Key Messages National Cancer Survivorship Initiative Central Hall, Westminster Monday 21 September...
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Transcript of Key Messages National Cancer Survivorship Initiative Central Hall, Westminster Monday 21 September...
Key MessagesKey Messages
National Cancer Survivorship Initiative
Central Hall, WestminsterMonday 21 September 2009
National Cancer Survivorship Initiative
Assessment and Care Planning
Ciarán Devane Chair, Assessment and Care Planning Workstream
National Cancer Survivorship Initiative
Two Million Survivors Two Million Survivors
But how many have a care plan for survivorship?
National Cancer Survivorship Initiative
Two Million Survivors Two Million Survivors
But how many GPs are awareof the treatment that their patients have received and their survivorship care plan?
National Cancer Survivorship Initiative
Two Million Survivors Two Million Survivors
But how successfully does the GP Cancer Care review meet their needs?
National Cancer Survivorship Initiative
Two Million Survivors Two Million Survivors
But how does Follow Up careneed to change to meet their needs?
National Cancer Survivorship Initiative
Active and Advanced Disease
Steven Wibberley Support, Active and Advanced Disease Workstream
National Cancer Survivorship Initiative
What we’ve done
Papers reviewing:
• Patterns of disease
• Developing ‘coping’
• Patient-centrednessin primary care
• Quality of health, living, being and dying
• End of life transitions
Papers reviewing:
• Patterns of disease
• Developing ‘coping’
• Patient-centrednessin primary care
• Quality of health, living, being and dying
• End of life transitions
Workshops on:
• What is meant by Active & Advanced
• Patient-centred support
• Primary care setting
• Transitions to EOLC
Workshops on:
• What is meant by Active & Advanced
• Patient-centred support
• Primary care setting
• Transitions to EOLC
National Cancer Survivorship Initiative
Priorities
Well-being - living with and beyond cancer• Coping, wellness, the ‘new normal’, relationships
Getting back into the system on recurrence• Self-referral, pathways from primary care, treatment by MDT, role of A&E
Transition to End of Life Care• Who decides and when, communications
– early involvemnent of palliative care
Ongoing assessment and care plansOngoing assessment and care plans
National Cancer Survivorship Initiative
Our ideal world would look like ...
Everyone hasa personalised care
plan
Everyone hasa personalised care
plan
Easy access to support and rehab
services
Easy access to support and rehab
services
Prompt and sensitive pathways
back into the system
Prompt and sensitive pathways
back into the system
EoLC decisionsare made together
by patients and professionals
EoLC decisionsare made together
by patients and professionals
National Cancer Survivorship Initiative
Long Term Consequences of Treatment
Alastair MunroProfessor of Radiation Oncology, University of Dundee
National Cancer Survivorship Initiative
The Consequences of Cancer and its Treatment• cause problems that currently affect 400,000 people• have significant impact on daily life• are both physical and psychological• may be hard to identify, for both patients and professionals• have significant economic impact• are insufficiently appreciated and understood• are secretly consuming resources• can be managed efficiently and effectively
– early intervention prevention⇒– later intervention decreased impact ⇒
• provide an ideal test-bed for exploring self-care
National Cancer Survivorship Initiative
How to improve matters: the decision space
SCA
L
E
SCA
L
E
SEVERITY / COMPLEXITY
National Cancer Survivorship Initiative
How to improve matters: the way forward…?• liaison with primary care and consumers
• record-linkage for identification of problems and syndromes (clinical informatics)
• systematic review of available knowledge
• developing new pathways and models of care – resolving the centralisation paradox– self-care and social networking– peripatetic experts?– one-off clinics?– the virtual MDT?
• economic analysis & spending to save
• devising and assessing new interventions
these are complex issues - which is why we would appreciateyour help with this afternoon’s workshop
National Cancer Survivorship Initiative
Self Management
Jessica CornerChair, Self-Management Workstream
Self Management Support Workstream
National Cancer Survivorship Initiative
Where are we now?
National Cancer Survivorship Initiative
Self Management in cancer
National Cancer Survivorship Initiative
Self Management support is what health services do to encourage cancer survivors make decisions that improve their health and clinical outcomes.(THF)
Collaborative professional – patient relationship
Collaborative professional – patient relationship
1. Self management programmes2. HCPs supporting self management
in routine clinical practice3. Aftercare services: Care co-ordinator/supporter
Interactive technologiesInternet/telephone
1. Self management programmes2. HCPs supporting self management
in routine clinical practice3. Aftercare services: Care co-ordinator/supporter
Interactive technologiesInternet/telephone
Selfmanagement
Support
Selfmanagement
Support+
National Cancer Survivorship Initiative
Cancer survivorship and self management: Reviewing evidence
• Review of evidence base for self management support for cancer survivors (and drawing on work in long term conditions)February 2008 Fenlon and Foster 2008)
• Mapping – a snapshot of services identified as supporting self management (Mar – July 2008)
• Review of outcome measures for self management support in the context of cancer survivorship April 2009 (Davies 2009)
• Updated review of the evidence for follow-up support services (Ongoing)
• Review of the evidence for impact of specific lifestyle factors on recovery, progression and health related quality of life (ongoing)
National Cancer Survivorship Initiative
Current Activity: Testing the framework
• First test site: – Test community Birmingham East and North PCT/HOE NHS Trust/Pan
Birmingham Cancer Network Self management programme for patients and advanced development programme for professionals as part of a redesigned follow-up and support pathway for breast cancer patients at Good Hope Hospital.
• Scoping an additional two potential test sites.
• Working with other workstreams to develop and test approachesfor survivors living with advanced disease, and for survivors experiencing long-term consequences of cancer and its treatment.
National Cancer Survivorship Initiative
Work and Finance
Barbara Wilson Chair, Work and Finance Workstream
National Cancer Survivorship Initiative
What we’re dealing with
• Basic provision of information,advice and support about workand financial support is not offeredto cancer patients, their familiesor carers
• Vocational rehab services for those who want to return to work duringor after cancer treatment are largely non existent
• Employers do not know how to support staff who have cancer
National Cancer Survivorship Initiative
Progress to date
• We have reviewed the literature on work and cancerand identified key gaps
• We have developed a proposed model of vocationalrehabilitation for cancer patients
• We have commissioned a study to explore whether DWP employment programmes meet the needs of cancer patients
• We are working closely with Macmillan’s Working ThroughCancer pilot to develop and test a toolkit of resourcesfor employers
National Cancer Survivorship Initiative
Key areas where we’re seeking your views
• A new model ofvocational rehabilitation
• Providing triage tools about work and financial matters from diagnosis onwards
• Strategy for increasing employers’ knowledgeand awareness about howto support employees affected by cancer.
National Cancer Survivorship Initiative
Children and Young People
Carole Easton Chair, Children and Young People Workstream
National Cancer Survivorship Initiative
Children and Young People • Personalised targeted follow up
• Reduction in numbers lost to follow up
• Reduction in empty episodes
• Risk stratified
• Informed supported self management
• Evidence based
• Access to universal and specialised community services
• As close to home as possible
• Cost effective
National Cancer Survivorship Initiative
Living as normally aspossible for as long as possible
Children and Young People
National Cancer Survivorship Initiative
Having the best possibleexperience of living withand beyond cancer
Children and Young People