Download Cancer Alliances Workshop

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
Advisory Group
National Cancer
Transformation Board
National Cancer Senior
Management Team
Prevention
workstream
Early
Diagnosis
workstream
www.england.nhs.uk
Patient
experience
workstream
Living With
and Beyond
Cancer
workstream
High Quality Modern
Services
workstream
Commissioning,
Provision and
Accountability
workstream
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
cancer across the
pathway
National priorities
delivered locally
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
www.england.nhs.uk
Accountable
Cancer
networks
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
Who are the
key
stakeholders
that would
make up
Alliances?
How do we
encourage a
collaborative
approach from
the start?
www.england.nhs.uk
How do we
give the
Alliances
levers?
What is the
relationship
with the
Cancer
Vanguard?
How should
Alliances
engage with
the prevention
agenda?
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
B01
Radiotherapy
B01
Radiotherapy
B01
Radiotherapy
B01
Radiotherapy
RECOMMENDATION
Sub Region (Hub)
Sub Region (Hub)
National
National
B02
Health Economy
B10
B11
B12
B12
B13
B13
B13
B14
B14
B14
B14
B15
B15
B16
B17
Service Line
Radiotherapy (All Ages)
Brachytherapy and Molecular Radiotherapy (All Ages)
Breast Radiotherapy Injury Rehabilitation
Proton Beam Therapy
Positron Emission Tomography Computed Tomography Scanning
PET-CT
(All Ages)
Thoracic Surgery
Cancer: Malignant Mesothelioma (Adult)
Upper GI Surgery
Cancer: Oesophageal and Gastric (Adult)
Sarcoma
Cancer: Soft Tissue Sarcoma (Adult)
Primary Malignant Bone Tumours Service (Adults and
Sarcoma
Adolescents)
CNS Tumours
Cancer: Brain and Central Nervous System (Adult)
CNS Tumours
Complex Neurofibromatosis Type 1 Service (All Ages)
CNS Tumours
Neurofibromatosis Type 2 Service (All Ages)
Urology
Cancer: Specialised Kidney, Bladder and Prostate (Adult)
Urology
Cancer: Penile (Adult)
Urology
Cancer: Testicular (Adult)
Urology
Ex-vivo Partial Nephrectomy
Chemotherapy
Cancer: Chemotherapy (Adult)
Chemotherapy
Cancer: Chemotherapy (Children, Teenagers and Young Adults)
Head and Neck Cancers Cancer: Head and Neck (Adult)
Teenage & young
Cancer: Teenagers and Young People
peoples Cancers
www.england.nhs.uk
Health Economy
Health Economy
Sub Region (Hub)
National
Health Economy
National
National
Health Economy
Sub Region (Hub)
Sub Region (Hub)
National
Health Economy
Sub Region (Hub)
Health Economy
Health Economy
23
NHS South STP population sizes
0.61M
1.66M
0.52M
0.92M
0.89M
0.54M
1.16M
0.84M
1.98M
1.78M
1.82M
0.76M
0.55M
www.england.nhs.uk
24
Combined populations of STP ‘clusters’
0.61M
2.5
1.66M
0.52M
0.92M
0.89M
0.54M
1.16M
0.84M
1.98M
4.4
1.78M
1.82M
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
Cancer Alliance Model - STRAW MAN FOR DISCUSSION
CANCER ALLIANCE PARTNERSHIP
•
•
•
•
•
•
•
•
Chair: Alliance
lead*
STP
lead(s)/rep(s)
Senior rep from
each provider
trust
GP/GP
federation
lead(s)
Director of
Public Health
Specialised
commissioner
lead
CCG lead
Voluntary sector
provider(s)
Meets every two
months
• To examine shared outcomes data to identify
areas across whole pathways where
improvement is required
• To agree an action plan which:
• Adds the next layer of detail on cancer
to STPs
• Addresses areas where improvement is
required
• Delivers the Taskforce strategy locally
(by both seeking to meet the Taskforce’s
2020 ambitions and focusing on some
specific recommendations/initiatives)
CANCER ALLIANCE ADVISORY
GROUP
• Charities
• Patients
• Other local
stakeholders
Meets quarterly
• To lead the delivery of the action plan by:
• Driving the activity required within their
own organisations
• Working together to lead the joint
activity
*A senior clinician or manager who has credibility to provide cross-organisational leadership within the NHS and with stakeholders
SUPPORT
•
•
•
Clinical Network staff (TBC: boosted by national funding)
NHS England and NHS I regional staff (TBC: boosted by national funding)
TBC: central support (e.g. on analytics)
• To provide challenge
and advice on the
development and
delivery of Alliance
action plans
Discussion questions
•
Does the straw man include the right members of the Cancer Alliance
Partnership and the Cancer Alliance Advisory Group? Is anyone missing?
•
What support will Alliance members need? How can we make use of existing
local capacity in supporting Alliances?
•
Ultimately the Commissioning, Provision and Accountability Oversight Group will
oversee Cancer Alliances, although Regional Executive Teams will also play a
key role. What other local governance arrangements - particularly in relation to
STPs - need to be taken into account?
•
Does the straw man represent a meaningful approach to clinical leadership and
patient engagement? If not, how can this be improved?
•
How often and in what way should the Cancer Alliance Partnership and the
Cancer Alliance Advisory Group meet?
www.england.nhs.uk
28
Discussion: 'gateway
points' for Alliance
development
Jo Cottam, National Cancer Policy Lead, NHS
England
www.england.nhs.uk
29
Discussion: scenario
Scenario: the members of the Cancer Alliance Partnership in a particular
area have been given formal accountability for the outcomes for their
cancer population. The members of the Partnership will all be held to
account for delivering improvements against these outcomes, and will
share both the risks and benefits of meeting these outcomes.
Discussion question: What steps will the Cancer Alliance need to have
taken before being given this formal accountability?
www.england.nhs.uk
30
Wrap up and close
Nigel Acheson, Regional Medical Director
(South), NHS England
www.england.nhs.uk
31