Manchester Cancer Provider Board Minutes of the meeting held on Friday 8 th January 2016 at The Christie

Transcription

1 Manchester Cancer Provider Board Minutes of the meeting held on Friday 8 th January 2016 at The Christie Present Neil McKay (NM) Independent Chair Hugh Mullen (HM) Pennine Acute Hospitals NHS Trust Roger Spencer (RS) The Christie NHS Ann Barnes (ABa) Stockport NHS Jack Sharp (JS) Silas Nicholls (SN) Darren Banks (DM) Salford Royal NHS University Hospital of South Manchester NHS Central Manchester University Hospitals NHS Claire Yarwood (CY) On behalf of Karen James Andrew Foster (AF) John Wilbraham (JW) David Makin (DM) Tameside Hospital NHS Wrightington, Wigan & Leigh NHS Foundation Trust East Cheshire Patient Representative In attendance David Shackley (DS) Medical Director Adrian Hackney (AH) Thomas Pharaoh (TP) Associate Director Tanya Humphreys (TH) Angela Lynch (AL) Greater Manchester Peter Elton (PE) Service Transformation Anthony Blower The Christie NHS Catherine Perry (ABl) Leila Williams (LW) Director, Greater Manchester Service Transformation (CP) Nigel Guest (NG) John Herring (JH) GMLSC SCN Amy Newberry (AN) Trafford CCG Manchester Cancer GMLSC SCN Manchester Business School - Respect 21 Trafford CCG Greater Manchester Service Transformation 1. Welcome and apologies ABa, as stand in Chair, welcomed everyone to the meeting and noted the apologies received. She chaired the meeting for agenda items 3, 6, 7, 8, & 9. NM joined the meeting late and resumed as Chair for items 4 &5. 2. Minutes from the last meeting on 16 th October 2015 The minutes from the last meeting were agreed to be an accurate record. 3. Matters arising 3.1 Action log Action 1: The Board agreed to remove this action from the log

2 Action 2: The Board agreed that this was linked to the vanguard programme and should be removed from the action log Action 3: TP noted that the subject would be taken up with the Trust Leads Board and reflected in the scorecard presented to the next Provider Board meeting Action 4: The Board heard that this action was complete. Action 5: The Board noted that this subject was on the agenda. Action 6: The Board heard that this action was complete. DS informed the Board that a GM wide anti-smoking group led by Stephen Pleasant and Wendy Meredith has been set up. Progress of the group will be reported back to the Provider Board. 4. Provider Board Funding 2016/17 DS confirmed that, following a series of discussions and negotiations, funding for Manchester Cancer has been agreed at the same level for a further 12 months until April CY stated that whilst Tameside was fully supportive the arrangement would have to be signed off by Monitor before they are able to commit to further funding. NM, acknowledged the TGH position but emphasised that all the GM trusts need to be full members of the MC Provider Board to maintain the effectiveness of Manchester Cancer. 5. Greater Manchester Cancer Vanguard RS explained that since the last Provider Board meeting there have been some new developments. Cally Palmer (Royal Marsden Chief Executive) has now been appointed to the role of NHS National Cancer Director for NHS England. RS confirmed that the value proposition is currently being drafted and had to be submitted by 08/02/2016. JS asked if the value proposition was a single proposition from Greater Manchester or from the three partner organisations and to what extent the provider board would be involved. RS clarified that there is one value proposition but it will comprise of individual component parts. A project team has been established to develop the proposition, who will engage with the Provider Board, Commissioners etc. DB asked what the Vanguard is, who is accountable and the role of a system integrator and lead provider. RS explained the background to the vanguard and its relationship within the national vanguard structure. He further explained that the answers to issues on lead provider and system integrator needs further exploration and discussion. There is a national reporting element to the vanguard, indeed to the National Cancer Director, but there will be a substantial element that will be under the governance of GM. The details on governance are not yet clear. NM stressed that there is a risk of delay by constantly waiting for more definitive information. The purpose of the Vanguard is to accelerate improvement in outcomes for people with cancer. There is enough knowledge across the Board to progress and get on and start thinking about what a system integrator and lead provider should look like. RS reiterated that the whole idea of the Vanguard is to test radical approaches and acknowledged that currently there isn t finite detail, but it is all about being innovative. He also advised that if too much time is spent going through every detail, transformation would be delayed. ABl suggested that the lack of clarity should be used as an opportunity to develop something new and innovative. RS told the Board that The Christie position is aimed at having an integrated, reformed single service and testing new interventions. 2

3 The Board queried the funding of both the National Cancer Vanguard and Devolution Manchester. RS told the Board that the Vanguard funding is totally separate from Devolution Manchester funding. He went to outline that the three National Cancer Vanguard applications have requested more money. Indications are that there is 750k/ 1million available between the three applications for this year. The ambition going forward is to successfully bid for substantial transformation funding: > 30million between the three sites has been mooted over the next 2 full financial years. These figures are purely ballpark as they have yet to be properly developed. NM stressed that the amount of money allocated to the Vanguard is dependent on the quality of the value proposition. DB asked for the Provider Board to be involved in the shape and design of the Vanguard, and requested clarity regarding the role of Manchester Cancer within the Vanguard. In trying to address this query DS explained what constitutes Manchester Cancer in terms of its clinical network, people affected by cancer resource and the back office functionality which facilitates bidding and delivering on transformation funding received by Manchester Cancer. He argued that Manchester Cancer has provided the Provider Board with an identity to bid for other money. NM pointed out that the Manchester Cancer brand has significant value and this should not be lost. RS reiterated that the existence of Manchester Cancer contributed to the success of the Vanguard application and will also help with the implementation of the National Cancer Strategy. NG told the Board that from a commissioning point of view there is an opportunity for success by having a system leader who is then able to work collaboratively to co-produce a better and innovative cancer system. NG stressed the importance of commissioners and commissioning in making final decisions on governance and provision of cancer services. In order to continue and improve the dialogue on this issue NM asked the Board how it would like to proceed. It was suggested that the next meeting be given over to discussion of the vanguard governance model, with facilitation if necessary, and that additional monthly meetings might be required. It was acknowledged that the Cancer Commissioning Board would be having similar discussions. ACTION: DS/TP to arrange facilitated vanguard governance discussion at next Provider Board meeting on 12 th February AF asked if the Board could see the Value Proposition as an advance draft paper. TP will provide a paper following the discussions of the meeting. ACTION: TP to circulate draft of value proposition 6. Update on Urology & OG Transformation Process AL spoke to briefing paper 3 and outlined the processes that have occurred so far in the transformation. She confirmed the next steps in the commissioning process. LW explained that the transformation process has been designed to include patient and stakeholder involvement and that it has been co-designed with people who use the services. 3

4 The aim now is to complete the work on standards and issue these to stakeholders by the end of January She confirmed that a series of workshops has been planned in February and March and asked that all providers became involved in this next step to co-design the service specification. She confirmed that she will be writing out to CEOs to request senior clinical and managerial involvement in these workshops. JS asked the transformation team to recognise that both OG and urology are services that have other service complexities attached to them and to ensure that they don t leave these associated services in a more vulnerable position. DB raised concerns about the process so far including the review by ECAP. He raised concern about the Urology Pathway board and how each institution is represented. DM asked about LW comments about pts access to standardised services. AL assured the board that these issues would be addressed during the workshops. 7. Update on Gynaecology single service DB confirmed that a meeting between NHS England and the providers would be taking place later today and the board would be updated at the next meeting. 8. Agenda Item 9 Update on Breast Services (paper 4) AH presented paper 4. UHSM were identified as the lead provider at Provider Board meeting in April A series of meetings have taken place, however the work of this group has been compromised as the role of the lead provider has not been clearly articulated. Nor how a lead provider might work with commissioners and be connected to the Vanguard. All the Provider representatives agree that there are too many providers and the service is not streamlined. Ah confirmed that the commissioning arrangements are very complex however the ambition remains to rationalise those arrangements. He went on to say that perhaps the transformation needs to be as rigorous as that in OG and Urology. DB also queried the role of lead provider and the fact that as part of the Vanguard there will be roles for lead providers in other tumour groups. He asked for clarity to be developed on what is meant by Lead Provider and System Integrator roles. AH did acknowledge that there is a lack of clarity and would welcome feedback from the Provider Board as to what is envisaged in terms of lead provider. JW advised the Board that he was disappointed that the Breast paper failed to include data from East Cheshire and asked for assurance that this wouldn t happen again. ABa assured him that this would be the case. Concern was raised (ABa) over the potential lack of evidence regarding the numbers talked about in the breast standards. ABa also felt that there is an over emphasis on the surgical aspect and the biggest problem is the lack of Radiologists and that Radiology needs to be flagged as a significant issue. CY asked how much engagement there has been from patients. AH confirmed that this has been limited with just one patient representative from the breast cancer pathway board involved. 4

5 DM said that he sat on the breast cancer pathway board but would like to see more representation from all areas of Greater Manchester. TH explained to the Board that the User Involvement team have been recruiting new members and have had many expressions of interest from ladies with or who have suffered with breast cancer. However, before anyone can join a MC pathway board they need to undergo training. This is currently underway and there should be a new female patient representative on the breast pathway board in March. LW explained to the Board that the plan has been clear in that commissioners will want single services with identified lead providers as it is no longer possible for every Trust providing every service. LW concurred with all that was said and asked how this discussion sits with a similar discussion at the Provider Federation Board. ABa confirmed she would take all the comments to the Provider Federation Board for further discussion but would welcome a steer from the provider board. ABa went on to point out that this is a general issue and not just a cancer issue ACTION: ABa to raise the issue at the next Provider Federation Board and feedback accordingly. 9. Agenda Item 10 Update on Acute Oncology Services This has been a longstanding agenda item and AH confirmed that all the letters from provider Trusts confirming that they would pick up the non-recurrent funding element of these posts, after the first year, had been located and he was optimistic that the issue would now be resolved. 10. Date and time of next meeting 19 th February, 8.30am-10.30, SRFT 5