Sarita Yaganti Project Lead Service Improvement
Cancer Commissioning Team West and South London
Cancer Commissioning Team: West & South London • 20 CCGs • 17 Trusts • 5 million people (ONS) • 3 ex-Cancer Networks • 2 CCT patient groups • 2 CSUs • 1 Integrated Cancer System (the London
Cancer Alliance)
The London cancer landscape Reconfiguration of Cancer Networks and Pan London
Teams – 5 became 3
and soon 3 will become 1 2 Integrated Cancer Systems (provider) - London Cancer (North and North Central London) - London Cancer Alliance (North West and South London) - pathway groups (one for each tumour site) 5 year cancer strategy for London being developed Pan London Living with and Beyond Cancer work stream in
place
What we know about current follow-up Variation: in follow up protocols across the geography in the content of the follow-up consultation information give to patient patients expectation and understanding of treatment Willingness of patients to have follow up but want a “cancer
specialist” in primary care CCGs Care Closer to Home agenda highlights the potential for
delivering primary care-led and delivered follow-up systems
Our ambition for follow-up No “one-size fits all” follow-up pathway Ensure patient choice can be exercised and patient experience is
enhanced Through training and education, we can assist primary and community
teams to position themselves to provide care closer to home Quality standards for follow up pathways are to be reflected in future
commissioning arrangements To continue to work collaboratively with patients, health professionals,
cancer charities to benefit the ongoing development and improvement in follow-up cancer care
Our aim for this project ...is to examine the evidence to discover and agree the best practice follow up of
suitable men living with and beyond prostate cancer in primary care and to recommend commissioning options for service delivery models.
Project objectives – the why To provide patients living with prostate cancer a safe,
comprehensive follow-up service delivered by primary care
Ensure care is tailored to patient's holistic needs (namely
psycho/sexual/social) and access to support services is available and equitable
Employ 2 Band 8a Nurses to: To identify what is needed to provide an appropriately skilled primary care workforce to deliver this model To enable practice nurses to support patients living with and
beyond a prostate cancer
Testing and evaluating a model of care
The Process – the how Supported by the CCT, two Band 8a nurses to take the project forward (recruitment in process) Mapping / Data
- Patient and professional interviews
GP v nurse
Evaluate current patient information (including verbal discussion on side effects)
Training and Developing primary care
Set up transfer of patients and information
Pilot the identified best practice model in Croydon CCG
Revaluate patient and professional experience
Recommend best practice model for CCG commissioning
- what, where, how, why, who, when?
Financial modelling: primary v secondary consultant v nurse
Key deliverables – the what Clearly defined, costed follow up model for the target
patient group Establish data metrics for auditing Clarify the infrastructure required in primary care to
deliver the pathway Set up/improve rapid access referral back into
secondary care To provide a locally accessible service for patients and
ensure choice of follow up is given as standard
Challenges Recruitment – second time round
New world of CSUs = exciting, hair raising twists and turns
at each corner!
Things that we took for granted i.e. employing clinical staff
for clinical roles
Data, data, data : Identifying data sources e.g. primary care v secondary care data Coding – what coding? Being very clear on what data you want need.
The future Developing ways of providing patient access to specialist clinical
support within primary care
Established “key worker” policies for follow-up patients Clear understanding of costs of different follow up pathways Peripatetic workforce – promoting shared resources between practices
Continue to evaluate services by using consulting with those that are a
part of the service – patients/providers/professions
Work with patients on what will enable them to be open and honest
about how the emotive side to cancer effects them so that holistic needs can be met
Learn from each other.....so.....
Let’s talk... Sarita Yaganti: Project Lead, CCT North West & South London
[email protected] Barbara Gallagher: User Involvement Lead, CCT West & South London
[email protected]
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