The Sheffield Transformational survivorship project
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The Sheffield Transformational survivorship project. NCSI - drivers. Cancer Reform Strategy 2007. Breast Colorectal Prostate. Revised pathway (NTCN 2011). Old. New. ‘One size fits all approach’ CEA 3/12 (2yrs) 6/12 (3yrs) CT 9 and 24 months Colonoscopy

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The Sheffield Transformational survivorship project

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The sheffield transformational survivorship project

The Sheffield Transformational survivorship project


Ncsi drivers

NCSI - drivers

Cancer Reform Strategy

2007


The sheffield transformational survivorship project

  • Breast

  • Colorectal

  • Prostate


Revised pathway ntcn 2011

Revised pathway (NTCN 2011)

Old

New

‘One size fits all approach’

CEA 3/12 (2yrs) 6/12 (3yrs)

CT 9 and 24 months

Colonoscopy

OPA 3/12 (2yrs) 6/12 (3 yrs.)

5 years secondary care led

Clinical components same

OPA frequency reduced

Transfer of care to PC


The sheffield transformational survivorship project

End of life care

Diagnosis & Treatment

Early monitoring

Progressive illness

Later monitoring

Recovery

What happens here?


The sheffield transformational survivorship project

Macmillan Health and Well Being Survey 2008


The sheffield transformational survivorship project

Where we think people are….

Is not necessarily the case…


New colorectal pathway 2011

New Colorectal Pathway 2011

Treatment

Summary

HNA

colon

Risk Stratification

Health and well-being event

HNA + Care Plan

Colonoscopy 5 yrly

HNA

review

CT

CT

15m

OPA

+

CEA

18m

CEA

21m

CEA

24m

OPA

CT result

CEA

6/52

OPA

+

CEA

3 m

OPA

+

CEA

6 m

CEA

9m

OPA

CT result

CEA

12m

CEA

Level 1

CEA 6 m

Colonoscopy

Colonoscopy

6m

OPA

for 1 yr.

CEA

HNA

rectal

Level 2

CEA 6 m

+

Review

Cancer

Care

Review


The sheffield transformational survivorship project

NCSI

‘immediate benefit to patient experience and quality of care along the pathway’


The sheffield transformational survivorship project

Project work-streams


The sheffield transformational survivorship project

A complete picture

The Recovery Package

Revised follow up

pathway

Locally commissioned

scheme

Self-management

Clinical effectiveness


Cost benefit analysis colorectal

Cost benefit analysis - colorectal

  • Forecast No. of potential eligible patients per year = 450

  • Old pathway (visit) > 2 x OPA per yr. @ £72 each = £64,800

  • 70% Level 1 = 315 > 2 x CEA per yr. @ £18 each = £11,340

  • 25% Level 2 =112.5 > 2 x CEA per yr. @ £18 each = £4,050

    + 1 x review per yr. @ 41 each = £4,612

    Total under scheme = £20,002

    Saving per year = £44,798


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