Download Cancer Improvement Plan Update - West Hertfordshire Hospitals

Cancer Improvement Plan
Update
January 2015
1
Introduction
This document summarises the actions required as part of WHHT’s cancer improvement programme. It builds on
previous work so that there is a single action plan showing what is needed in response to external recommendations, to
ensure achievement of national cancer standards and to promote continuous improvement of cancer services.
The following sections are included in this updated document:
1
Current Performance
2
Cancer Programme Governance Structure
3
Latest Cancer Action Plan
4
Current Management Structure for Cancer Services
5
Key Risks
The cancer action plan is expected to continuously evolve, particularly given that a new improvement and new service
manager are both shortly to take up post. It will be used by the Cancer Improvement Group to assess progress and will
also be regularly discussed with the CCG. Please note that this is a draft version and so is not yet for further circulation.
Document Authors:
S Davey, D Foster & E Moors
Notes: Some completed actions are included in this version so that the broad direction of travel can be seen. Also, the
master plan from which these snapshots have been taken can be easily organised so that progress against the external
recommendations made by S Ramsden et al can be seen.
2
1.
Latest Cancer Services Performance
3
2.
Cancer Improvement Programme Governance
2.1 Cancer Governance Structure & Existing Operational Governance Structure
Transformation Committee
Subcommittee of WHHT Trust Board
Executive Steering
Committee
TLEC
Divisional Management Committees
CCG Cancer
Action Group
Cancer Improvement
Group
Trust Access Meeting
Weekly Divisional Access Meetings
Project 1:
Peer Review
Project 2:
Cancer Care
Pathways
Project 3:
Information
Quality
Project 4:
Infrastructure
& Admin
Programme Structure, in Place for Duration of RTT Programme
Project 5:
Divisional
Cancer Action
Plans
Operational Structure, Remains after Cancer Programme Closes
4
2.
Cancer Improvement Programme Governance
2.2 Cancer Programme Meetings & Membership
Transformation Committee
(as Sub-Committee of WHHT Trust Board )
Executive Steering Committee
Meeting Frequency: Fortnightly
Chair: Chief Executive
Remit: To provide overall strategic direction for the Trust’s Transformation Programme; to receive updates from each
programme, to consider links and wider implications to remove any obstacles that are impeding progress.
Membership: All Executive Team
Cancer Improvement Group
Meeting Frequency: Weekly
Chair: Cancer Programme Senior Responsible Owner ie Deputy CEO
Remit: To deliver the cancer improvement programme according to plan, identify dependencies between projects and ensure coherent
approach.
Membership: Clinical Lead for Cancer, Medicine Divisional Manager, All Project Leads, Women & Children’s Divisional Managers, Surgery
Divisional Manager, Clinical Support Divisional Manager, Associate Director for Performance & Information.
Project team meetings for each individual project as required.
A dedicated weekly meeting is already in place for the cancer information & quality project.
5
2.
Cancer Improvement Programme Governance
2.3 Cancer Improvement Programme Leadership Structure
Clinical Lead
Lead Executive: Senior Responsible Officer
Dr A Barlow
(Cancer Clinical Director)
L Hill
(Chief Operating Officer)
Cancer Improvement Lead
[Oversees Overall Cancer Action Plan]
Project 1:
Peer Review
Scope:
Ensuring that peer
review process is robust
and any
recommendations made
are delivered.
Management Lead:
M Sorley
Project 2:
Cancer Care
Pathways
Project 3:
Information
Quality
Project 4:
Infrastructure &
Administration
Project 5:
Divisional Cancer
Action Plans
Scope:
Ensure the care
pathway for each
tumour site is reviewed
and streamlined, eg with
1-stop clinics or direct
access diagnostics.
Scope:
Delivery of robust
governance structure
for managing cancer
waiting lists and care
pathways, with reliable
underlying information.
Scope:
Ensuring that booking
pathways are robust,
communication with
patients and GPs is
effective, the access
policy is adhered to
and standard operating
pathways in place.
Scope:
Ensuring that each
division delivers the
national cancer waiting
time standards and that
there are action plans in
place for specialties for
which there are
concerns.
Management Lead:
Cancer Improvement
Manager
Management Lead:
Information lead tbc
Management Lead:
Cancer Service
Manager
Management Lead:
Cancer Improvement
Manager
Please note that this is a programme management structure, not a line management structure.
6
3
Cancer Action Plan
3.1 Peer Review
Issue / Recommendation
Actions Needed
Peer review needs to embedded, so that
action plans are adequately tracked and
recommendations delivered.
• Review current peer review process & capacity needed.
Action Owner
Lead
Target Comment
Service / Finish date
Organisatio
n
Michelle Sorley WHHT - 01-Mar-15
Medicine
• Generate timetable for peer review and reporting arrangements, so progess Michelle Sorley WHHT is routinely fedback within WHHT appropriately.
Medicine
01-Mar-15
RAG Rating
for
Completion
on Time
Green
Green
Further actions continued overleaf . . .
7
3
Cancer Action Plan
3.2 Care Pathways
Issue / Recommendation
Actions Needed
Progress the recently initiated Beds and
Herts Cancer Forum review of all cancer
pathways between primary, secondary and
tertiary care providers using the National
Cancer Action Team Toolkit and
Commissioning Cancer Services Report
2011
• Map care pathways to policies on what should be happening and compare
Tonia
with ECRIC data to see what is actually happening. Further update will be
Dawson/Healt
provided at the CCG Cancer Action Group with representation from Beds and h Awylward
Herts Cancer Forum who are a core member, as a precursor to further
review with MDTs.
Methodical care pathway review is required, • Full-time cancer improvement manager in post
led by clinical teams and in liason with CCG.
Implementation of newly agreed pathways
Action Owner
D Foster
Lead
Target Comment
Service / Finish date
Organisatio
n
CCG
01-Feb-15
RAG Rating
for
Completion
on Time
Green
WHHT Medicine
01-Feb-15 Offer made on
24/12/14 awaiiting conf
start date.
Green
• Confirm priorities and tumours sites to be completed in phases, linking with
Cancer
work completed on capacity and demand. Plan is for capacity & demand work Programme
to inform pathway development.
Lead
WHHT &
CCG
01-Feb-15
Green
• Complete review of phase 1 tumour sites and confirm changes/actions
needed as result of phase 1.
Phase 1: Lung, head & neck and urology
Cancer
Programme
Lead
WHHT &
CCG
01-May-15 Need to confirm if this
is realistic timescale
Amber
• Complete review of phase 2 tumour sites and confirm changes/actions
needed as result of phase 2.
Cancer
Programme
Lead
WHHT &
CCG
31-Aug-15 Need to confirm if this
is realistic timescale
Amber
• Complete review of phase 3 tumour sites and confirm changes/actions
needed as result of phase 3.
Cancer
Programme
Lead
WHHT &
CCG
30-Nov-15 Need to confirm if this
is realistic timescale
Amber
• Confirm where straight to test pathways can be implemented.
Cancer
Programme
Lead
WHHT &
CCG
01-May-15
Green
• Confirm where further one-stop clinics can be established
Cancer
Programme
Lead
WHHT &
CCG
31-May-15
Green
• Implement direct to test pathway for lung patients - will provide GPs direct
A Barlow / P
access to diagnostics for CT scan which would be available to the consultant
Sawyer
at 2ww appointment.
WHHT &
CCG
31 Nov 14
Done
8
3
Cancer Action Plan
3.3 Information Quality (1 of 2)
Issue / Recommendation
Actions Needed
Booking Safeguards:
Although patients referred as 2WW on the
PAS system have a code that distinguishes
them with “C”, the system will not prevent
these referrals from being booked into
routine, urgent or follow-up slots. It would
seem sensible to engineer the PAS system
(if possible) to prevent this, and/or to add a
flag or warning to the system to alert the
user when this operation is being performed.
In addition to this, there should be better
controls over who has permission and who
has training to perform the relevant
conversion of appointment slots on the PAS,
to ensure that this is fit for purpose.
• The PAS supplier has confirmed that the system cannot be engineered in
the way described. The 2ww timeline is triggered by the referral data itself.
Data quality:
A suite of reports to test compliance with
booking policies and recording outcomes
should be created and used regularly by
senior managers, identifying barriers to
compliance and regularly monitoring metrics
in these areas, building on the recent work of
the Intensive Support Team. The Board/subcommittees should request assurance on
data quality regularly.
The Trust and local partners should move
over to secure NHS email accounts to
improve communication and information
governance, eliminating the need to use
facsimile communication.
Action Owner
Lead
Target Comment
Service / Finish date
Organisatio
n
Femi
WHHT 01-Dec-14
Odewale/ Sam
Medicine
Ingram
RAG Rating
for
Completion
on Time
Red?
• Where referrals are made through Choose and Book, published slots are
controlled to prevent this happening.
Femi
Odewale/ Sam
Ingram
WHHT Medicine
01-Dec-14
Done
• An audit report detailing PAS clinic edit permissions has been produced for
review by divisions. Relevant actions will then be taken regarding and further
controls required – ongoing as part of out-patient transformation.
Femi
Odewale/ Sam
Ingram
WHHT Medicine
01-Dec-14 Ned to confirm that
clinic edit permissions
have been updated.
Green
• Change appointment slot type on the new outcome form with this will be
“2WW” instead of “VU” when the new PAS upgrade takes place next month.
Femi
Odewale/ Sam
Ingram
WHHT Medicine
01-Dec-14 Need to confirm
completion
Green
• 2ww, 31 and 62 day Cancer PTLs have been developed and are in use .
Sandra Davey
WHHT Medicine
In place
Done
• Ensure newly agreed validation timetable is implemented & embedded
Femi Odewale
WHHT Medicine
01-Feb-15
Green
• Data quality reports have been developed and are available for use. These
compare Infoflex and PAS data for reconciliation purposes. Currently
undergoing validation prior to being fully utilised.
Sandra Davey
WHHT Medicine
In place
Done
• An Information Team resource attends the weekly Cancer access meetings to
provide support but this is variable and needs to be embedded.
Sandra Davey
WHHT Medicine
01-Nov-14
Done
• Appoint a second Cancer Information Analyst post
Debbie
Foster/Mark
Currie
• The Trust is currently transitioning to a new infrastructure managed service
which will include provision of secure email (nhs.net and Trust email within
single mailbox).
Mark Currie
WHHT Information
01-Jun-15
Green
• As part of the infrastructure service transformation, fax is being phased out
and replaced by scan to email.
Mark Currie
WHHT Information
01-Jun-15
Green
• Similarly all primary care are moving from practice specific email addresses
to nHS.net account and hence will complement this work.
Mark Currie
WHHT Information
01-Jun-15
Green
WHHT 01-Nov-14 6 month extension to
Medicine/Infor
second analsyt post
mation
agreed
Amber
9
3
Cancer Action Plan
3.3 Information Quality (2 of 2)
Issue / Recommendation
Actions Needed
IT systems: the use of parallel systems and
lack of information sharing between Infoflex
and PAS is a risk that should be addressed.
Infoflex is slow, unreliable and should be reexamined in light of these issues above and
the external and internal reviews. This is part
of the Trust’s IT business case.
• The Trust IM&T Strategy is being refreshed to make recommendations
regarding future IT system requirements- cancer service requirements need
to be reflected in this.
S Gilchrist
• As part of the infrastructure managed service, the supplier will be delivering
an integration engine and clinical data repository which will provide a single
portal view into the Trust’s clinical systems including Infoflex and PAS.
S Gilchrist
WHHT Information
Late 2015
Green
• Data quality reports have been produced to assist with reconciliation
between PAS and Infoflex.
Lisa Emery
WHHT Information
01-Oct-14
Done
Visibility of service outcome and
performance data:
the accountability of all staff for providing
high quality services needs to be increased
by making staff across MDTs aware of the
performance of their services. Involve staff in
the design of performance reports and
provide regular opportunities to review these
and act on them.
• Monthly validation of breaches is in place for all cancer which supports
accurate data uploading.
Sandra Davey
WHHT Medicine
01-Oct-14
Done
• However the progress on the visibility of service outcome and performance
data has been slow. There is patient level data but the MDTs are not aware of
the performance of their services as data collection remains fragmented. We
have requested a suite of reports for individual tumour sites but these are not
available.
Mark Currie
WHHT Information
December
2014 to
February
2015
• The plan is for the new Data Manager to meet with all MDT Leads and MDT
Co-ordinators so that there is a greater understanding of what information by
tumour site is required.
Femi Odewale
WHHT Medicine
The current cancer database (an addition to • Complete specification outlining what is needed from the cancer information
Mark
infoflex) is not fit for purpose and future
system.
Currie/Elizabet
plans need to be finalised.
h White
WHHT Medicine
• Reach a decision regarding immediate and longer-term strategy for cancer
information system.
Action Owner
Lisa Emery
Lead
Target Comment
Service / Finish date
Organisatio
n
WHHT On going
Information
WHHT Information
The cancer team have
escalated the on-going
concerns with data and
data collection.
December Dependent on staff
2014 to time being available.
February
2015
01-Nov-14
Expected to complete
by end Dec 14.
Delayed exp mid Jan
RAG Rating
for
Completion
on Time
Green
Red
Amber
Amber
tbc
Amber
• Ensure routine validation of long-waiters is in place.
Femi
WHHT - Div
Odewale/ADM
Teams
31-Jan-15
Amber
• Ensure sufficient dedicated information analyst support for cancer team.
D Foster/Mark
Currie
01-Dec-14 6 month extension to
second analsyt post
agreed
Amber
WHHT Information
10
3
Cancer Action Plan
3.4 Infrastructure & Admin (1 of 2)
Issue / Recommendation
Actions Needed
Action Owner
Lead
Target Comment
Service / Finish date
Organisatio
n
Appointments processes need to be
• This is included in the two week wait project group work stream. This is a
Sandra Davey
WHHT Complete
improved, with a more patient focussed
sub group of the cancer committee. The group consisting of senior managers
Medicine
approach, so that cancer 2WW referrals are are implementing all the recommendations which have been made on 2 week
scheduled into appropriate appointment
wait referrals, reducing paper and fax usage and ensuring that patients are
slots and arranged to suit the patient’s
offered appointments in chronological order.
needs, encouraging attendance as a result.
• Proposals are being agreed for the 2ww central booking team to be providing
Sam
WHHT 31-Jan-15 Proposals agreed,
the service between 8am to 7pm from the current provision of 9-5pm which
Ingram/Femi
Medicine
need to be
will enhance patient’s access outside the normal working hours.
Odewale
implemented
RAG Rating
for
Completion
on Time
Done
Amber
• However other improvements include having generic emails addresses
Sandra Davey
particularly for straight to test patients internally so that diagnostics results are
available at the 2ww appointment
WHHT Medicine
31-Oct-14
Done
• Standard Operating Procedures have been developed awaiting approval.
Femi
Odewale/Sam
Ingram
WHHT Medicine
31-Dec-14 Not yet all completed.
Amber
• All relevant staff have received cancer waiting times training including all
Sandra Davey
MDTs. A training lead has been allocated for outpatient training and
competency frameworks are being developed to provide assurance that these
processes are being followed.
Skills: training in systems and processes
• All MDT teams and OPD administrative staff have received cancer waiting
Sandra
relating to cancer patients, including national times training.
Davey/Sam
guidance and local Trust policy, needs
Ingram
addressing. All administrative staff in OPD • Upper GI team scheduled to receive training.
Sandra
need to be trained in all aspects of the
Davey/Sam
booking pathway to increase flexibility,
Ingram
continuity and understanding. Continue the
training started by the Intensive Support
Team and ensure this is sustained and
refreshed regularly.
WHHT Medicine
31-Oct-14 Will need repeated in 1
year's time, at the
maximum.
Done
WHHT Medicine
30-Sep-14
Done
WHHT Medicine
01-Dec-14 Awating conf. That
training hastaken place
Done?
• Pilot proposed for a cancer admin support to be based with the central
Femi
booking team in order to commence tracking of patients on infoflex at source. Odewale/Sam
Ingram
WHHT Medicine
31-Jan-15 Not yet happened, but
imminent.
Amber
• Email accounts being created to allow email of referrals, to reduce the
reliance on paper and faxes for internal direct to test.
Sandra
Davey/Sam
Ingram
WHHT Medicine
31-Oct-14
Done
Femi
Odewale/Sam
Ingram
CCG
01-Feb-15 Need to confirm plans
with CCG.
Amber
Processes for developing, implementing and
assuring adherence to policy: future policies
will require better consultation and
engagement to reinforce best practice.
Standard operating procedures/individual
action cards should be co-developed to
support this.
Handling referrals:
review and improve the process within the
Trust for noting receipt and tracking
incoming 2WW cancer referrals. The
continuing reliance on a paper-based log
and email list is not sustainable. The Trust
should also review with the CCG the
potential for Choose & Book to be used
widely in managing 2WW
• Increase the use of choose & book for cancer referrals
11
3
Cancer Action Plan
3.4 Infrastructure & Admin (2 of 2)
Issue / Recommendation
Actions Needed
Changes to Choose and Book: enable direct
access for GPs to make referrals to
diagnostics on the 2WW pathways. The
paperwork should include advice to keep
people updated of decision changes and the
value of these appointments.
• Some diagnostic services have this facility enabled through Choose and
Book. Further diagnostic services will be reviewed as part of the two week
wait project group work stream. This will also be included in work undertaken
as part of upcoming Choose and Book system upgrades.
Urgent non-cancer referrals and the
management of DNAs in this context need to
be considered too e.g. when patients are
referred to the Rapid Access Chest Pain
Clinic. Give the same attention to reviewing
non-cancer urgent referral DNAs as cancer
2WW DNAs.
A standard response form at the hospital
would improve consistency of information
regarding the outcome of the referral. Faster
responses would also be beneficial, as
would clear guidance on response times to
achieve.
Lead
Target Comment
Service / Finish date
Organisatio
n
Femi Odewale
WHHT 01-Mar-15 Dependent on Choose
Medicine
& Book system
upgrade and on
diagnostic capacity.
RAG Rating
for
Completion
on Time
Amber
• The 2WW DNA report currently only covers 2WWs – Urgent referrals could
easily be added into the same report/a separate one, however the trust is
currently exploring this further
Femi
WHHT Complete Plan for review of rapid
Odewale/Mark Medicine/Infor for 2ww access patients tbc
Currie
mation
October
2014
Red
• Priority is given to all 2ww outcomes following consultation with letters sent
to referrer within 48 ours following appointment.
Sandra Davey
WHHT Medicine
Done
• Further discussion underway to email the outcome letters via nhs.net and
confirm this is acceptable.
Sandra Davey
WHHT Medicine
• Implementation of emailing outcome letters is in the outpatient
transformation plan, but cancer improvement group need to be assured of
progress.
Action Owner
Complete
October
2014
Discussion
25
November
2014
Femi
WHHT 01-Mar-15
Plans need to be
Odewale/Sam Medicine/Infor
confirmed.
Ingram/Mark
mation
Currie
Done
Red
To review the governance of the two week
cancer pathway in primary care, including
dental practices, and agree standards for all
referring clinicians, including the use of “
Choose and Book”.
• CCG as part of the development of CCG GP IT strategy/Framework will be
implementing the E-Referral come April 2015. In the mean time as part of
good practice, we are developing standards for the use of choose and book
and regular audits around 2ww at General Practice
Avni
Shah/Shane
Scott
CCG
01-Feb-15
Amber
• Liaising with NHSE regarding agreeing standards for 2ww from Dental
Practices
Avni
Shah/NHSE
CCG
01-Jan-15
Amber
Ensure adequate operational leadership &
support for cancer services
• New cancer services manager in post.
D Foster
WHHT Medicine
01-Feb-15 NB: There is an interim
gap.
Green
• Review Cancer Specialist Nurse stucture and confirm and actions needed
Michelle Sorley
WHHT Medicine
01-Feb-15
Green
• Review office arrangements for cancer service team - present
accommodation is inadequate.
Femi
Odewale/Debb
ie Foster
WHHT Medicine
01-Jun-15
Amber
12
3
Cancer Action Plan
3.5 Divisional Action Plans
Issue / Recommendation
Actions Needed
Lead
Target Comment
Service / Finish date
Organisatio
n
Establish a patient and public participation • Patient and Public Participation Forum is already set up across Bed and
Tonia
CCG
01-Dec-14 Needs ongoing review
forum for cancer services to help educate Herts Cancer Forum. Work needed to ensure there are representatives from Dawson/Healt
to embed
the public and specifically focus on reducing Herts Valleys at this forum and how we engage with the forum on the various h Awylward
DNAs on the 2WW pathway
aspects of work including work from Herts Valleys under Primary care
Transformation around Prostate cancer etc.
Capacity & demand for cancer services
• Focus initially on lung, head & neck and urology, and complete capacity &
Femi
tbc
31-Jan-15 Approach to be
needs to be understood.
demand review.
Odewale/ADM
confirmed
• Review capacity & demand for all other tumour sites.
Robust achievement of 2-week wait
standard
ie standard has been achieved for 6
consecutive
months. of 31-day standard
Robust achievement
Femi
Odewale/ADM
tbc
• Agree plan to ensure that 2-week wait is sustainable for the breast service.
E Odlum
• Agree plans to ensure that 31-day standard is sustainable for all specialties
RAG Rating
for
Completion
on Time
Green
Amber
31-Mar-15 Approach to be
confirmed
Amber
WHHT Surgery
31-Jan-15
Green
D Foster(until
Prgramme
Lead in post)
WHHT Medicine
31-Jan-15
Green
• Agree plans to ensure that 62-day standard is sustainable for colorectal
E Odlum
WHHT Surgery
31-Jan-15
Green
• Agree plans to ensure that 62-day standard is sustainable for urology
E Odlum
WHHT Surgery
31-Jan-15
Green
• Agree plans to ensure that 62-day standard is sustainable for lung
D Foster
WHHT Medicine
31-Jan-15
Green
ie standard has been achieved for 6
consecutive months.
Robust achievement of 62-day standard
ie standard has been achieved for 6
consecutive months.
Action Owner
13
3
Cancer Action Plan
3.6 Governance
Issue / Recommendation
Ensure governance changes made as a
result of external review are embedded.
Actions Needed
• Review all actions taken to ensure appropriate escalation of concerns and
sharing of good practice are embedded & reinforce messages made during
Oct 14.
• WHHT Cancer strategy away day planned for February 2015.
Lead
Target Comment
Service / Finish date
Organisatio
n
Femi Odewale WHHT 28-Feb-15
Medicine
WHHT Medicine
Avni Shah/Phil
Sawyer
CCG
01-Jan-15
Green
Avni Shah/Phil
Sawyer
CCG
01-Jan-15
Green
b.Education and training for primary care on Cancer
Avni Shah/Phil
Sawyer
CCG
01-Jan-15
Green
c.Regular audits in general practice around cancer
Avni Shah/Phil
Sawyer
CCG
01-Jan-15
Green
d.Development of local pathways with providers to support direct access
to diagnostics such as lung cancer
Avni Shah/Phil
Sawyer
CCG
01-Jan-15
Green
e.Wider system end to end pathways in collaboration with Beds and Herts Avni Shah/Phil
Cancer Forum
Sawyer
CCG
01-Jan-15
Green
• With the formation of the Herts Valleys Cancer Action Group, focus on
Cancer has been raised across the organisation and a development of work
plan around Cancer is currently being developed which will include the
proposed
on:
a.Earlywork
diagnosis
WHHT Medicine
28-Feb-15 Will take place once
new improvement lead
in post
01-Oct-14 D Foster to confirm
with L Hill if further
action is required.
RAG Rating
for
Completion
on Time
Green
Cancer
Programme
Lead
D Foster/Lisa
Emery
The NHS Trust Development Authority,
• Any actions required of WHHT need to be confirmed.
Monitor and NHS England should require
Boards to assure themselves of the quality
of data used to measure compliance with
national targets in cancer and other NHS
Standards.
Leadership capacity and continuity to
transform
Action Owner
Red
N/A
14
4. Operational Cancer Service Management Structure
Medicine Divisional Director
Medicine Divisional Manager
Acute Oncology
Service –
note that this
doesn’t come
under WHHT line
management
arrangements
Breast MDT
Facilitator
Breast MDT
Assistant
Michelle Sorley
Lead Nurse for
Cancer & Palliative
Care
Cancer &
Palliative Care
Clinical
Specialist Staff
Colorectal &
Data
MDT Facilitator
Urology MDT
Facilitator
Colorectal/Urology
MDT Assistant
Cancer Clinical Director
Cancer
Programme
Lead
Audit & Data
Manager
Cancer Service
Manager
Audit & Data
Assistant
Admin
MDT Manager
Dermatology and
Upper GI /CUP
MDT Facilitator
Lung and CNS
MDT Facilitator
Dermatology/Lung
MDT Assistant
Gynae Paeds
and Colp MDT
Facilitator
Haematology &
Head and Neck
Pathway
Facilitator
Band 4
Gynae, Haem and
H&N MDT Assistant
Please note that this is a newly established structure – vacant posts are shown in italics and interim cover arrangements have been put into place.
until substantive staff are in post.
15
5.
Key Cancer Improvement Programme Risks
•
Breast clinic capacity increased, backlog cleared, patient choice is key risk to
compliance going forwards. Identifying best practice to implement locally, to reduce
this risk to a minimum, with HV CCG.
•
Tumour site capacity issues being addressed and recovery plans are being
developed with support from IST. Current focus are urology and colorectal, work will
shortly begin on lung.
•
Data input and clinical systems issues identified in internal and IST reviews,
impacting on accuracy of reporting of cancer performance. Cancer Informatics
Group in place to address immediate issues and deliver data quality improvement
plans. The option appraisal is due for completion in December.
•
Increase in validation capacity and capability until software solutions in place.
•
Due to staff turnover within the Cancer Management team interim support has been
appointed.
16