Transforming Cancer Services Team

1. Transforming Cancer Services Team • Programme Overview – 17/18

2. Cancer • All Londoners have access to world class care before and after a cancer diagnosis • Healthy London Partnership is taking up the work of the London Transforming Cancer Services Team. It is delivering the Five Year Cancer Commissioning Strategy(published April 2014) to ensure patients are diagnosed sooner, and receive the same effective, high-quality care wherever they seek treatment in London. It is focusing on five key areas: Every year more than 30,000 Londoners learn they have cancer, and there are more than 200,000 people living with and beyond cancer – enough to fill Wembley stadium twice. It is the leading cause of early death. We need to do more to spot cancer sooner and follow on with optimal treatment and care in every part of the capital. 1 Improving early detection and awareness Developing centres of excellence and reducing variations in quality and experience Helping people living with and beyond cancer Supporting commissioning and contracting Improving patient experience 2 3 4 5

3. Cancer • Local health and wellbeing • TCST working in partnership to deliver: • Working with health and well being boards on how to prevent cancer and do a better job of supporting people who survive. • Using targeted screening approaches tailored to our local population’s needs. • Teaching people about the early signs and symptoms of cancers so they can get help sooner. • Ensuring robust systems are in place so that GPs are better able to detect and diagnose cancers at earlier stages. • Delivering a structured approach for following up on cancer patients so their condition is managed in the long term • Providing cancer waits, diagnostics and analysis to all London stakeholders Improving the survival rates and experiences of people with cancer is a priority for London CCGs. We are working with local partners to improve screening and then supporting people when they are diagnosed with cancer.

4. Current landscape in cancer services • Half of people born since 1960 will be diagnosed with cancer in their lifetime, with that proportion continuing to rise. Significant improvements in cancer survival, however, have been made over the last 15 years with more than half of people receiving a cancer diagnosis now living 10 years or more. This progress has been driven by improvements in knowledge of how to treat and control cancer, combined with the delivery of transformative care. • The most common cancers vary considerably by age group; different cancer types tend to be diagnosed in young people compared with old people • One year survival rates for all cancer types in London have been showing an upward trend, indicating improvement year on year • One and five year survival rates for lung, oesophagus and stomach cancer have improved in London since 2003 • 42% of cancer cases are preventable • 70% of people living with and beyond cancer have at least one other long term condition

5. Who are we? What do we do? • Our vision • All Londoners* have access to world class care before and after a cancer diagnosis • Our mission • As a trusted and expert partner, we drive delivery of world class cancer outcomes through collaboration, commissioning support, clinical leadership, education and engagement • The pan-London Transforming Cancer Services Team are responsible for: • A once for London approach to implementing the national strategy • Providing subject matter expertise, evidence and intelligence for cancer commissioning support • Working with partners to reduce variation and deliver improved cancer outcomes • Primary care development and education • Targeted service improvement in secondary care Note: Vision and mission statements updated at TCST Team Away day 2 May 2017 * Transforming Cancer Services Team supports all 32 London CCGs and West Essex CCG

6. Healthy London Partnership • Transforming Cancer Services Team is part of the portfolio of programmes within the Healthy London Partnership (HLP). • HLP was established in April 2015 in response to the pledge outlined by the London Health Commission to take London from seventh in the global city rankings to number one. HLP brings together London’s health and care system to deliver changes that are best done ‘once for London’. • Every London CCG and NHS England (London) have made a commitment through HLP to unite our partners and take collective action to transform health and care in London. Our partners include the Mayor of London, Greater London Authority, Public Health England, London councils and Health Education England. Collectively we believe it is possible to achieve a healthier, more liveable global city by delivering on the ambitions set out in Better Health for London: Next Steps and the national NHS Five Year Forward View. • In 2016/17 HLP was in a unique position to support the developing sustainability and transformation plans in the five STP areas across the range of workstreams. In some areas like urgent and emergency care, prevention and children and young people HLP has provided staff who have been embedded in the STP workstreams. In other areas like transforming primary care, HLP has provided the funding to deliver on the GP five year forward view. Across all other programmes, HLP has provided support and strategic advice. • In 2017/18 HLP will be supporting STPs through the central strategic team, as well as continuing to provide embedded support. Furthermore HLP will deliver on a series of agreed ‘once for London’ projects that deliver the Better Health for London and Five Year Forward View ambitions, for example, continuing to develop the Patient Relationship Manager System for NHS111 which puts particular patients and their care plans, directly in touch with clinicians.

7. National publications The Healthy London Partnership Transforming Cancer Services programme was set up on behalf of London’s Commissioning Groups (CCGs) and NHS England (London region) to deliver the Five Year Commissioning Strategy for London. Since then the Five Year Forward View and the National Cancer Strategy have also been published to guide the transformation of cancer services across London. Five Year Commissioning Strategy for London National Cancer Strategy: Achieving world class cancer outcomes (Independent Cancer Taskforce) Implementing the Cancer Taskforce Recommendations: Commissioning person centred care for people affected by Cancer Next steps on the NHS Five Year Forward View Apr 2014 Apr 2016 Mar 2017 Jul 2015 Dec 2015 May 2016 Sep 2016 Oct 2014 Five Year Forward View Achieving world class cancer outcomes: taking the strategy forward NHS Operational Planning and Contracting Guidance 2017-2019 Delivering the Forward View: NHS Planning guidance

8. Key achievements in 16/17 (1) • Embedding of data and communications flow, through creating bespoke cancer wait products for London • Practice Profiles Plus containing 6 years of data disseminated across London • Participation in development of regional optimal prostate pathway and national optimal lung pathway • Breach reallocation tool developed and implemented in London • Every London Trust radiography and endoscopy team visited by TCST • Contributed to DCF bids to support securing investment funding • Demand and capacity reports and recommendations for diagnostic optimisation completed for all London Trusts • Good practice screening guide developed and disseminated across GPs in London • GP endorsement of bowel screening in every single GP practice across London resulting in 1% increase in bowel screening uptake • Implementation of NG12 NICE guidance through agreement of local criteria for referrals and the development of associated referral forms. Audit shows 60% of London has NG12 referral criteria in place

9. Key achievements in 16/17 (2) • Facilitator programme between primary and secondary care established, helping support primary care to use tools that enable earlier diagnosis of cancer • Training Needs Analysis tools developed and published for a range of primary care clinicians in early diagnosis and living with and beyond cancer. • Lymphoedema commissioning guidance, mapping and specification published. Successfully influenced BHR to include lymphoedema in their cancer work programme as mapping showed there is no service currently in place. • Macmillan funding secured for Cancer Rehabilitation Clinical Lead until Dec 2018 and a new Mental Health clinical lead for one year until Dec 2017 • Successfully influenced four STPs to include the primary care led pathway for management of stable prostate cancer in STP plans, with ongoing bespoke support. Published a sample business case to accompany other resources published in 2015/16. • Cancer Rehabilitation Scoping Report and accompanying YouTube video • London Cancer Commissioning Operational Model signed off and implemented • 52 bespoke patient experience reports produced and distributed for Trusts and CCGs across London

10. National requirements

11. London STP map and representation NCL STP Cancer Lead: Neil Snee TCST SMT Lead: Julie Lees STP Clinical Lead: Clare Stephens CCM: Michael Yare NWL STP Cancer Lead: Lizzy Bovill TCST SMT Lead: Andy McMeeking STP Clinical Lead: Afsana Safa CPM: Bec DuBock Enfield Barnet Harrow Haringey Waltham Forest Hillingdon Brent Redbridge City & Hackney Camden Camden Islington Ealing Havering Newham Barking & Dagenham Hammersmith & Fulham Central London Tower Hamlets NEL STP Cancer Lead: Sue Maughn TCST SMT Lead: TBC STP Clinical Lead: Vacant CCM: Kate Kavanagh & Tony Lawlor West London Hounslow South- wark Richmond Greenwich Wandsworth Lambeth Lewisham SWL STP Cancer Lead: Jonathan Bates TCST SMT Lead: Liz Price STP Clinical Lead: Tony Brzezicki CPM: (Laura Morrison) Bexley Kingston Merton SEL STP Cancer Lead: Andrew Eyers TCST SMT Lead: Julia Ozdilli STP Clinical Lead: Anthony Cunliffe CPM: Stephanie Alexander Bromley Sutton Croydon *TCST also serves West Essex CCG which borders Enfield, Waltham Forest, Redbridge and Havering CCGs 21

12. STP leadership Each STP footprint is led by a Senior Responsible Owner and has representation from the CCG, Lead Provider and Local Authority

13. Role of delivering cancer improvements National requirements Regional delivery Pan-London delivery: TCST Cancer Vanguard: RM Partners Cancer Alliance Cancer Vanguard: UCLH Cancer Collaborative STPs NCL NWL SWL SEL NEL 7x CCG 5x CCG 8x CCG 6x CCG 6x CCG Trusts Trusts Trusts Trusts Trusts

14. Programme and projects Transforming Cancer Services Programme Early diagnosis In year delivery of cancer waits Diagnostic capacity, demand & optimisation Living with and beyond cancer Quality, safety, governance & leadership • Improving population awareness Optimisation of screening uptake • Implementation of emerging NICE guidelines • Implementation of Straight to Test and Direct Access • Service specification • Case finding • Programme Management • Recovery package and stratified follow up commissioning guidance • Primary Care education • Quality of Life • Programme Management • Communications & engagement • 7 day median access • Pathways • PTLs • Optimisation of MDT meetings • Performance analysis • Improvement support and training • Planning for diagnostics • Engagement • Providing Trust support • Flexible support • Governance • Commissioning and contracting • Improving patient experience • Communications

15. TCST Stakeholder map Keep satisfiedInform and consult Work together Inform, consult and collaborate • Meetings and briefings • Engagement events • Newsletters, digital communication and promotion • Online presence • Direct communication • Meetings and briefings • Engagement events • Newsletters, digital communication and promotion • Online presence • Direct communication High • CCG Accountable Officers • Public Health (LA) • London Clinical Senate • London-wide LMCs • Royal Colleges • Health Education England • Department of Health • NHS England (Operations & Medical Directorate) • NHS Improvement • SPGs & CCGs • GP Cancer Leads • Cancer taskforce • SCN Cancer (ICSs) • Cancer charities • CCB • CCB CAG • CCB PAG • NHSE Specialised Commissioning • PHE Screening • Healthy London Partnership • Heath Ministers • Mayor of London • GLA • ADASS Stakeholder influence Show consideration Inform and consult Keep informed Inform only • SCN – Children’s & Young People • Patients and public • GP practices • SCN – Mental Health • NHS Providers • NCIN / NCRS • Academic Health Science Networks • Patients and public • GP practices • Engagement events • Newsletters, digital communication and promotion • Online presence • Engagement events • Newsletters, digital communication and promotion • Online presence Low High Stakeholder interest

16. Cancer commissioning governance model London Cancer Learning Partnership Agrees priorities and makes final decisions Ensures strategic proposals for cancer fit with the wider spec comm strategy Accepts priorities presented by CCB and supports delivery Cancer Commissioning Board (CCB) Cancer Vanguard (London) RM Partners ACN UCLH Cancer Collaborative NWL STP SEL STP SWL STP NEL STP NCL STP Formulates the pan-London programme and provides recommendations SEL Cancer Alliance Alignment of priorities Commissioning governance Delivery governance Cancer Commissioning Board Clinical Advisory Group (CCB CAG) Specialised Commissioning Executive Group Cancer Intelligence Priorities for London Steering Group Early Diagnosis Advisory Group (EDAG) CCB Patient Advisory Group (CCB PAG) LWBC Partnership Board (LWBC) 20 KEY: Provides advice and reports to Two way relationship Provides input, information (and representatives)

17. Organisational structure Liz Wise Director Sue Maughn Deputy Director - Clinical 1.0 WTE 8D Julie Lees Associate Director – PMO and Patient Experience 1.0 WTE, 8C Liz Price Associate Director – Living with and Beyond Cancer 0.8 WTE, 8C Julia Ozdilli Associate Director – Early Diagnosis 1.0 WTE, 8C Andy McMeeking Deputy Director - Improvement 1.0 WTE, 8D Prof Adrian Newland Secondary Care Advisor 0.2 WTE Bonnie Chrysanthou Programme Manager 0.5 WTE, 8C Dr Tony Brzezicki SWL GP Lead/ CCB Co-chair 0.2 WTE Natalia Neira Project Manager 0.45 WTE, 8A Sarita Yaganti Project Manager 1.0 WTE, 8A Barbara Gallagher User Involvement & Patient Experience Coordinator 1.0 WTE, 6 Liz Jones Programme Manager 0.6 WTE, 8C Dr PawanRandev Primary Care Education Lead 0.4 WTE Zara Gross Project Officer (Covering Maria’s post) 1.0 WTE, 7 Dr Karen Robb Rehab Clinical Lead Fixed Term funded by Macmillan (Dec 18) 0.8 WTE, 8C Shirley Lee PMO 1.0 WTE Dr AfsanaSafa NWL STP GP Lead 0.2 WTE Jason Petit Senior Cancer Intelligence Lead 1.0 WTE, 8B Maria Adeeko Project Officer (On Maternity Leave) 1.0 WTE, 7 Afet Mehmet Business Support 1.0 WTE, 6 Dr Philippa Hyman Mental Health Clinical Lead Fixed Term funded by Macmillan (Dec 17) 0.6 WTE, 8B Dr Anthony Cunliffe SEL STP GP Lead 0.2 WTE Pamela Shiel TCST Administrator 0.8 WTE, 5 ChipoChirewa Cancer Intelligence Lead 1.0 WTE, 8A TBC Primary Diagnostic Lead 0.3 WTE Dr Ishani Patel GP Advisor – Early Diagnosis 0.3 WTE Charlene Onofiok TCST Administrator 1.0 WTE, 5 Lucy Young Snr Cancer Information Analyst Fixed Term funded by HLP 1.0 WTE, 7 Dr Clare Stephens NCL STP Lead 0.2 WTE Judith Shankleman Public Health Advisor 0.2 WTE, 8C KEY: Funded by Macmillan NEL STP Lead Post vacant 0.2 WTE TCST Molly Loughran Cancer Information Analyst Fixed Term funded by HLP 1.0 WTE, 6 Funded by CRUK until Mar 17 Embedded in CSUs/CCGs Funded by HLP until Apr 18 Bethany Wickramasinghe Cancer Information Analyst Fixed Term funded by HLP 1.0 WTE, 6 NEL NWL NCL SEL SWL Kate Kavanagh NEL Cancer CommMgr Tony Lawlor NEL Cancer CommMgr BecDuBock NWL Cancer Performance Manager Michael Yare NCL Assistant Director Cancer Commissioning Stephanie Alexander SEL Cancer Performance Manager Laura Morrison SWL Cancer Performance Manager 6 Jason Kapitzke NEL Cancer Comm Support