Post on 12-Jan-2016
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!