Cheshire and Merseyside Cancer Alliance. Helen Porter Director of Nursing and Quality 19 th April 2017

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1 Cheshire and Merseyside Cancer Alliance Helen Porter Director of Nursing and Quality 19 th April 2017

2 Independent Cancer Taskforce Published five year strategy for cancer in July 2015 with aim to improve cancer services across the entire patient pathway by 2020: Fewer people getting preventable cancers More people surviving for longer after a diagnosis More people having a positive experience of care More people having a better, long-term quality of life Spearhead a radical upgrade in prevention and public health Drive a national ambition to achieve earlier diagnosis Establish patient experience on a par with clinical effectiveness and safety Transform our approach to support people living with and beyond cancer Make the necessary investments required to deliver a modern, highquality service Overhaul processes of commissioning, accountability and provision

3 The case for change: Rising incidence and cost, with inequitable outcomes 1 in 2 younger people will be diagnosed with cancer at some stage of their lives 40% of cancers could be prevented by changes in lifestyle The key messages are: Cardiovascular Cancer costs are rising 9% per year, with diagnostics demand increasing by 7% Pr 1 Prevention needs to be a priority to reduce the incidence of cancer in Cheshire and Merseyside 2 3 We need to diagnose cancers earlier and focus on research/new technologies to close the outcome gap We need to invest in survivorship to manage the growth in demand and cost for cancer services 18,000 C&M cancer diagnoses per year 700 Excess cancer deaths per year from cancer 3 Number of times that the cancer survivor population could fill Anfield by 2030 In Cheshire & Merseyside: 50% Patients reporting that they did not have enough support from health and social care after treatment 9.9M Cost avoidance available from investment in stratified follow up programmes for common cancers 87% 62 day stretch performance standard for C&M by 2019 (86.2% current Q3) Cheshire and Merseyside Delivering the Five Year Forward View

4 Cancer Alliances Establishment of Alliances recommended by the Cancer Taskforce to: drive and support improvement and integrate care pathways, using a dashboard of key metrics to understand variation and support service redesign. (rec 78) Cancer Alliances will bring together clinical and other senior leaders locally across a defined geography to: plan for and lead the delivery of the Taskforce s ambitions locally; and reduce variation in outcomes and in access to high quality, evidence based interventions across whole pathways and for the Alliance s whole population.

5 Cancer Alliance Programme Board STP Executive Sponsor for Cancer Andrew Cannell Clatterbridge Cancer Centre NHS FT Medical Director Dr Chris Warburton Aintree University Hospitals NHS FT Local Delivery System leads: Cheshire & Wirral North Mersey Mid Mersey Dr Mark Lipton Fiona Taylor/Stephen Fenwick Ann Marr/Paul Mansour Wirral University Hospitals NHS FT NHS South Sefton CCG/AUH NHS FT STHK/S&O Specialised Commissioning Andrew Bibby NHS England NW Coast Clinical Research Network Professor Terry Jones University of Liverpool Director of Finance Mark Greatrex Wirral Community Trust NHS FT Health and Wellbeing Board Patient Representatives Workstream leads: Prevention and public health Earlier diagnosis Patient experience Living with and beyond cancer High quality modern services TBC Ray Murphy/Tony Murphy Dr Sandra Davies Dr Debbie Harvey Sue Redfern Jan Snoddon Dr Peter Kirkbride Liverpool City Council NHS South Sefton CCG STHK NHS Halton CCG Clatterbridge Cancer Centre NHS FT

6 England = 615 C&M STP = 674 Variation in C&M Incidence per 100k population Significant differences in Liverpool City population

7 Variation in C&M: Early stage diagnosis and preventing premature mortality Stage 1 / 2 Cancer Diagnosis 8% gap by CCG Preventing premature (<75) mortality per 100k population Significant priority for Cheshire and Merseyside England = 141 C&M STP = 164

8 Screening Challenge: Bowel - % uptake: Gap between England and Alliance Cheshire and Merseyside Delivering the Five Year Forward View

9 National Cancer Transformation Fund C&M recommended for funding in phase 1: Transforming cancer services in C&M across the whole footprint Lung, colorectal and vague symptoms focus on early diagnosis Embedding best practice pathways Tackling diagnostic delays, straight to test, MDT meeting, support worker staff Diagnostics Capacity and demand across the STP pathology, imaging, endoscopy Recovery package Access to holistic needs assessment, treatment summaries, education events, and GP cancer care review Stratified pathways (supported self management) Breast, prostate, colorectal

10 Scope for the Cancer Programme Our vision in Cheshire and Merseyside is to achieve cancer incidence, mortality and survival rates for our population that are amongst the best in Europe. Prevention & Public Health Early Diagnosis High Quality Modern Services Improving Patient Experience LWBC Commissioning, provision and accountability Implementing the NCTF Prevention activities at scale Targeted interventions Making every contact count lifestyle advice for cancer patients New diagnostic models Increase uptake in screening Implementing NICE guidance Review multiple trust care pathways Streamlined MDTs Access to molecular testing Chemotherapy and radiotherapy networks Single integrated patient experience survey Developing digital solutions for how patients interact with cancer services Focus on access to key worker Implementing the recovery package for all Stratified follow up for breast, colorectal and prostate Holistic needs assessment and GP end of treatment summaries Establishing the core cancer alliance PMO team. Developing governance and KPIs across the programme Assuring LDS priorities and plans Managing interface with STP Lung Colorectal Vague Symptoms Recovery package Follow up Pathology Endoscopy Imaging Linked to: Demand management and prevention/ clinical support services/hqhc/collaborative productivity/changing how we work together Enabling Support Functions Future workforce/ Finance models / Future Commissioning

11 Highlights on the cancer transformation Y1 journey 1. Our objectives for the end of year 1 Improved Cancer Waits performance Stratified pathways in place for LWBC 2. Our objectives for the end of year 2 2% improvement in early diagnosis Haem-onc model of care for C&M developed C&M Transformation Programme Highlights Opening of the new Royal Liverpool National profile of Clatterbridge in the Community programme further enhanced New Cancer Centre; hub-based model of care New service models including Radiotherapy Networks Y2 Y3 Our objectives for the end of year 3 Streamlined MDTs developed linked to reconfigurations Molecular testing developed Gap in cancer screening closing Implementation of priority programmes Delivery of the Taskforce recommendations (2021) Delivery of the Cancer Transformation Fund Delivery of the 62 day standard and 28 day diagnosis standards (2020)

12 A note of thanks Melanie Zeiderman Petrina O Halloran Mike Clinton Jane Randles Angela Dawe Sharon Rowe Hannah Randles Jeanette Oxton Steve Khan Alison Meehan

13 Cheshire and Merseyside Delivering the Five Year Forward View Thank you Cheshire and Merseyside Delivering the Five Year Forward View