What’s on the Horizon

Anita CorriganNurse 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

National Cancer Survivorship Initiative

QUALITYQUALITY

PRODUCTIVITYPRODUCTIVITY

INNOVATIONINNOVATION

PREVENTIONPREVENTION

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

QUALITYUP

COSTDOWN

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 consultNHS 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

North West Strategic Health Authority

Merseyside & Cheshire Cancer Network Taskforce

Cancer Network Partnership Group

National Cancer Patient Forum

Clinical Network Groups Locality Groups Network Projects etce.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!