1 / 21

SWAG Cancer Alliance Operating Plan and Funding Progress 2019/20 6 September 2019

SWAG Cancer Alliance Operating Plan and Funding Progress 2019/20 6 September 2019. Please note these slides are for reference only and only the headlines will be presented at the board meeting. Cancer and the NHS Long Term Plan – Headlines.

wthomas
Download Presentation

SWAG Cancer Alliance Operating Plan and Funding Progress 2019/20 6 September 2019

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. SWAG Cancer Alliance Operating Plan and Funding Progress 2019/20 6 September 2019

  2. Please note these slides are for reference only and only the headlines will be presented at the board meeting

  3. Cancer and the NHS Long Term Plan – Headlines To build on progress made on cancer, the NHS Long Term Plan will: • Diagnose 75% of cancers at stage 1 or 2 by 2028 • Roll out Rapid Diagnostic Centres across the country so that patients displaying symptoms of cancer can be assess and diagnosed in as little as a day • Introduce a new, faster diagnosis standard which will ensure that patients receive a definitive diagnosis or ruling out of cancer within 28 days • Deliver personalised cancer care for all, giving patients more say over the care they receive • Secure our place at the cutting edge of research, offering genomic testing to all cancer patients who would benefit, and speeding up the adoption of new, effective tests and treatments

  4. Milestones from Long Term Plan

  5. SWAG Plan 2019/20 • The Alliance has an allocation of £5,732,000 for 19/2020 • Cancer Alliances, through bringing together their partners, must ensure that the plans provide strategic direction for, and be consistent with, the 19/2020 plans of their constituent systems and organisations. The Plan sets out how our Alliance will allocate the funding to deliver: • Planning Guidance deliverables–Alliances will lead delivery of a number of the 2019/20 Planning Guidance priorities for cancer (operational performance, screening and early diagnosis, personalised care); and • Cancer Alliance core team–Alliances will continue to lead a whole-system approach to improvement and transformation, supported by a core Alliance team. As a rough guide, Alliances should not be allocating more than 10% of their total allocation to the core team. • Plan formally agreed 3 June 2019

  6. High Level Summary National Planning Guidance Deliverables 19/20 Deliverable 1 - Sustainable Operational Performance 1a Delivery of all 8 CWT standards; • increase capacity, encourage effective, cross-organisational working and broker agreements between providers to balance supply and demand more effectively across the system 1b. Improve time to diagnosis • All Trusts to be collecting the faster diagnosis standard mandatory data items from 1st April 2019, and evidence demonstrable improvement in numbers of lung, prostate and colorectal cancer patients diagnosed in 28 days • Implementation of the timed pathway for OG cancer in all Trusts; Deliverable 2 – Screening and Early Diagnosis • Implement 1 Rapid Diagnostic Centre per Alliance • Screening uptake - demonstrable impact on uptake of the bowel, breast and cervical screening programmes Deliverable 3 – Personalised Care From April 2020: • All breast, colorectal and prostate cancer patients from diagnosis (including secondary cancer) to have access to personalised support; • Approximately two-thirds of patients who finish treatment for breast cancer to be on a supported self-management follow-up pathway and from diagnosis; • All Alliance Trusts to have in place protocols for stratifying the follow up of prostate and colorectal patients and systems for remote monitoring for these patients and from diagnosis

  7. Deliverable 1 - Sustainable Operational Performance Indicative Allocation – 2.5mPrincipals Increase capacity, encourage effective, cross-organisational working and broker agreements between providers to balance supply and demand more effectively across the system l 1a. Delivery of all 8 CWT standards - Increase capacity; • The Cancer Alliance Board agreed the following underlying principles for allocation: • Funding to be split into fewer, larger ‘pots’ than previous years.  In practice this means different amounts will be given to different providers, based on agreed criteria, in order to best meet the stated objective across the Alliance geography • No ‘bidding processes’ within the Alliance (there may be for external funds, should they become available) • Must support pathway improvements not just ‘raw activity’.  This can be to support pathway change or to support services pending an agreed change that cannot happen immediately.  Capital items that cost less than £5K each (e.g. some endoscopes) can be included.  Training and upskilling initiatives are particularly encouraged. Principal applied – to balance the need for permanent, sustainable change against short term interventions to improve performance temporarily

  8. SWAGDeliverable 1a - Sustainable Operational Performance Increasing capacity – 210K – each provider allocated 26, 250 Scoping and baseline work and provide summary analysis to support the targeting of additional funding to increase capacity for Gynae, and Head & Neck cancers (sites with high proportion of avoidable breaches) including diagnostic support;

  9. SWAG Deliverable 1a - Sustainable Operational Performance cont. 1a. Delivery of all 8 CWT standards; • Encouraging effective, cross-organisational working – 250K Plan to be agreed • Broker agreements between providers to balance supply and demand more effectively across the system – 50K Implement cross organisational reporting for pathology and radiology for priority tumours - ? progress

  10. SWAG Deliverable 1b - Sustainable Operational Performance 1b. Improve time to diagnosis • All Trusts to be collecting the faster diagnosis standard mandatory data items from 1st April 2019 Each provider 45,874 to support tracking and data/business intelligence for Alliance assurance –total 367K committed • Evidence demonstrable improvement in numbers of lung (220K), prostate (1.1m) and colorectal cancer patients diagnosed in 28 days (143K); • Implementation of the timed pathway for OG cancer in all Trusts (200K); See slides 11-14 Principals Agreed by providers • The Alliance pathway datasets will be used both the assess proposal and monitor outcomes of funded developments • Failure to deliver the metrics, including through not making a sustainable change, may result in the provider being excluded from 2021/2 performance/early diagnosis Alliance funding

  11. 1b. Improve time to diagnosis • Evidence demonstrable improvement in numbers of lung patients diagnosed in 28 days- 220K • Funding allocation Based on no of 2WW referrals Q4 18/19 data • Turnaround times for CT scans (request to report) and requesting of the ‘package of tests’ for potentially curative patients have been identified as opportunities; Actual Metrics 1.51 First outpatient appointment following GP '2WW' referral by day 6 of 62 day pathway (median) (NB. Patients must have had CT scan reported by this appointment). Median. All lung 2WW referrals received by the provider. 1.52 Providers will need to demonstrate that for an increasing number of lung cancer patients all required tests available to refer to locally will be requested at the first outpatient appointment.  These tests will need to be performed and reported in a reasonable and reducing timeframe toward meeting wait times as described in the the NOLCP.  This will be monitored through quarterly pathway data returns to the Cancer Alliances.

  12. SWAG Deliverable 1b - Sustainable Operational Performance

  13. 1b. Improve time to diagnosis • Evidence demonstrable improvement in numbers of colorectal patients diagnosed in 28 days - Allocation: 143K Funding allocation Based on no of 2WW referrals Q4 18/19 data • Colorectal - turnaround times for radiology and endoscopy are identified as the main barriers to achievement, along with patient compliance with taking bowel preparation. Providers to consider opportunities’ for achieving within pathway times Metrics • 1.71 First diagnostic test (colonoscopy, flexi sig or CT colon) performed by day 14 of the 62 day GP pathway. Median. All 2WW colorectal referrals received by the provider • 1.72 Staging CT and/or MRI scan reported by day 21 of the 62 day GP pathway. Median. Patients with a colorectal cancer diagnosis only following 2WW referral received by the provider

  14. 1b. Improve time to diagnosis – PROSTATE 1.1m • Evidence demonstrable improvement in numbers prostate (1.1m) cancer patients diagnosed in 28 days - Providers will need to evidence that by year end they are achieving a median turnaround of 9 days from request to biopsy (timescale from national optimal pathway), and offering best practice pathway – • Funding allocation Based on no of 2WW referrals Q4 18/19 data • NBT,RUH,WAH,YDH 635,573 allocation not yet available pending UAN discussions/costed plan – see agenda item 3 • TST approved 67,800 plan to move to trial LA Template Bx Q3 and offered to all patients from Q4, in parallel with moving to best practice pathway MRI first to determine whether biopsy necessary • SFT – pending discussions re UAN in Wessex • Glos – pending discussions' re UAN in midlands

  15. 1b. Improve time to diagnosis • Implementation of the timed pathway for OG cancer in all Trusts (200K); • 1.81 OGD by day 7 of the 62 day GP pathway. Median. All upper GI 2WW referrals received by the provider. Referrals for HPB symptoms may be excluded if the provider wishes and is able to do so • 1.82 Staging CT reported by day 14 of the 62 day GP pathway. Median. Patients with an OG cancer diagnosis only following 2WW referral received by the provider • Funding allocation Based on no of 2WW referrals Q4 18/19 data

  16. SWAG Deliverable 1b - Sustainable Operational Performance

  17. SWAG Deliverable 1b - Sustainable Operational Performance 1b. Improve time to diagnosis - additional deliverable agreed by SWAG - support dermatology services to make best use of technology in managing demand for skin cancer referrals (100K) The majority of skin cancer patients are given their diagnosis or decision to treat at first appointment (stopping the 28 day ‘clock’ there and then). Therefore managing initial demand is the key to achieving the 28 day target. UH Bristol’s funding request – please see paper ‘skin funding doc’ for detail UHB intends to re-establish a cancer tele dermatology hub service, previously successfully piloted, results published, showing patient experience equal to that of the conventional skin cancer delivery model and that time to first appointment (and thus also diagnosis) is reduced. Patients seen by a medical photographer at a local clinic, photos of lesion(s) and pt history sent remotely to a dermatology consultant who issues a standard letter with advice and if necessary asking the patient to attend for the lesion to be biopsied/removed. This model has worked particularly well for Somerset patients as it can be provided locally and avoids patients having to travel to Bristol. Trust also intends to scope the possibility of a partnership with one of the larger GP practices to provide a clinic there as this could provide an opportunity to support and train GPs further in skin lesion management which in turn could reduce unnecessary referrals at source The Trust is also considering piloting the use of a ‘FotoFinder’ machine, https://www.fotofinder-systems.com which utilises artificial intelligence to identify suspicious skin lesions. The machine can be operated by a trained nursing assistant and patients are then referred to a consultant when appropriate. Therefore the Trust would like to request £35,000 of the Alliance’s skin cancer funding towards establishing these clinics for the rest of the financial year The Trust is basing its request on the number of acute providers in the Alliance (8) and the fact it is providing services for the footprint of three of these. (100,000/8)*3=37,500. Therefore the Trust is ensuring there is sufficient resource available for any other provider who wishes to request it. The Alliance has expressed a particular desire to ensure there is funding for Somerset patients given the issues last year with backlogs developing at the referral management centre. Therefore UH Bristol undertakes to ensure that at least one of the hub clinics will be in the Somerset region to address the needs of the ‘Taunton’ demographic. Recommendation/Action for Cancer Alliance Board - Approve funding to ensure improved timeliness of diagnosis of skin cancer for patients in Bristol, North Somerset and Somerset. The Cancer Alliance is asked to support this request so the funds can be rapidly released and used to quickly set up clinics to address the rapidly rising demand for this service. Please note NBT and Gloucestershire ICS are working up dermatology plans

  18. Deliverable 2. Screening and Early Diagnosis Indicative Allocation –2m 2a. Demonstrable impact on stage at diagnosis – • Demonstrable impact on Screening programmes Uptake based on local needs 135K Joint Partnership with SW Cancer Alliances, PHE & NHS England - • GP innovation fund to target cervical screening programmes (determined by PHE) to demonstrate actual improvements’ in uptake in year.   • Development of an evidence based coordinated system-wide management of activity aimed at improving screening uptake and coverage with a specific focus on reducing inequalities. • Mapping exercise which can run in parallel to the interventions and so going forwards into next year we will have a clear plan of evidence based interventions and identified areas to target (if we receive new funding for 20/21 for screening uptake). See agenda item 10.1 Prevention and Screening for detail • Introduce AI support tool for primary care 335K see agenda item 10.1 for progress • Address inequalities by improving access, early diagnosis and patient experience for those with mental health conditions and LD 148,775K – verbal update • Support PCNs in early diagnosis 635K 2b. Rapid Diagnostic Centres 900K see agenda item 9

  19. Deliverable 3 – Personalised Care • From April 2020:All breast, colorectal and prostate cancer patients from diagnosis (including secondary cancer) to have access to personalised support;Approximately two-thirds of patients who finish treatment for breast cancer to be on a supported self-management follow-up pathway and from diagnosis; • All Alliance Trusts to have in place protocols for stratifying the follow up of prostate and colorectal patients and systems for remote monitoring for these patients and from diagnosis • 270K • Baselines being collated, STPs agreeing systems, Alliance awaiting costings before confirming allocations for set up costs (not all providers require any systems and some do not require for all 3 sites)

More Related