Lung NSSG Meeting 13 May 2013

1. Lung NSSG Meeting13 May 2013 Barbara Gill, Transition Lead, EoE SCN

2. Contents • Reminder of new NHS organisations • Specialised Commissioning • New Strategic Clinical Network structure • MVCN Structures moving forward? • Primary Care initiatives – local and national • Lung Cancer Campaign and Lung Film

3. NHS England PCTs and SHAs now gone 4 Regions – ours: Midlands and East of England 27 Area Teams – ours is: Hertfordshire and South Midlands Area Team • Includes Herts, Luton, Beds, Milton Keynes and Northampton • Jane Halpin is Chief Executive • Main base is Charter House, WGC

6. Commissioning Arrangements • (27) Area Teams (ATs) • Will commission GP, dental, pharmacy services • (211) Clinical Commissioning Groups (CCGs) • Will commission most secondary health services • With help from their CSUs • (10) Specialised Commissioning hubs • Will commission specialised health services • Specialised cancer services • Radiotherapy • Chemotherapy…. • Contract with MVCC

7. Local CCGs • East and North Herts CCG • Herts Valley CCG • Luton CCG • Bedfordshire CCG Commissioning support provided by: Greater Eastern Commissioning Support – also supporting Essex CCGs

8. Commissioning Specialised Cancer Services 2013/14 Pam Evans Cancer Services Commissioner Midlands and East SCG (East of England)

9. From April 2013, all specialised services will become the core responsibility of the NHS Commissioning Board (NHS CB) • The NHS CB will directly commission Primary Care, Offender Health, Military Health, Specialised ‘Prescribed’ Services • Specialised services will account for over £11.8bn - or 10% - of the entire NHS budget from 2013-14 • 75% of cancer services are included in specialised services

10. Clinical Commissioning Groups Needs full engagement so as to understand each others intentions. Community Care Developing Integrated Pathways Joined up approach to commissioning even if contracts are led by a different authority Primary Care NHS Commissioning Board 10 ATs with a lead for specialised services Secondary Care Tertiary Care Quaternary Care

11. Manual for prescribed or specialised services 143 services are listed and described. Specialist cancer services include: • Blood and marrow transplantation services (all ages) • PET CT Services (all ages) • Primary malignant bone tumour services (adults and adolescents) • Proton beam therapy service (adults and children) • Radiotherapy Service (all ages) • Chemotherapy service (all ages) • Specialist Cancer Services for specified rare cancers (adults) • Specialist Cancer Services (children and young people) The full manual can be found at http://www.commissioningboard.nhs.uk/resources/spec-comm-resources/

12. B3h Cancer: Anal B3i Cancer: Mesothelioma B3j Cancer: Head & Neck B3k Cancer: Urological B3k2 Cancer: Penile B3k3 Cancer: Testicular B3l Chemotherapy: Adult B3m Chemotherapy: Paediatric B3n Cancer: Teenagers and young people B4a Blood & Marrow Transplantation: Adult E4 Paediatric Oncology E3h Paediatric Medicine: Palliative Care

14. Cancer Drug Fund (CDF) from April 2013 From April 2013 the NHS CB will be responsible for the CDF Applications will be provider based not population based Four Local area teams will administer all applications. For the Midlands and East Region this will be the Leicestershire and Lincolnshire Area Team One national list covered by cohort policies. Request to access will be on a notification basis with automatic approval for requests meeting the cohort policy criteria Local clinical panels (Midlands and East) will consider exceptional individual applications if not part of a cohort

15. Cancer Network Arrangements 12 Strategic Clinical Network and Senates

17. EoE Strategic Clinical Network • Cancer • Cardiac • Maternity and Children • Mental Health and neurological disease • Respiratory* Hosted by East Anglia Area Team, based in Fulbourn, Cambridge

18. East of England SCN Cancer Team Barbara Gill Transition Lead Ruth Ashmore SCN Associate Director Rory Harvey Clinical Director (Cancer) Tonia Dawson Lead Nurse and Manager (Cancer) Liz Wilson PA Sarah Steele Quality improvement Lead James Perry Quality improvement Lead Allison Warr Quality improvement Lead Gill Schram Quality improvement Lead Hannah O’Kane NSSG Admin 18 NHS | Presentation to [XXXX Company] | [Type Date]

19. MVCN – Short term local presence • Barbara Gill (4 days/week) • SCN Transition lead (Cancer –Essex/MVCN) • Oversight of primary care projects/SI budget • Liz Jones • Project manager, NAEDI/Chemo • Chris Roach • Project co-ordinator • (Sarah Steele – SCN Link)

20. SCN Communications • Letter from Ruth Ashmore (19 April) • Local networks to remain • Current patient pathways to remain unless changes discussed and agreed • 2013/14 Cancer Work Programme being drafted, but local views will be sought • Local Cancer Forum to be established • NSSGs to be given support for 2013/14

21. SCN Cancer Team Objectives • To drive out unacceptable variation in pathways of care • To reduce inequality of access to all aspects of care • To improve quality of life and outcomes for patients 21 NHS | Presentation to [XXXX Company] | [Type Date]

22. SCN Cancer Team Objectives We will do this by: • Analysing national, regional and local data on patient outcomes and experience • Providing advice and recommendations to commissioners • Strategic planning across complex pathways of care • Delivering quality improvement programmes

23. Academic Health Science Networks “AHSNs will …. transform the identification and spread of innovation and best practice” “Whilst roles differ… they have complementary agendas & close alignment & collaboration is expected.. “It will be for local health communities to determine how these structures are best developed to meet local needs…”

24. AHSNs - Local links

25. Peer Review • The National Cancer Peer Review will continue • Providers will need to take greater responsibility for Peer Review in future

26. Local Discussions • NSSG support, what is needed locally? • SCN to provide some support but will also have expectations... • Peer Review, who will upload NSSG docs? Host provider? • Local Cancer Forum required 2/12 • What other structures are needed?

27. Primary Care

28. Primary Care/Public Awareness The Challenge: Survival Rates DH: save 5,000 lives by 2014-15 To get to European Average levels Late diagnosis is seen to be key problem in UK

29. Reducing Time to Diagnosis Diagnostic delay Weller, Vedsted, Rubin G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012;106:1262-7. doi:10.1038/bjc.2012.68

30. Primary Care Education Activities To Date • Primary Care Education • Films: Colo rectal, Ovarian, Skin • Resource Kits: Colo rectal, Ovarian • Education events: 18 events • Risk assessment Tools • Audits: SEA, Cancer Diagnosis, Safety Netting • Website: local resources and links to other resources • Practice Profiles Analysis • 3 reports produced, including 3 year trend analysis • Macmillan GPs • NSSGs • Primary Care Forum • Outreach to CCGs etc. and local practices

31. Public Awareness Campaigns • Various public awareness campaigns run locally, bowel, lung, upper GI, Ovarian. • More successful when linked with national campaigns – Television ads, big impact • National campaign and local GP education Film and resource kit will maximise impact

35. Public Cancer Awareness Campaigns and Engagement

36. Public Cancer Awareness Campaigns and Engagement

37. National ‘Be Clear on Cancer’ Awareness Campaigns 2013/14 National lung cancer campaign – launch early July 2013 Keen to produce Lung Film for GPs to coincide with national campaign

38. Lung Film • MAKE World Media Ltd • Sian Kevill, Hannah Charlton and team • Develop Key Messages for GPs • East of England relevance • Identify ‘assets’ (Images) • Patient perspective • Comment on Script • Filming • Need good clinical engagement, quick turnaround times

39. Key Messages?