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SCHEDULE 2 – THE SERVICES A. Service Specifications Mandatory headings 1 – 4: mandatory but detail for local determination and agreement Optional headings 5-7: optional to use, detail for local determination and agreement. All subheadings for local determination and agreement Service Specification No. HCCG ES05 Service Prostate Cancer Commissioner Lead HCCG Primary Care Commissioning Lead Provider Lead General Practice Period 1st April 2015 – 31st March 2018 Date of Review Annual Review 1. Population Needs 1.1 National/local context and evidence base Prostate cancer is one of the most common cancers in men with approximately 35,000 new cases in England and Wales and 10,000 deaths. The disease is predominantly associated with older men but around 20% are men under 65 years of age. As the incidence of prostate cancer is high and five-year survival rates are around 70% many men are alive who have been diagnosed with prostate cancer. An estimated 215,000 men are alive in the UK having received a diagnosis of prostate cancer. Deprivation incidence gradients have been reported for both and England and Wales and Scotland, with higher rates in the least deprived populations. These deprivation gradients have widened during the 1990s due to the greater relative increase in incidence for men in the most affluent groups and are likely to be influenced by accessibility and uptake of PSA testing. 2. Outcomes 2.1 NHS Outcomes Framework Domains & Indicators Domain 1 Domain 2 Domain 3 Domain 4 Domain 5 2.2 Preventing people from dying prematurely Enhancing quality of life for people with long-term conditions Helping people to recover from episodes of ill-health or following injury Ensuring people have a positive experience of care Treating and caring for people in safe environment and protecting them from avoidable harm Local defined outcomes Increase in 5 year survival rates for men within Hardwick CCG diagnosed with prostate cancer Reduction in under 75 mortality rate for males within Hardwick CCG diagnosed with prostate cancer Increase in patient satisfaction in relation to access and convenience 3. Scope 3.1 Aims and objectives of service The aims of this service are to move the care of locally advanced prostate cancer patients stable on treatment out of the acute hospital and into primary care. The objectives of this service are to: Provide routine follow up management of patients with locally advanced prostate cancer stable on treatment To identify patients whose disease has progressed and ensure rapid referral back into secondary care for review 3.2 Service description/care pathway The service to be provided is 6 monthly follow-up consultations for patients with established locally advanced prostate cancer who are stable on treatment. The consultation will cover a review of the patients PSA test results, symptoms and side effects of treatment. Patients in secondary care with locally advanced prostate cancer stable on treatment will be identified and discharged from acute hospital care via discharge letter to their GP. Upon receipt of the discharge letter the patients care is transferred to the primary care provider who will take formal responsibility and accountability for the on-going care of the patient. The primary care provider will ensure:-. A register is kept of all patients with locally advanced prostate cancer patients stable on treatment to be managed within primary care; Each patient on the register is contacted to arrange a review consultation within primary care with a 6 monthly frequency; Any patient failing to make an appointment or failing to attend for the review consultation will be followed up. Should a patient no longer wish to receive followup, this should be documented clearly in the patient’s records and the reason stated; Each patient on the register to have a named GP who will take responsibility for managing the care of the patient; The agreed protocols for management of patients with locally advanced prostate cancer stable on treatment will be adhered to for the management of every patient. It is the provider’s responsibility to ensure that the protocols used reflect the most up to date version; 3.3 Specialist advice will be sought wherever required; All patients will be informed of the results of any tests. Population covered The service will be for patients registered with a Hardwick CCG GP Practice. 3.4 Any acceptance and exclusion criteria and thresholds Patients identified within acute hospital care with locally advanced prostate cancer, stable on hormone manipulation and appropriate for management within a primary care setting. The service should not currently be provided to patients with Hormone Relapsed Prostate Cancer (HRPC) or those patients on an Active Surveillance regime. The primary care provider will be responsible for contacting the patients discharged from acute care to arrange the initial, and all subsequent, appointments for review consultations. 3.5 Interdependence with other services/providers Secondary Care 4. Applicable Service Standards 4.1 Applicable national standards (eg NICE) NICE guidelines CG175 updated January 2014 . 4.2 Applicable standards set out in Guidance and/or issued by a competent body (eg Royal Colleges) 4.3 Applicable local standards 5. Applicable quality requirements and CQUIN goals 5.1 Applicable Quality Requirements (See Schedule 4 Parts [A-D]) 5.2 Applicable CQUIN goals (See Schedule 4 Part [E]) Detailed in Over All BOS Specification. 6. Location of Provider Premises General Practice 7. Individual Service User Placement Not Applicable