 13th February 2012, 24 GPs attended. The topics covered were: Management of Sarcoma Referral Pathway for the new Sarcoma Diagnostic Clinics Symptoms & referral for suspected colo-rectal cancer Update on Metastatic Cord Compression Pathway GP Learning Event Report and evaluation embedded below See Appendix 4 GP LEARNING EVENT REPORT The Cancer Network is working with the Welsh Clinical Communications Gateway Project and the National Specialist Advisory Group for Cancer on the development of referral proformas for each cancer site to support direct e-referral from primary care. Key worker role progress report embedded below. See Appendix 5 SWCN KEY WORKER REPORTING TEMPLATE 2

3 PC2.5 DC5 In December 2012, WG agreed part funding of a new Tenovus Cancer Rehabilitation Unit. This new unit will be lymphoedema and cancer rehabilitation dedicated and will travel across all Wales. The service also entered the NHS awards. Waiting list time now at 18 weeks. NERS project continuing to succeed. Report attached as well as new education exercise pop up for wards and primary care. Macmillan agreed further funding until August 2014 to increase project to Neath, Port Talbot and Bridgend. See Appendix 6 MACMILLAN NERS PROGRESS REPORT See Appendix 7 ECR POSTER DC6 Ongoing delivery of GP education programme. Collaborative planning between primary and secondary care continues to ensure the curriculum is relevant and applicable. USC referrals to include patient contact numbers to reduce DNA s. Discussion with LMC and letter sent to all GP s to reiterate this message. See Appendix 8 - LETTER FOR GP S ON USC REFERRALS DC8 Revised Colorectal USC Proforma under development, with the aim to improve the quality of referrals and reduce the number inappropriate referrals. Centralised post menopausal bleeding (PMB) clinic located in Neath Port Talbot Hospital, providing an equitable and consistent service to patients with PMB across the Health Board was implemented in November The projected impact was to free up a significant amount of existing Urgent Suspected Cancer (USC) outpatient capacity in POW and NPTH (circa 500 OP slots p/yr) improving compliance with the 10 day USC target for first OP appointment, furthermore, with the increase in hysteroscopy capacity, help to alleviate the bottleneck of hysteroscopy capacity at times of peak demand across the whole Directorate. DC9 3

4 ABMUHB Multidisciplinary operational policy places responsibility on individual Multidisciplinary Teams and their Leads for development of pathways and analysis of problems with missed or late diagnosis. See Appendix 9 ABMU HB CANCER MDT S OPERATIONAL POLICY Monthly SaFF data is now fed back to individual MDT Leads for their review, analysis of the pathway and their comment. DC10 TC1 TC2 Audit of admissions that may benefit from Acute Oncology Service (AOS) undertaken April 2013 further analysis on findings required. AOS Steering Group re-established to take forward service development. Meetings being arranged with Gillian Knight (Network Lead) to assist with development of service. Funding confirmed by Swansea Locality for 6 month pilot arrangement in Singleton Hospital. Palliative Care peer review self assessment submitted. Lung peer review self assessment submitted and visit undertaken. Awaiting formal feedback. Local MDT Operational policy launched at Cancer Executive Board in January. Consultation period complete. Executive approval required prior to implementing. A task and finish group has been established within the Health Board to propose a revised process for the management of USC and NUSC Pathways across the organisation. Action Plan embedded below. See Appendix 10 SCHEDULED CARE ACTION PLAN 2013/14: DSU RECOMMENDATIONS All Lung USC and NUSC breaches for 2012/13 reviewed by management team and MDT lead to ensure that lessons learned and areas of delay identified. Analysis of review will be shared with members of the lung MDT. TC3 4

5 TC4 TC7 TC9 IMRT introduced for prostate patients and target achieved. Relevant cases e.g. IPFR s for drugs awaiting NICE review, are referred for discussion to neighbouring LHB s to improve consistency in decision making and equity of access, as well as risk management. National IPFR workshops. Ongoing communication between IPFR panels Clinician education to improve quality of IPFR s with the aim of reducing delays. ABMUHB Cancer Lead now sits on IPFR panel. Monthly chemotherapy safety group established and Terms of Reference agreed. Chemotherapy review clinics action plan being developed nurse led opportunities being considered. The Quality & Safety Committee were provided with an overview of the key findings from the self assessments undertaken for the three Lung Cancer Multidisciplinary Teams within Abertawe Bro Morgannwg University Health Board as part of the Lung Cancer Peer Review process. Paper embedded below. See Appendix 11 QUALITY & SAFETY REPORT MN1 Key worker group being re-established with the clear objective of sharing best practice and reviewing the need for clear definition of the role of the key worker and the process for developing written care plan May 22nd 2013 See Appendix 12 SWCN KEY WORKER REPORTING TEMPLATE 5

6 MN2 MN3 Primary Changing for the Better (C4B) Programme has now been completed, and workstreams are developing detailed implementation plans South Wales Cancer Network and site specialist Multidisciplinary Teams working in collaboration to identify specific needs and deliver patient centred services. Review of MDT staffing and sustainability, particularly for MDT s providing a cross-border service for ABMUHB and Hywel Dda HB Ongoing work to improve 2-way communication between MDT s, primary and secondary care. MacMillan Cancer Information post Band 6 post commenced 1st April Band 5 to be advertised when assessment of need made. Pod ordered by MacMillan on the 17/04/13 MN5 The Macmillan Patient Information and Engagement Coordinator for the South Wales Cancer Network has: Held a Patient Conference at Margam Park on November 27th 2012 attended by almost 100 Patients, carers and Health professionals Issued a special edition newsletter summarizing the presentations made at the conference; as well as an Autumn Newsletter and Spring edition to be issued this month Focus group in Swansea area looking at Breast Cancer Patient attitudes to Follow up (presented at South Wales Cancer Network Breast Workshop Jan 2013) and further focus groups currently being undertaken at Withybush Hospital with breast cancer patients and their attitudes to the service available. All patients are encouraged to self manage with support from HCP. Two new patients education Pop ups have been created explaining benefits of exercise and how to manage lymphoedema. They will be placed at locations across ABM for a week. Patient s referrals will be monitored to review impact. MN6 Cancer Rehabilitation Club continues to be run at Swansea University Pool. All Wales lymphoedema services now operational and collecting data on a monthly basis 6

7 TR Palliative care study established in Princess of Wales Hospital and Singleton Hospital this quarter New Principle Investigators in Palliative Care Congratulated on recruitment for an Adjuvant Breast trial and described as a flagship site. Continue to be in the top 5 UK sites for a locally advanced prostate trial. Singleton is the leading recruiter in an International Commercial Melanoma Trial, being 1 of only 5 selected sites within the UK Two research staff members are qualified as GCP facilitators and regularly deliver the GCP programme in conjunction with NISCHR CRC. All ABMU staff involved in research can access this training free of charge. MDT s within ABMU have been involved in a CRUK funded randomised trial looking at interventions designed to increase recruitment into clinical trials. This has led to two publications with ABMUHB staff being co authors. Stratified medicine programme continues to thrive in ABMUHB and now has staff in Princess of Wales. Recruitment targets have been reached for this quarter Challenges DC8 TC3 The clinic has been implemented as planned with the associated number of additional outpatient slots. However, due to an increase in demand, there have been a small number of patients seen within Consultant clinics when the PMB clinic has been fully booked. This has not compromised waiting times but has created an overspill outside of the centralised service model. Moreover, the hysteroscopy capacity has yet to be fully realised (training issues have resulted in only 50% of the planned activity being delivered during Nov 12 Mar 13). Implementation of a new service of highly technical radiotherapy treatment required extensive commissioning, collaboration and development work in addition to provision of the existing routine service. IMRT experienced personnel unavailable for recruitment. TR Added work load to very busy departments such as Radiology, Pharmacy and Medical Physics due to the impact of recruitment into clinical trials Clinician time balance between clinical and research work Electronic trial data capture has increased over the last quarter causing a strain on staff resource in Cancer Institute Wales Cancer Bank Breast services moving from Singleton Hospital will have an impact on recruitment 7

8 Corrective Actions Planned DC8 A review of USC referrals for Nov 12 - Mar 13 is being undertaken to understand the increase in USC PMB demand in greater detail. Increase the hysteroscopy activity in April/May to deliver 100% of projected increase in activity TC3 More extensive external training undertaken than anticipated initially. TR Discuss feasibility of increasing staff support through other financial sources such as activity based funding Assess feasibility of employing data manager to assist research nurses in time consuming electronic data capture Clinicians to discuss job plans with divisional lead to allow for protective research time Discuss / negotiate using savings from drug spend as a result from free drug being supplied within a clinical trial to fund further research infrastructure Cancer bank services will move as needed to cover clinics in Neath Port Talbot Priorities for Next Quarter PC2.4 AHP and Nurse Head and Neck Pathway Consolodate the pathway with inclusion of Specialist nurse and therapeutic radiography involvement Standardise Head & Neck leaflets Audit Meetings planned for June 2013 with the Head and Neck Task and Finish Group. New Macmillan SALT appointed to commence post in September Metastatic Spinal Cord Compression education - Education continuing. Macmillan Cancer Support has funded a 2-year project 1wte band 8a- Macmillan Metastatic Spinal Cord Compression Service Improvement Lead from the Network but housed and managed within ABMUHB. Aiming to be with recruitment July 2013 New Cancer Rehabilitation Event aimed for winter

9 Fatigue Pathway - Final meeting to be held in June 2013 Finalise and implement screening tool Finalise patient information leaflet Further GP Learning events to be arranged. Finalising of initial (three) referral proformas for submission to the Welsh Clinical Communications Gateway Project. Commence re-design of the Web-site to include an up-dated Directory, with information to support primary care in new areas such as acute oncology. Work with NWIS and other stakeholders to look at the development of improved access to information for Primary Care from the Canisc system, to support patient management. Development of Primary Care Pathway for rectal bleeding for ABMUHB. PC2.5 DC6 DC8 The new Tenovus Cancer Rehabilitation Unit will be fully operational by September Launch date is 17th September This new unit will be lymphoedema and cancer rehabilitation dedicated and will travel across all Wales. Information Governance to be arranged. Closely monitor the service to ensure all additional hysteroscopy activity is delivered and that the PMB clinic can manage the number of USC PMB referrals within the current clinic templates. TC3 EBUS business case being updated to reflect current needs and will be submitted to Locality Board June Implement IMRT for treatment of head and neck cancer patients. Continue and consolidate the prostate IMRT programme. TR Work with departments and R&D to establish what extra support is needed Continue to increase recruitment and trials in rarer cancers on the portfolio Increase the number of interventional trials on the portfolio Increase the number of new PI s working on Cancer Portfolio studies within the Health Board Wales Cancer Bank to recruit staff for Neath Port Talbot 9

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