Download What`s on the Horizon - Cheshire & Merseyside Strategic Clinical

What’s on the
Horizon
Anita Corrigan
Nurse Director
11.06.2010
The National Cancer Programme

Are we making progress?

How are we making progress?

Where should we focus our efforts to
become ‘world class’?
Progress on cancer mortality
By age group (1995-7 to 2005-7)

All ages:14% fall

Under 75 years:18% fall

Over 75 years: 5% fall
How are we making progress?

Prevention

Screening

Better service organisation

Better treatment

Better care
Where should we focus our efforts?

Earlier diagnosis

Ensuring cost-effective innovations are
disseminated rapidly across the NHS

Survivorship care

Reducing inequalities (by race, age,
gender etc.)

Developing new treatments
Earlier Diagnosis

Late diagnosis is estimated to result in up to
10,000 avoidable deaths p.a.

Late diagnosis is the major reason for poor
survival in the UK

Late diagnosis is almost certainly due to a
combination of factors:



Low awareness and late presentation by patients
Delays within primary care
GPs having poor access to diagnostics
Uptake of new innovations

In general we are slow to take up new
innovations within the NHS

Examples include:




Robotic Surgery
New approaches to radiotherapy (e.g. IMRT)
New cancer drugs
This is not simply due to cost constraints or
delays in getting decisions through NICE
Survivorship Care

There are now around 2 million survivors
of cancer in the UK

We need to focus more on their quality of
life and their care after primary treatment

Personalised assessment, information
and care planning will be central to this.
Reducing inequalities

Major disparities in incidence, uptake of
screening, stage at presentation, treatment,
survival and experience of care according to:




Race
Age
Gender
Social deprivation

Lifestyle factors (incidence) and late diagnosis
(survival) are key factors

Collection of detailed information MDT level is
essential to assess optimum care is being delivered.
Cancer Drugs

Some new drugs are making a very significant
impact e.g.



Imatinib in chronic myeloid leukaemia
Rituximab in Non Hodgkins Lymphoma
Trastuzumab in HER2 positive breast cancer

For many other drugs the impact on survival or
mortality is at best ‘modest’ – though individual
patients can benefit significantly

New drugs have an important role in the ‘war on
cancer’, but are only one part of the picture.
The QIPP Challenge
QUALITY
INNOVATION
PREVENTION
PRODUCTIVITY
National Cancer Survivorship Initiative
Why do we need QIPP

Predicted £15 to £20bn shortfall in NHS Funding
from 2011-2014

Above inflation investment and growth in last
decade not sustainable

Increasing demand: Older people; Drugs; A&E;
We need a combination of:





New Care Models
Clinical Excellence
Productivity & Efficiency
Cost control
QUALITY
UP
COST
DOWN
Engaging patients
“ the involvement of the public in the NHS must be
embedded in its structures: the perspectives of
patients and of the public must be heard and
taken into account wherever decisions affecting
the provision of healthcare are made”
Ref: Learning from Bristol: the report of the public inquiry into children’s
heart surgery at the Bristol Royal Infirmary 1984 - 1995
Engaging patients
“It is self evident, but worth
repeating, that the NHS can
meet people’s needs better if
we listen to what people tell
us, instead of relying on
existing knowledge and
assumptions.
We can develop better, more
responsive services if we
involve and truly listen to not
only those who are already
using services, but those who
are not.”
Patient and Public Engagement Toolkit for
World Class Commissioning, 2008
The Duty to involve and consult
NHS organisations must make arrangements to
involve users, whether directly or through
representatives (whether by being consulted or
provided with information, or in other ways) in:

planning the provision of services
the development and consideration of
proposals for changes in the way services are
provided, and decisions to be made affecting the
operation of services.

Section 11 . Health and Social Care Act
How do we involve the public, understand
the patient and carer experience and gain
involvement?
Department of Health
National Cancer
Patient Forum
North West Strategic
Health Authority
Merseyside & Cheshire
Cancer Network Taskforce
Cancer Network
Partnership Group
Clinical Network Groups
Locality Groups
Network Projects etc
e.g. patient survey
What’s next for MCCN
building relations with LINks, key
stakeholders and partners
 drawing on patient influence when
redesigning services
 Using patient feedback to improve
services
 Engaging different elements of population

We need you!
Challenges are what
make life interesting;
overcoming them is
what makes life
meaningful.
Joshua J. Marine
Thank You!