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The Northern Cancer Alliance: Challenges and Opportunities Mr Andy Welch Chair Northern Cancer Alliance North East and North Cumbria www.necn.nhs.uk Development of the Northern Cancer Alliance The Alliance foot print agreement was based on a number of factors including: • Population base • Patient flows • Service pathway interdependencies • Existing organisational relationships • Deliverability • Patient Groups • Resource implications, including economies of scale Alliance Vision Our goal is to increase cancer survival rates across this region, ensuring that we reduce inequalities, deliver the best possible outcomes for every patient affected by cancer and the best possible patient experience. Northern Cancer Alliance Challenges • Health inequalities • Increase in demand – diagnostic services • Ageing population • Workforce • Spread of deprivation • Performance • Variation • Rurality of geography • Collaborative decision making Proportion of Cases Stage 1 or 2 - 2014 Registrations 60% CCG Network England 50% 40% 30% 20% 10% 0% 48.3% 49.5% 50.3% 51.1% 51.1% 51.3% 52.7% 53.6% 53.8% 54.4% 54.5% 55.0% N Tyne N Durham DDES HAST New/Gates S Tyne Stees Nland Sland Cumbria HRW Darlington 59.0 59.5 57.8 57.4 56.9 56.7 56.2 56.5 56.0 53.9 53.4 NHS Cumbria CCG NHS Sunderland CCG NHS Northumberland CCG NHS North Durham CCG NHS Newcastle Gateshead CCG NHS Hartlepool and Stocktonon-Tees CCG NHS North Tyneside CCG NHS Darlington CCG NHS South Tyneside CCG NHS Durham Dales, Easington and Sedgefield CCG 0 NHS South Tees CCG 1 year Survival Index (%)- All Cancers by CCG - 2013 - with England Comparison All Ages and >75 80 All Ages 70.1 69.8 69.4 Age >75 All Ages - England Age >75 England 70 60 68.9 68.8 68.4 68.1 67.7 67.1 67.0 66.1 50 40 30 20 10 Opportunities – Allows networked services across the region – Allows the collaboration and integration with our 3 STPs – Transformation funds to address specific targeted interventions • redesign of cancer pathways • best patient flow for diagnosis and treatment of all our patients. Structure slide North Region Cancer Taskforce Provider Boards/Governing Bodies North Region ALLIANCE BOARD Clinical Leadership Group PREVENTION LIVING WITH AND BEYOND CANCER Site Specific Expert Reference Groups • • • • • • • Brain and Central Nervous System Breast Colorectal Gynae-Oncology Haematology Head and Neck Hepato Pancreatic Biliary (HPB) Cancer Managers Version 0.8 March 2017 • • • • • • • North CCG Forum Commissioning Forum PATIENT EXPERIENCE EARLY DIAGNOSIS Commissioning Boards/Governing Bodies STP Partnership Boards Lung Oesophagogastric (OG) Psychology Sarcoma Skin Thyroid Urology Cancer in the Community and • • • • • HIGH QUALITY MODERN SERVICES COMMISSIONING, PROVISION AND ACCOUNTABILITY INFORMATION AND DATA Cross Cutting Expert Reference Groups Acute Oncology / Metastatic Spinal Cord Compression / Cancer of Unknown Primary Chemotherapy Genetics Histopathology CYPCG • • • • Cancer Locality Groups Public Health England Psychological Health Radiology Radiotherapy Supportive, Palliative and End of Life Care HCPH Network Attended by Alliance Manager Local Authority, Public Health Priorities Prevention • decrease smoking prevalence by increasing uptake of smoking cessation service • embed secondary prevention model in cancer pathways Awareness • increase community awareness and cancer education; increase screening uptake • review communications to improve earlier presentation with symptoms Early diagnosis • improve GP use of 2ww urgent referral route; GP direct access to diagnostic tests Priorities Audit • increase use of SEA audit in primary care; audit emergency presentations Services • review provision of radiotherapy across Alliance • include patients in redesign of pathways and services Patients • improve performance in Cancer Patient Experience Survey. Priorities Diagnostics • scope diagnostic capacity and projected demand in radiology, endoscopy, pathology • create academy of pathologists, networked radiology diagnostic services Workforce • Liaison with HEE- radiologists and pathologists; train wider cancer workforce in new skills and roles Pathways • redesign pathways to accommodate Alliance requirements: commencing with lung, upper/lower GI, urology • introduce new ‘vague symptoms’ pathway; very urgent referral route Measurements of success – by 2020 • • • • • • Increase the proportion of patients with a recorded cancer stage Increase the proportion of cancers diagnosed at stage 1 and 2 Ensure 95% of patients referred for testing are definitively diagnosed, or cancer is excluded, within four weeks Increased 1 year survival Direct GP access to diagnostic tests with timely reporting Conform to cancer waiting time standards – may be modified Operational Success Entirely dependent on clinical ‘buy in’