Acute Oncology & Chemotherapy Clinical Network Group (CNG) Work Programme 2014-2015 Version 1.0 This Work Programme has been agreed by: Title Name Date Agreed AO & Chemotherapy CNG Chair Ernie Marshall 29.07.2014 CMSCN Clinical Lead Chris Warburton 29.07.2014 CWW Area Team Medical Director Kieran Murphy 29.07.2014 This programme has been agreed by the AO & Chemotherapy CNG and will be reviewed 3 times a year 29.07.2014 CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 1 of 12
Version Control This is a controlled document please destroy all previous versions on receipt of a new version. Date Approved: July 2014 Review Date: April 2015 Version Date Issued Review Date Brief Summary of Change 1.0 July 2014 April 2015 Approved AO & Chemotherapy CNG This work programme sets out how the AO & Chemotherapy CNG intends to deliver improved outcomes and quality improvements. It details, the key deliverables and measures of success that exist for each objective. Progress will be reviewed 3 times a year at each CNG meeting. For the latest version of this Work Programme please see website http://www.cmscn.nhs.uk CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 2 of 12
3 Year Service Delivery Plan Minimise number of people developing disease and improve survival rates Domain/Goal Strategic Direction 2014 Domain 1/Goal 1 Domain 2/Goal 2 Domain 2/Goal 3 Domain 4/Goal 4 Treatment AO/CUP MDS collection by each MDT/service Improved SACT compliance Monitor the number of palliative patients dying in their preferred place of care Increase number of CUP patients receiving active treatment Increasing portfolio of trials with equal access for patients Monitoring new approaches to cancer drug pricing Improved planning for new drugs on the horizon and all cancer teams should be using a capacity planning tools Exploring new ways of delivering chemotherapy/skill mix changes Holistic Care HNA & patient information prescriptions embedded in routine practice Implementation of care plans & end of treatment summaries MSCC Management Agreed implementation plan for NICE QS & revision of network guideline Annual audit - Timeliness of the Investigation of MSCC Annual audit - Timeliness of Definitive Treatment of MSCC Annual audit - Outcome of Definitive Treatment of MSCC Service Improvement Improved patient experience survey results Implement network AO/CUP audit programme CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 3 of 12
Domain 5/Goal 5 Reduce emergency admissions Reduce length of stay Consolidate Acute Oncology Services across network, with a view to 7 day service provision Raise C&M profile nationally Exploring chemotherapy closer to home where possible Clinical Governance E-prescribing agreed procurement plan in place by each provider 30 day SACT M&M reviews in place in each provider 2015 Domain 1/Goal 6 Domain 1/Goal 7 Domain 3/Goal 6 Domain 4/Goal 7 Epidemiology: Improved SACT compliance Analysis and agreed actions to support improvements in emergency presentation rates Treatment Increasing portfolio of trials with equal access for patients Care closer to home Monitoring new approaches to cancer drug pricing Improved planning for new drugs on the horizon and all cancer teams should be using a capacity planning tools Exploring new ways of delivering chemotherapy/skill mix changes Follow up Consensus on risk stratified follow-up Holistic Care HNA & patient information prescriptions embedded in routine practice CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 4 of 12
Improved patient experience survey results Improved door to needle time 2016 Domain 1/Goal 8 Domain 1/Goal 9 Domain 4/Goal 10 Epidemiology: Benchmarking local outcomes data Treatment Increasing portfolio of trials with equal access for patients Regular monitoring of C&D within chemotherapy outpatient units and pharmacy aseptics identifying trends and safe working limits (SWL) Dedicated In-patient beds Community AO model & interface with LTC team agreed Monitoring new approaches to cancer drug pricing Improved planning for new drugs on the horizon and all cancer teams should be using a capacity planning tools Exploring new ways of delivering chemotherapy/skill mix changes 24 hour Integrated Helpline in place Holistic Care Equitable access to high quality survivorship programmes in each locality supported by risk stratified follow-up CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 5 of 12
CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 6 of 12
Clinical Governance (Ref: Cancer SCN Priority 2 & Domain 1, 2 & 4) Work Programme Purpose: To ensure co-ordination and consistency across the network for cancer policy, practice guidelines, audit, research and service development in relation to the acute oncology, cancer of unknown primary & chemotherapy services. Progress rating: BLUE Completed GREEN On target AMBER Minor concerns RED Major concern Objective 1: Full compliance with national peer review quality measures (2014) to quality assure acute oncology, cancer of unknown primary & chemotherapy services cancer services Measure of success Task Lead Target Date Progress 100% compliance with AO/CUP/Chemotherapy Update constitution Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by Peer Review Measures Produce annual report Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by Review work programme Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by Annual self- assessment Anita Corrigan/Ernie Marshall June 2014 Sign off remotely by Update clinical guidelines Individual CNG authors July 2014 Sign off remotely by Objective 2: To have a fully functioning CNG which supports improving the quality of acute oncology, cancer of unknown primary & chemotherapy services, safeguards high standards of care and creates an environment in which excellence in clinical care flourishes Measure of success Task Lead Target Date Progress 100% organisational representation MDT Lead Clinicians or representative in attendance for 2/3 of CNG meetings Review and confirm membership Jo Myler June 2014 Sign off remotely by Agree meeting dates and venue Jo Myler March 2014 Completed. Agree work programme 2014-2015 including areas for service development Review outcome indicators AO MDS CUP MDS SACT compliance NS time to antibiotics Ernie Marshall June 2014 Sign off remotely by AO Leads/CNG July 2014 Sign off remotely by CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 7 of 12
Survivorship (Ref: Cancer SCN Priority 2& Domain 2) Objective 3: Ensure that those living with and beyond cancer get the care and support they need to lead as healthy and active a life as possible, for as long as possible Measure of success Task Lead Target Date Progress 100% completion of HNA at diagnosis 100% treatment summary Implement recovery package which includes: CNG Nursing representatives March 2015 Planned 100% Cancer Care Review a. Holistic Needs Assessments completed Agreed stratified follow up and care planning at key points protocol of the care pathway Access to education and support programme in each locality b. A Cancer Care Review completed by GP or practice nurse to discuss the person s needs Primary Care CRG March 2015 Planned c. A Treatment Summary completed at the end of each acute treatment phase, sent to patient and GP Offering a patient education and support event, such as a Health and Wellbeing Clinic, to prepare the person for the transition to supported self- management, which will include advice on healthy lifestyle and physical activity NICE Smoking cessation - supporting people to stop smoking (QS43) identify smokers/refer to smoking cessation services routinely CNG Nursing representatives March 2015 Planned CNG Nursing representatives March 2015 Planned MDT Lead Clinicians/CNG March 2015 Planned CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 8 of 12
Patient Experience (Ref: Cancer SCN Priority 4 & Domain 5) Baseline survivorship support & develop further action plan A. Bass Sept 2015 Planned Objective 4: To monitor network progress and to use the findings to drive quality improvements locally Measure of success Task Lead Target Date Progress National Cancer & Results reviewed by CNG. Mike Varey May 2014 Completed Chemotherapy Patient MDT remedial action plans MDT Leads July 2014 CNG to discussion Experience Surveys + CMSCN AOT surveys results discussed at CNG presented to CNG & actions agreed. Progress reviewed at year end. MDT Lead Clinicians/CNG March 2015 Planned Remedial Action Plan MSCC high risk patients MDT Lead Clinicians/CNG March 2015 Planned developed based on survey identified by CNG, clinical advice results to drive year on year given to patient reinforce with improvements in results. (% written information. improvement to be determined in 2014) Reduced LOS Explore strategies & develop supporting case of need to prevent emergency admissions e.g. o Fast track clinic access o Day case capacity/chemotherapy clinic utilisation o Dedicated In-patient beds o Community AO model & interface with LTC team o 24 hour Integrated Helpline CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 9 of 12
Clinical Audit /Service Improvement/Education (Ref: Cancer SCN Priority 4 & Domain 5) Network AO patient & HCP survey undertaken annually. Results presented to CNG & actions agreed. MDT Lead Clinicians/CNG March 2015 Planned Objective 5: Patients have equitable access to treatments that could potentially improve outcome. Measure of success Task Lead Target Date Progress Reducing inequalities and Improved SACT compliance MDT Lead Clinicians/CNG Nov 2014 Ongoing variation in quality and performance Variances in clinical outcomes will be analysed & addressed. Network-wide collection of AO/CUP MDS & annual monitoring of outcomes data MDT Lead Clinicians/CNG Nov 20154 Ongoing Promote secondary prevention through specialist advice Diet Exercise Smoking cessation Increase recruitment into randomised, non-randomised trials and commercial studies Develop a research infrastructure to share learning and best practice Host an education/audit day to share good practice Chemotherapy algorithms developed. Deviations monitored. E-prescribing procurement plans agreed by each provider. Dose banding pilot evaluated & action plan developed. MDT Lead Clinicians/CNG March 2015 Planned MDT Lead Clinicians/CNG March 2015 Ongoing Helen Neville-Webb/MDT Lead Clinicians/CNG March 2015 Ongoing Ernie Marshall Sept 2014 Planned MDT Lead Clinicians/CNG March 2015 Planned CSC Leads /CNG March 2015 Ongoing NPG March 2015 Ongoing CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 10 of 12
Continued MSCC Clinical Case Reviews & sharing of lessons learnt. Annual network NS Audit & year on year improvements in door to needle time. Work with primary care on admission avoidance strategies Morbidity & Mortality Meetings in place in each Trust Explore strategies & develop supporting case of need to prevent emergency admissions e.g. o Fast track clinic access o Day case capacity/chemotherapy clinic utilisation o Dedicated In-patient beds o Community AO model & interface with LTC team o 24 hour Integrated Helpline MSCC Leads Sept 2014 Planned NS Leads Dec 2015 In progress MDT Lead Clinicians March 2015 In progress MDT Lead Clinicians Dec 2014 In progress MDT Lead Clinicians/CNG Sept 2015 Planned CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 11 of 12
Cheshire & Merseyside Strategic Clinical Networks (CMSCN) Vision To improve the health & wellbeing of our population through collaborative working CMSCN Values Cheshire and Merseyside Strategic Clinical Networks and Senate will work within the values of NHS England. Central to our ambition is to place patients and the public at the heart of everything we do through: clinical leadership, patient & people focus, continuous improvement, Strategic Goals CMSCN have agreed the following strategic objectives for this period: Champion equitable access to high quality services supported by evidence & best practice Meaningful & effective patient & public involvement in strategic decision making Support commissioners to reduce unwarranted variations in service delivery Support commissioners & providers to deliver whole system improvement and act as a vehicle to ensure equitable outcomes for the population of Cheshire & Merseyside Support commissioners in ensuring best value for money in addition to improving the quality of care and outcomes Cancer SCN Priorities To support overall delivery of CMSCN s strategic objectives, the following priorities have been agreed by the Cancer Strategic Clinical Network 1. Improving outcomes for cancer patients: prevention and earlier diagnosis (NHS Outcomes Framework Domain 1) 2. Improved quality of life for patients living with & beyond cancer (NHS Outcomes Framework Domain 2) 3. Improved patient experience through high quality, cost effective cancer pathways (NHS Outcomes Framework Domain 4) 4. Supporting commissioners to reduce variation: through high quality, cost effective cancer pathways high quality cancer care guided by national guidance and best practice (NHS Outcomes Framework Domain 5) CMSCN AO & Chemotherapy CNG Work Programme 2014-15 (Version 1.0 approved 29.07.2014) Page 12 of 12