who will staff the hospitals of the future when cancer is
TRANSCRIPT
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WHO WILL STAFF THE HOSPITALS OF THE FUTURE WHEN CANCER IS
CENTRALISED?
CANCER COLLABORATIVE INITIATIVES
– AN UPDATE
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CSC brief history
• Started in 1999
• Phase 1: 51 projects in 9 cancer networks
• Phase 2: 275 projects in all 34 cancer networks
• Phase 3: To become long term and sustainable via trusts and cancer networks
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CANCER SERVICES COLLABORATIVE
•Improve experience and outcomes of care for people with suspected or diagnosed cancer by improving the way care is delivered
•Program to support local teams in cancer networks to make significant changes for patients
•Key implementation strategy for NHS Cancer Plan
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Cancer collaborative infrastructure
National cancer director
National clinical leadsand programme managers
34 cancer networksNetwork cancer leads
Service improvement lead
Trust levelService improvement
facilitators
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April 2003 - CSC Partnership will see ……...
Service Improvement Leader in every cancer network– fourth member of network team - link to StHA
Clinical Lead - work alongside Service Improvement LeaderService Improvement Facilitators appointed by networks
– Trust / network based– focusing on improving whole system of care in each
tumour– link to peer review, service delivery plans, 3 year
planning cycleMandatory collection waiting times - (HSC)
– demonstrate patient journey times
Patients involved in modernising services
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NATIONAL CANCER PLAN TARGETS
• One month from urgent referral Maximum one month wait from diagnosis to treatment for breast cancer by 2001 all cancers by 2005
• Maximum two month wait from urgent GP referral to treatment for
breast cancer by 2002all cancers by 2005
• to treatment for all cancers by 2008
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CANCER SERVICES COLLABORATIVE
•Re-design
•Methodology
•Funded
£25M 2002-2003
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CANCER SERVICES COLLABORATIVE
•Capacity and Demand
•Mapping Patient Pathway
•Implement Change
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CSIP – PROGRESS SO FAR
69% of Upper GI Cancer Patients in CSIP projects treated within 62 days
of referral
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CANCER SERVICES COLLABORATIVEPATIENT PATHWAY MAPPING
EPSOM/ST HELIER NHS TRUST
•Access
•Endoscopy
•Staging
•MDT
•Centre referral
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NATIONAL ENDOSCOPY PROGRAMME
• Reduction in active waiting list
- flexibility- pooled waiting lists- changing case mix
(Aintree University Hospitals)
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Diagnosis
Leicester• Consultant led single visit diagnostic and therapeutic clinic with
same day consultation and endoscopy • Capacity and demand study - led to reorganisation of
gastroenterology clinics• All procedures pre booked to use spare capacity
Mount Vernon• Notification of new diagnosis faxed to GP within 24 hours of
diagnosis
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MDT
Leicester
MDT co-ordinator in post - facilitate and support team
Role• Prepares notes,results, attendance list and follow up actions
– GP fax back of MDT outcome
– Cross referral proforma following MDT
– Record MDT outcomes and treatment plans in case notes
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Staging
East Somerset• Tertiary referral pro-forma with staging CT scan -
patients referred via fax to MDT on tertiary site with reported CT and histology slides
• Median wait from GP referral - treatment reduced from
79 days to 40 days
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DRIVERS FOR CHANGE
• Modernising Medical Careers
• EWTD
• Seamless Training
• Peer review
• IOG Standards
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SERVICE CHALLENGES
• Providing services for local population
• GI Service provision
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IMPROVING OUTCOMES PROFESSIONAL CONCERNS
• Centralisation of Surgery
• Effect on DGH Surgery
• Effect on Benign Upper GI Practice
(AUGIS 2001)
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IMPROVING OUTCOMES IN UPPER GI CANCERS
• Specialist Commissioning vs PCT Commissioning
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IMPROVING OUTCOMES IN UPPER GI CANCERS
•Manpower Planning
Workforce Development Confederations
Training
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IMPROVING OUTCOMES IN UPPER GI CANCERS
• Patient Involvement
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PERSON SPECIFICATION
• General surgery training
• General GI training
• Endoscopy skills – JAG approved
• Trainer
• Upper GI Cancer diagnostic team skills