london cancer workshop 15 th march 2011. agenda timesession 2.00pmwelcome and objectives 2.10pmthe...
TRANSCRIPT
Agenda
Time Session
2.00pm Welcome and objectives
2.10pm The model of care
2.25pm Provider network development
2.45pm Question and answer session
3.00pm Coffee
3.15pm Workshop sessionInternal info and performance management
4.00pm Feedback and discussion
4.20pm Closing remarks and next steps
4.30pm End of session
Objectives
• To inform providers of the implementation programme
• To engage providers in the development of the provider network model and specification
• To outline to providers the timeframe for specification development and provider network bids
• To prompt providers to begin provider network discussions and bid development
Developing the proposals
• 45 clinicians working over 12 months
• Three work areas: early diagnosis; common cancers and general care; rarer cancers and specialist care
• Case for change: December 2009
• Model of care: August 2010
• Extensive 3-month engagement on proposals – over 85 per cent of survey respondents supportive
The case for change
• Later diagnosis has been a major factor in causing poorer relative survival rates
• There are areas of excellence in London but inequalities in access and outcomes exist
• Treatment and care should be standardised
• Specialist surgery should be centralised: common treatments should be localised where possible
• Comprehensive pathways should be commissioned; organisational boundaries should not be a barrier
The model of care
• Improve early diagnosis by addressing public awareness, GP access to diagnostics, screening uptake rates and health inequalities
• Extended local provision of common cancer services, such as chemotherapy, non-complex surgery and acute oncology
• Further consolidation of surgical services for rarer cancers into specialist centres
• A small number of networks of providers delivering standardised pathways
Provider networks
• Model of care recommends the split of commissioning and provider networks
• Provider networks to deliver comprehensive pathways in response to fragmentation of services
• Concept right but language of networks clouds issue
• Integrated cancer systems containing all NHS organisations delivering cancer services from diagnosis to end of life care
Workstream Phase oneDec 10–Mar 11
Phase two Apr 11–Mar 12
Phase three Apr 12–Mar 13
1. Public health and primary care
2. Best practice
3. Radiotherapy commissioning
4. Provider network designation
5. Provider network development
Implementation workstreams
Workstream Phase oneDec 10–Mar 11
Phase two Apr 11–Mar 12
Phase three Apr 12–Mar 13
1. Public health and primary care
2. Best practice
3. Radiotherapy commissioning
4. Integrated systemdesignation
5. Integrated systemdevelopment
Integrated system designation
• Providers will be asked to respond collaboratively to a integrated system specification
• There will be more than one and fewer than five
• Which system they are in will be the provider’s choice
• Only providers in a system will provide cancer services
• Legal status required for contracting
Services
• Integrated systems will be required to demonstrate how they will contribute to the delivery of the model of care:
– Early diagnosis
– General care
– Common cancer
– Rarer cancers and specialist care
Specification
• In addition to services, the integrated system specification will cover 6 areas:
– Scope
– Governance
– Information
– Incentives
– Culture
– Research and education
Standards
• Commissioners will set measures and thresholds to assure quality and drive excellence
Patient experience
Patient safety Effectiveness
Structure
Process
Outcome
Incentives
• Money – Commissioning incentives
– Within integrated system
– E.g. stroke tariff
• Workforce – Cross boundary working
– Clinical leadership
• Reputation – Of system versus of organisation
– Performance info across pathway
The givens
• We will change the way we commission to commissioning by pathways
• Only those part of an integrated system will provide cancer services
• Will contain as a minimum all secondary and tertiary care providers
• Some pathways will cross systems
• Will demonstrate commitment to implementing model of care for common and rarer cancer services
• Clinically led with an overarching governance board will manage system as single entity
Timeline
Event/task By
London Delivery Group 31st January 2011
Announcement of specification development process 8th February 2011
Individual meetings with providers Feb/Mar 2011
Specification development events Early March 2011
Publication of specification April 2011
Support for bid development Apr/May/Jun 2011
Individual or group meetings with providers Apr/May/Jun 2011
Deadline for bid submission 30th June 2011
The givens
• We will change the way we commission to commissioning by pathways
• Only those part of an integrated system will provide cancer services
• Will contain as a minimum all secondary and tertiary care providers
• Some pathways will cross systems
• Will demonstrate commitment to implementing model of care for common and rarer cancer services
• Clinically led with an overarching governance board will manage system as single entity
Group session – internal info
Tables 1 and 3
• How will the system track patients between its constituent parts?
• How will clinical information be shared across the system to manage patients along the care pathway?
• Will there be any information governance issues and how might these be managed?
• What are the potential barriers to the collection and sharing of this information?
Group session – performance info
Tables 2 and 4
• What information will the governance board need to ensure performance of the system as a whole?
• How will the governance board ensure that data is comparable across the system?
• What information will commissioners need to be assured that comprehensive pathways delivered?
• What are the potential barriers to the collection and sharing of this information?
Next steps
• Ongoing work in March on commissioning an integrated system
• Outline specification published in April
• Ongoing development of the model beyond April
• Bidding stage from April to June
• Tailored support available during bid development
• For further information on the case for change and model of care visit www.csl.nhs.uk/publications