MCIP Recruitment Pack

MCIP Recruitment Pack Page 1 of 13

Welcome Thank you for the interest you have shown in the MCIP Programme. An exciting partnership has been established to redesign cancer care in Manchester. Funded by Macmillan Cancer Support, this 3.45m initiative is putting people affected by cancer at the heart of change. Phase 1 invests 2.35m in primary, palliative, community and end of life care. It includes enhanced training for the health and social care workforce and the development of new palliative care services. Phase 2 invests a further 1.1m into local redesign work and is focused on reviewing and improving breast and lung pathways. To achieve our shared ambition for Manchester to have the best cancer care possible we are recruiting a fixed term programme team to work across South, North and Central Manchester Clinical Commissioning Groups with local GPs, hospitals, hospices and Manchester City Council as well as local people. In this pack you will find an overview of the MCIP Programme, including some of its agreed outcomes and governance structure. We are recruiting now for our Deputy Programme Lead and Phase 1 posts. Discussion about the shape of the Phase 2 team structure is underway following the recent signing of the Phase 2 funding agreement. Recruitment for posts will utilise a mix of assessment centres and interviews (February early April). If you apply for a post with a later closing date, please be aware that due to the number of posts you may not receive a quick response. Posts may be closed early if there is a high volume of applicants. All advertised posts will be fixed term until 31 December 2015 (option to extend is funding dependent). The posts will be based at South Manchester CCG, Princess Road, Manchester, M14 7LU. Secondments are welcome but prior agreement of the sending organisation should be sought before an application is made and agreement noted on the application form. Applications should be made on the NHS Jobs web site. To arrange an informal discussion/ for more information please e-mail our interim Programme Coordinator: maia.fradley@nhs.net Good luck in your application! Janet Tonge MCIP Programme Lead Page 2 of 13

The Posts Deputy Programme Lead (Up to 56,504, AfC Band 8b, fixed term) You will pull together our phase 2 programme and lead the Phase 2 team. You will be able to work across different health and social care sectors to develop an ambitious yet realistic plan agreed by key partners and local people. Closing date: 5pm 13/03/14 Learning and Development Lead (Up to 47,088, AfC Band 8a, fixed term) You will lead our workforce development activities across primary, community and palliative care as well as develop work on Phase 2.You will be experienced in designing or commissioning training and development programmes in a health and social care context. Closing date: Noon 06/02/14 Programme Managers (2 x WTE, Up to 40,558, AfC Band 7, fixed term) Working with a wide range of stakeholders, you will use your excellent organisational and planning skills to keep our Phase 1 projects on track. Closing date: 5pm 11/02/14 User Involvement Facilitator (0.6 WTE, Up to 34,530 p.a. pro rata, AfC Band 6, fixed term) You will ensure that people affected by cancer are at the heart of change. You will have an in depth knowledge and understanding of patient/carer involvement, a person centred approach and experience of working in user involvement/patient and public engagement. Closing date: 5pm on 24/02/14 Programme Co-ordinator (Up to 27,901, AfC Band 5, fixed term) You will support the team to deliver effective project and programme management. You will have experience of using project management methodologies and strong project co-ordination experience. Closing date: 5pm 23/03/14 Programme Administrator/PA (Up to 22,016, AfC Band 4, fixed term) You will provide a comprehensive administration service for the Programme including PA support as well as organising/supporting meetings and events. You will have strong experience of office administration and meeting/event co-ordination. Closing date: 5pm 23/03/14 For all posts you will be able to build consensus and plan multiple projects using your experience of work in a Health or Social Care context to understand different perspectives. If you have a passion to make a difference in cancer care then you may be just what we are looking for! Page 3 of 13

MCIP Programme Team Structure MCIP Programme Lead PA/ Programme Administrator Learning and Development Lead Deputy Programme Lead Programme Managers 2 x WTE Learning and Development Team/ Contract tbc Administrator tbc Programme Co-ordinator Phase 2 team tbc User Involvement Facilitator Page 4 of 13

MCIP Phase 1 Project Overview In 2009/10 Macmillan worked with the Monitor Group and the NHS in Manchester to track interventions, resource use and associated costs of lung and breast cancer patients. The study highlighted discrepancies of treatment between patients with similar disease profiles resulting in higher costs. Poor co-ordination of care was identified as a key element contributing to these discrepancies. The report also highlighted possible changes in pathways of care which would improve services for all patients. This led Macmillan to invest in a system redesign project in the City of Manchester. The MCIP Programme builds on Macmillan s previous 12m investment in Manchester over the last eight years to redesign pathways of care for people affected by cancer. The programme will deliver across the three Manchester CCG s, North, Central and South Manchester, (102 General Practices) more patient-centred and co-ordinated support from the point of diagnosis all the way through treatment and beyond. Part of this will be reducing the number of interventions for patients by managing their care better and preventing issues escalating unnecessarily into a crisis or emergency, reducing the length of hospital stays and being able to choose to die at home if they wish. Phase one of the Project will focus on primary, community and palliative care across all tumour groups. This will be followed by work in secondary care around lung and breast pathways, investment in hospital-based breast and lung services and will be subject to a separate memorandum of understanding. Macmillan s ambition is to spread the good practice across other tumour groups and across Greater Manchester and Cheshire. Project Scope The scope of phase 1 which is a programme covering Community and Primary care including Palliative Care and End of life, will address the needs of all cancer types and will support the delivery of Macmillan s Nine Outcomes. Involvement of People Affected by Cancer Co-design and involvement of people affected by cancer is a hallmark of the MCIP Programme and one of our operating principles. We have agreed that: User insight and input is gathered and used throughout the scoping, implementation and evaluation stages of any work Page 5 of 13

That a range of methods are used to gather user insight and input into the work in order to ensure a representative perspective is obtained (including traditionally seldom heard groups) There is a parity of esteem between the input / views of patients and carers with those of professionals and managers That patient experience is given as equal a waiting as clinical outcome and cost reduction / efficiency, within the programme Primary care work stream Background Patient experience surveys show that there is a wide variation in the levels and standards of support received in general practice in terms of early recognition of signs/symptoms of cancer, early referral and subsequent support offered during and post diagnosis. The proportion of patients with a cancer diagnosis within a practice is relatively low in comparison with other disease specific groups. It is also accepted that where patients are diagnosed at a late stage via primary care or diagnosed via a medical emergency route their relative survival rates are compromised. It is acknowledged that the use of cancer registers is sporadic and are frequently out of date so they are of limited use to the practice to support patients. Cancer care reviews are not undertaken consistently across the 102 general practices and nor do they assist in helping practices support the holistic needs of patients. This is compounded by GPs and practice staff often feeling ill prepared in supporting and talking to patients affected by cancer. This situation is exacerbated by the lack of information and support surrounding cancer in general practice available to patients, carers and primary care staff. Activities Activities and service delivery targets have been selected as a result of Macmillan s extensive experience of cancer care best practice and their endorsement of a number of national health initiatives. Outcomes All practices have up to date cancer registers. Standard cancer care reviews are adopted by all practices. Increased use of risk stratification. A Macmillan Quality Standard Mark for General Practice.is developed and GP Practices are encouraged to apply. Cancer champions identified for every practice. GP s have increased knowledge to enable early referral and regularly use national cancer decision tools. Effective sharing of best practice and learning across Manchester Patients holistic and psychological needs are fully addressed People affected by cancer are more informed about their condition, how to manage it and where/when to seek support. Page 6 of 13

Community Care Work stream Background There is a growing recognition that cancer after care is not as effective as it could be due to fragmentation between the various providers. This can cause patients to feel disempowered to manage their own condition and often feel isolated. People living with cancer have on-going unmet needs from their cancer and treatment, for example late side effects of treatment, greater risk of other long term conditions and risk/fear of cancer recurrence. There is also a drive to deliver care in the community and closer to home, to improve patient experience and meet needs after treatment. Outcomes Increased awareness, knowledge and skills among community health and social care staff around cancer to support people affected by cancer. Improved communication and more coordinated pathways between acute, primary care and community care. Improved quality of care and patient experience. People with cancer feel that their individual needs are thoroughly assessed and understood. People are more informed about their condition, how to manage it and where/when to seek support. Increased confidence and ability to self-manage among people with cancer Carers of people affected by cancer feel better supported and more empowered People lead healthier lifestyles through changed attitudes and behaviours Improved health and well-being and quality of life for people affected by cancer. Supported, Palliative and End of Life Care Work stream Background The evidence shows that the system in Manchester needs improving and that there is inequity in end of life care where 63% of patients die in hospital. From the 2012 patient experience survey only 38% of patients felt they were given enough support by health and social care services following hospital discharge. Outcomes Increased compliance with Gold Standards Framework. All GP practices establish a robust palliative care register and have monthly palliative care practice meetings. Increase the number of patients who have a recorded preferred place of care. Increase the number of patients who have an advanced care plan. Increase user involvement in the development of supported palliative and end of life care services. Page 7 of 13

People affected by cancer have an increased confidence and ability to manage cancer and the knowledge of how to seek support. Increased confidence and reduced anxiety and isolation among carers. Reduced inpatient hospice admissions. Reduced emergency admissions due to cancer and/or complications Reduce the number of hospital follow up appointments (before and after) inpatient admissions. Impact of all three work streams Improved experiences and outcomes for people affected by cancer. Contributes to Macmillan nine outcomes and local partner priorities. People affected by cancer know they have had a Macmillan experience Well trained and skilled workforce in Manchester who are better able to support people affected by cancer at any point of their journey. Earlier diagnosis and detection of recurrence leading to improved survival rates. A fully integrated and joined up care pathway that is more efficient, cost effective and meets the needs of people affected by cancer. Improved long term health and well-being of people with cancer and of their wider network of families/friends/carers through transfer of knowledge and behaviours. Enhanced patient experience across the system and particularly at the end of life, so people have increased dignity, respect and choice at end of life. Widespread attitudinal behavioural changes among people affected by cancer and professionals, particularly around the changing cancer story and the shift towards greater self-management. Page 8 of 13

MCIP Phase 2 Background The funding agreement for the second phase of the Macmillan Cancer Improvement Partnership programme was signed by the Chief Officer of South Manchester CCG on behalf of the Partnership in December 2013. This followed a series of workshops that led to the development of logic models. Phase 2 is intended to build upon Phase 1 and aims to improve cancer outcomes for breast and lung patients through development of seamless pathways for the full patient journey - prevention and promotion, through early diagnosis and treatment, to survivorship or end of life care: The rationale to redesign the lung pathways is based on: pathway complexity, higher lung cancer incidence and mortality levels in Manchester than elsewhere. The rational to redesign breast cancer pathways is based on unsustainability of current follow up models and need to respond more to issues related to survivorship. Expected outcomes The agreement is for 1.1m of Macmillan Cancer Care support funding to be used to improve outcomes for breast and lung cancer patients as set out below. Intended outcomes following Lung Pathway redesign: Increase in the number of patients diagnosed through the 2 week referral route Development of a complete seamless pathway of care from pre diagnosis to post treatment programmes to palliative and EOL care Care delivered closer to patients home or place of choice Redesign of the diagnostic pathway which will improve efficiency and improve patient experience and out comes Lung cancer patients will be well informed and have the right information and support that is right for them. When new problems emerge patients will be supported through anticipatory planning Post treatment programmes established to increase patient and carer confidence in coping, problem solving and accessing services Key patient problems such as breathlessness, fatigue, anxiety and nutritional support are addressed through established referral pathways Patients and their carers will feel supported in both palliative and end of life care Service users at the forefront of co creation Page 9 of 13

Intended outcomes following Breast Pathway redesign: Improved cancer outcomes through seamlessly delivered pathways from diagnosis to end of life care Reduced variation in access to and experience of care through consistent application of best practice Patients are offered information about their cancer, and their support and treatment options, including the short and longer term consequences of treatment Patients are given support through treatment itself, including support for life style changes Carers support needs are addressed People living with and beyond cancer are empowered to self-manage their condition based on their needs and preferences and are informed to do so There is a greater focus on recovery and health and wellbeing after cancer treatment Movement away from a single model of follow up to tailored support that enables early recognition of the consequences of treatment and the signs and symptoms of further disease Patients are offered tailored follow up to meet their needs which will ensure that their needs will be better met and resources used more effectively Patients know how to maintain a healthy lifestyle including the benefits of physical activity User groups for people affected by cancer understand what should be available and can participate with confidence in local discussions with commissioners and providers Patient who are concerned about a recurrence know how to re-access specialist care Patients who are at EOL have choice in their preferred place of care and access to the right professionals and support at the right time. Further anticipated benefits: Money released to support further work in the community so patients can be cared for closer to home. Improvements to mortality outcomes especially related to lung patients Prevention of unnecessary A and E attendances and hospital admission Improved care coordination across the pathways resulting in more integrated and joined up care. Opportunity to redesign follow up and reduce the number of routine hospital follow up attendees Implementation of survivorship and post treatment programmes Increase the delivery of care closer to home Allow more patients to spend end of life in their preferred place of care Patients will be at the forefront of influencing how cancer services are commissioned in the future Page 10 of 13

A shift of focus from the provider to the patient Patients will no longer feel lost in the system Opportunity and commitment by Macmillan to spread the learning from this programme to other cancer types. Phase 2 Delivery Stages Stage 1: Strategic review and planning, designing optimal services Information gathering on current and best practice for breast and lung pathways including palliative and end of life care. Assessment of need, review of current services and prioritisation of key areas. Design of optimal pathways using national guidance and established best practice. Stage 2: Revision and development of a commissioning service specification and implementation of that service specification Review of current service specifications and development of outcome based specifications for all interventions linked to each provider involved in the cancer pathways for breast and lung including end of life services and which support the delivery of Macmillan s Nine Outcomes. Development of key tumour specific metrics based on national quality standards and local objectives including key performance indicators. Implementation of service solutions as detailed in the logic models and with which enable the outcomes for the project to be realised. Stage 3: Monitoring and evaluation Development of a performance monitoring and management systems to monitor outcomes, quality standards and patient experience. Page 11 of 13

MCIP Proposed Governance Structure The MCIP Board is currently considering how to develop its structure to support the newly agreed Phase 2 work. The phase 1 work streams are all established along with the majority of the working groups. Below is the currently proposed structure. Page 12 of 13

Macmillan Nine Outcomes Delivering the Macmillan nine outcomes are key to the work of MCIP and underpins the programmes intended outcomes and activities. They are set out visually below. Page 13 of 13