Cancer Alliances Workshop (South Region) Thursday 9 June 2016 11:00 – 15:00 www.england.nhs.uk
Welcome Nigel Acheson, Regional Medical Director (South), NHS England www.england.nhs.uk 2
Context and background Cally Palmer, National Cancer Director, NHS England www.england.nhs.uk 3
Why a focus on cancer? “The disparity between incidence and awareness of bowel cancer in the UK is greater than that of any other cancer. This results in poor awareness of symptoms, late detection, high mortality and greater treatment expense than would be the case if awareness were higher.” “The first mention of the word 'cancer' was used by a doctor in the middle of a sentence. It seems that he may have believed that I had already been informed.” “….. Some doctors are rather keen to give information as quickly as possible without recognising where the patient is coming from. Medical information needs to match patient need.” “We over diagnose, over treat, and treat for marginal benefit.” www.england.nhs.uk 4
Implementation Plan www.england.nhs.uk 5
National Cancer Programme Five Year Forward View Board National Cancer National Cancer Transformation Board Advisory Group National Cancer Senior Management Team Prevention Early Commissioning, Patient Living With High Quality Modern Diagnosis Provision and workstream experience and Beyond Services workstream Accountability workstream Cancer workstream workstream workstream www.england.nhs.uk 6
Key priorities for 2016/17 £15m to test the faster diagnosis standard in 5 areas and Launch a National Diagnostic Capacity Fund and Roll out the ACE wave 2 pilots: • London Cancer • Greater Manchester • Leeds Multi-disciplinary diagnostic centres in • Bristol the community • Oxfordshire • Airedale, Wharfedale & Craven Cancer Alliances www.england.nhs.uk 7
What are Cancer Alliances? Bring together providers and commissioners A shared focus on National priorities cancer across the delivered locally pathway For the first time an integrated dashboard Work across and with STPs to provide the detail on cancer Knowing where the gaps are and working together to address www.england.nhs.uk 8
Phase 1 Cancer Dashboard www.england.nhs.uk 9
Alliances to Accountable Networks? Est. Cancer vanguard Est. alliances Shared learning and testing Accountable Cancer networks www.england.nhs.uk 10
Alliance footprints – how many? www.england.nhs.uk 11
Timeframes May – June 2016 Local design workshops Start July 2016 Draft Alliance footprints and local structures proposed End July 2016 Oversight Group agrees Alliance footprints and local structures From September NHS England business plan commitment on starting to roll out Cancer Alliances End October 2016 Draft Cancer Alliance action plans proposed Mid November 2016 Oversight Group agrees action plans www.england.nhs.uk 12
Questions What is the Who are the relationship key How do we with the stakeholders give the Cancer that would Alliances Vanguard? make up levers? Alliances? How do we How should encourage a Alliances collaborative engage with approach from the prevention the start? agenda? www.england.nhs.uk 13
Purpose of the workshop Jo Cottam, National Cancer Policy Lead, NHS England www.england.nhs.uk 14
Recap… • Cancer Alliances are the local stakeholders. • They are not employing organisations. • On the basis of shared data and metrics, Alliances will agree action plans which set out at a system-wide level the activity required to deliver the Taskforce strategy locally. This means: • Delivering improvements against 2020 ambitions • Delivering particular initiatives. • In practice this will involve adding the next layer of detail on cancer to STPs . • Alliances will take decisions required to lead the cross-organisation, whole system approach to improving outcomes. www.england.nhs.uk 15
Therefore… • This is not completely separate to the STP process – we are looking to ensure that STP leads are driving the establishment of Alliances. • Alliances will need support – this will be determined locally, but we expect this will be provided in part by Clinical Networks. • The establishment of Alliances does not change the statutory responsibilities of individual members. • The progress made by Cancer Alliances in leading improvements in cancer outcomes will be highlighted by performance against: • the integrated cancer dashboard • metrics associated with Alliance action plans. www.england.nhs.uk 16
Purpose of the workshop • To develop proposals, informed by engagement with key regional stakeholders, on: o The geographic footprints of Cancer Alliances o The structure of each Cancer Alliance/how each Cancer Alliance will function locally to ensure that each can lead the improvement of cancer outcomes for its population o The ‘gateway’ points for the development of Cancer Alliances over the coming years. www.england.nhs.uk 17
Discussion: proposed geographies Pat Haye, Deputy Director Clinical Networks and Clinical Senates (South), NHS England www.england.nhs.uk 18
Principles for determining Cancer Alliance geographies • Ideally, Cancer Alliance geographies will both: 1. Be aligned with patient flows 2. Be aligned with STP footprints. Where it is not possible to meet both of these criteria, the first criterion will take precedence. • Cancer Alliances will bring together stakeholders from across the whole cancer pathway, therefore Alliance geographies must include one or more tertiary centres. • We expect that Cancer Alliances will cover populations of between 2-3 million. www.england.nhs.uk 19
Specialised Commissioning Strategic approach Vaughan Lewis Clinical Director Specialised Commissioning (South) www.england.nhs.uk
STP spend by top service areas - 14/15 www.england.nhs.uk 21
5 year strategic view • Population focus • 2 to 3 Million population base for most specialised services • Consolidation into fewer centres • Clustering of inter-related and co-dependent services • Horizon scanning re emerging technologies • Emphasis on quality • Networked provision of lower acuity elements of care • Transformation through STP alliance www.england.nhs.uk
National Recommendations CRG ref CRG Service Line RECOMMENDATION B01 Radiotherapy Radiotherapy (All Ages) Sub Region (Hub) B01 Radiotherapy Brachytherapy and Molecular Radiotherapy (All Ages) Sub Region (Hub) B01 Radiotherapy Breast Radiotherapy Injury Rehabilitation National B01 Radiotherapy Proton Beam Therapy National Positron Emission Tomography Computed Tomography Scanning B02 PET-CT Health Economy (All Ages) B10 Thoracic Surgery Cancer: Malignant Mesothelioma (Adult) Health Economy B11 Upper GI Surgery Cancer: Oesophageal and Gastric (Adult) Health Economy B12 Sarcoma Cancer: Soft Tissue Sarcoma (Adult) Sub Region (Hub) Primary Malignant Bone Tumours Service (Adults and B12 Sarcoma National Adolescents) B13 CNS Tumours Cancer: Brain and Central Nervous System (Adult) Health Economy B13 CNS Tumours Complex Neurofibromatosis Type 1 Service (All Ages) National B13 CNS Tumours Neurofibromatosis Type 2 Service (All Ages) National B14 Urology Cancer: Specialised Kidney, Bladder and Prostate (Adult) Health Economy B14 Urology Cancer: Penile (Adult) Sub Region (Hub) B14 Urology Cancer: Testicular (Adult) Sub Region (Hub) B14 Urology Ex-vivo Partial Nephrectomy National B15 Chemotherapy Cancer: Chemotherapy (Adult) Health Economy B15 Chemotherapy Cancer: Chemotherapy (Children, Teenagers and Young Adults) Sub Region (Hub) B16 Head and Neck Cancers Cancer: Head and Neck (Adult) Health Economy Teenage & young B17 Cancer: Teenagers and Young People peoples Cancers Health Economy www.england.nhs.uk 23
NHS South STP population sizes 0.61M 1.66M 0.52M 0.92M 0.89M 1.78M 0.84M 0.54M 1.98M 1.82M 1.16M 0.76M 0.55M www.england.nhs.uk 24
Combined populations of STP ‘clusters’ 2.5 0.61M 1.66M 0.52M 0.92M 0.89M 4.4 1.78M 0.84M 0.54M 1.98M 1.82M 1.16M 0.76M 0.55M www.england.nhs.uk 25
Discussion: local structures Chris Harrison, National Clinical Director for Cancer, NHS England www.england.nhs.uk 26
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