Cancer Pathways Redesign Programme
The NUH Recovery Package Journey so far…….
Implementing the Recovery Package in Greater Manchester
Event – 2nd November 2017
Lisa Janiec - Macmillan Cancer Pathways Programme Manager
Stephanie Day - Macmillan Recovery Package CNS
Cancer Pathways Redesign Programme
#TakeAwayMessages
• Background of the NUH cancer pathways
redesign programme
• Implementation approach
• Lessons learnt to date
Cancer Pathways Redesign Programme
Overview of Cancer in Nottinghamshire
• Incidence and mortality is higher than the national
average for some tumour sites
• Every day 16 people will hear that they have
• cancer
• Every day 8 people die from the illness
• In 2016/17 4411 people were diagnosed with cancer
• By 2030 over 69,000 people will be living with
cancer
NB: Data does not included non-melanoma cancers
Cancer Pathways Redesign Programme
Cancer
Pathway
Programme
Journey
Need to improve
communication
between primary
and secondary care
Need for integrated care
pathways
One size fits all approach to
follow up care
Care closer to home agenda
Cancer Pathways Redesign Programme
What we did
• Inclusive Steering Group
• Leadership support from Cancer Lead Clinician
• Task & finish groups to take work forward
• Expansion of implementation team
• PPI engagement to understand local needs
1. Information and Support
2.
Managing my condition
3. Professionals working with
me
4.
Work
Cancer Pathways Redesign Programme
What we have achieved to date
Treatment Summaries
Being developed/in place as part of each follow up pathway for Breast, Colorectal,
Gynaecology, Lung, Oncology, Upper GI and Urology
Electronic Holistic Needs Assessment (eHNA) Project
Rolled out to all tumour sites Evaluation completed
Impact mapping tool developed to inform local service developments
Health & Wellbeing Events
Nottingham patient/carer conference Apr 17
HOPE courses running throughout the year
Moving Forward Programme for Breast & Prostate Cancer patients
Maggie's Centre
Cancer Care Reviews
Working alongside Macmillan GP Cancer Leads to support testing of the newly
developed template linked to the recovery package
Four stratified follow up pathways in place (Colorectal, Breast, Gynaecology & Prostate)
Four to be developed by 31/03/2020
(Lung, Upper GI, Urology & Ovarian)
NUH seen as national leader for this work
Cancer Pathways Redesign Programme
Treatment Summary Approach
1. Vital part of the stratified follow up pathways
2. Team have to meet up and agree it and then
review it regularly
3. Developed a report with IT to monitor
implementation
4. Can help reduce work but its getting that
message across that’s the hard part……
Challenge = getting all consultants on board
‘What's in it for me?’
Cancer Pathways Redesign Programme
Cancer Pathways Redesign Programme
Value for GPs?
“Everything in one
place
Contact telephone
numbers and
Alert symptoms”
“Straightforward with
clear instructions for
monitoring and
documentation by
both GP and patients
& earlier identification
of patients needs“
“Treatment aim i.e.
curative/palliative is
excellent as often this
isn't clear on GP
letters/discharges”
"clear
summary of
diagnosis and
treatment and
section on GP
actions"
Cancer Pathways Redesign Programme
Value for Patients • 80% of endometrial cancer patients surveyed
recalled receiving the treatment summary
• All of these patients rated it as helpful, with most
reporting it is very helpful
• Patient Quote:
“Received after discharge most helpful thing was
that the treatment aim was defined as curative”
Cancer Pathways Redesign Programme
Cancer Pathways Redesign Programme
Benefits / The Good
• Provides information and support for patients
symptoms and/or concerns that they may have
• Helps prioritise what’s important to them
• Supports referrals to other services that may be
closer to their home
• Helps them plan ahead from diagnosis to life after
treatment
Cancer Pathways Redesign Programme
The Bad
• HNA –not needed ‘we already do it’
• Opening the ‘can of worms’
• Reliant upon key people
• Lone worker CNS
• Sickness
• Ipad's maintenance
Cancer Pathways Redesign Programme
The Ugly / Challenging
• Sustainability
• Scope Creep
• ‘Its not a fad’
• ICT
• Migration
• Time
Cancer Pathways Redesign Programme
4%
21%
58%
2%
10%
5%
2015-2017 Patients Concerns
I have questions about mydiagnosis/treatment that I would like todiscuss
Emotional/Psychological Concerns
Physical Concerns
Spiritual Concerns
Practical Concems
Relationships/family
Count of concerns raised
Severity score of concerns raised
Cancer Pathways Redesign Programme
Cancer Impact Maps in
Nottinghamshire
Cancer Pathways Redesign Programme
Health & Wellbeing events
Cancer Pathways Redesign Programme
Cancer Care Review & Primary
Care Engagement
Cancer Pathways Redesign Programme
Lessons learnt • System wide steering group to support development
of integrated care approaches
• Clinical Leadership as part of the implementation
team to influence peers
• Engage staff to work alongside them to understand
and develop their patient pathways e.g. where to offer
eHNA
• Partnership working is key to develop pathways,
new models of care and support for onward referrals
Cancer Pathways Redesign Programme
Contact Details Lisa Janiec – Macmillan Cancer Pathways Programme Manager
Email: [email protected]
Mobile: 07812 268 498
Twitter: @LJaniec
Stephanie Day – Macmillan Recovery Package CNS
Email: [email protected]
Mobile: 07812 268 779
Twitter: @stephday56
Macmillan Cancer Partnership in Nottinghamshire webpage
http://www.macmillan.org.uk/Aboutus/Healthandsocialcareprofessionals/M
acmillansprogrammesandservices/MacmillanCancerPartnershipinNottingh
am.aspx