Developing the NCSI 2012 document: taking action to improve outcomes

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nal Cancer Survivorship Initiative Developing the NCSI 2012 document: taking action to improve outcomes

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Developing the NCSI 2012 document: taking action to improve outcomes. What I will cover. Why now? Purpose Process Emerging thoughts What we need from you. Why now? (1). Cancer survivors needs are not being fully met Poor survivorship: - PowerPoint PPT Presentation

Transcript of Developing the NCSI 2012 document: taking action to improve outcomes

Page 1: Developing the NCSI 2012 document:  taking action to improve outcomes

National Cancer Survivorship Initiative

Developing the NCSI 2012 document: taking action to improve outcomes

Page 2: Developing the NCSI 2012 document:  taking action to improve outcomes

National Cancer Survivorship Initiative

What I will cover

• Why now?

• Purpose

• Process

• Emerging thoughts

• What we need from you

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National Cancer Survivorship Initiative

Why now? (1)

• Cancer survivors needs are not being fully met

• Poor survivorship:– Damages outcomes (mortality, quality of life, patient

experience)– Costs money (preventable ill health, avoidable emergency

admissions more expensive treatment and care)

• We can’t do more of the same - from 1.7 million survivors now to 3 million in 2030...

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National Cancer Survivorship Initiative

Why now? (2)

• To date focus has been:– Researching – extent, needs, impact– Developing – communities of interest– Testing – new approaches– Evaluating – feasibility, effectiveness

• But not many patients have benefitted in the ‘real world’...

• Some interventions are ‘rollout ready’ - now we need to deliver better survivorship support at scale

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National Cancer Survivorship Initiative

Enga

gem

ent w

ith c

linic

ians

&

com

miss

ione

rs

2009 2015 Time

InvestigateInnovate

Implement

We are here

2012 should be a step change

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National Cancer Survivorship Initiative

If we go no further, we’ve failed

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National Cancer Survivorship Initiative

Turn promising examples into routine practice

Our challenge:

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National Cancer Survivorship Initiative

Moving on from uncertainty

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National Cancer Survivorship Initiative

Good survivorship will...

1 Help people live longer

2 Improve their quality of life

3 Support them in making a faster and fuller recovery from cancer

4 Enhance their experience of care

5 Protect them from avoidable harm

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National Cancer Survivorship Initiative

Developing the document

Next steps document

NDP workshops

NCSI workstreams

Feedback from patients Feedback

from clinicians

Pilots and test sites

Research NCSI Symposium

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National Cancer Survivorship Initiative

Testing our thinking

• NCSI project templates

• ‘Dragon’s Den’

• NDP workshops

• Macmillan clinical advisory board

• Today

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National Cancer Survivorship Initiative

Taking action

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National Cancer Survivorship Initiative

Treatment

Promoting recovery

Sustaining recovery

Managing consequences

of treatment

Active & recurrent disease

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National Cancer Survivorship Initiative

Support from point of diagnosis• Survivorship starts from the point of diagnosis – work discussions

start now

• Patient experience and quality of life are linked: taking action to improve one will benefit the other

• Critical role of CNSs / AHPs

• Peer Review?

• National Cancer Patient Experience Survey?

• Information prescriptions?

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National Cancer Survivorship Initiative

Promoting recovery• The package (assessment and care planning, treatment summary,

cancer care review and health and wellbeing clinics)

• Prehabilitation

• ‘Rehabilitation prescriptions’?

• Tariffs for phases of care? Best practice tariffs? CQUINs?

• Peer Review?

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National Cancer Survivorship Initiative

Sustaining recovery• If physical activity was a drug, its efficacy would mean it was

considered a ‘wonder drug’

• Follow-up: tailored and risk stratified

• Efficiencies in follow-up need to be matched by investments in other areas of the survivorship pathway – but whose responsibility is this?

• Cancer care review template?

• National Cancer Patient Experience Survey?

• Best practice tariff?

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National Cancer Survivorship Initiative

Managing the consequences of treatment• Most patients will need to manage some consequences of their

treatment

• The nature of consequences will vary – ‘the Maher classification’

• Failure to manage the consequences costs money and lives

• Breast Radiotherapy Injury Rehabilitation Service (BRIRS)

• READ codes

• CQUIN for use of PROMs

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National Cancer Survivorship Initiative

Managing the consequences of treatment – key principles• Prevent or minimise consequences where possible

• Inform patients of potential consequences when these are known and document these in treatment summaries

• Identify groups at increased risk of late effects (long term follow-up of patients in trials; recording through national datasets)

• Monitor at risk patients consistently

• Respond where a new risk is identified, utilising PROMs and health service datasets and informing patients

• Provide appropriate services for patients suffering from the consequences of treatment

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National Cancer Survivorship Initiative

Active and recurrent disease• Key principles for survivorship apply

• CNSs and palliative care really matter

• Addressing weaknesses in the intelligence is a priority

• What does the metastatic MDT look like?

• What are the true costs of active and recurrent disease?

• Which outcomes matter most to patients?

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National Cancer Survivorship Initiative

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National Cancer Survivorship Initiative

Your task

• Have we identified the right issues?

• How do we get the whole system to prioritise survivorship support?

• Will the levers work?

• What are we missing?

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National Cancer Survivorship Initiative

It’s as easy as x, y, z...

X% of providers implementing rollout ready interventions

Y% of patients being managed differently at the point of recovery

X% being managed remotely during follow-up