The NUH Recovery Package Journey so...

Cancer Pathways Redesign Programme

The NUH Recovery Package Journey so far…….

Implementing the Recovery Package in Greater Manchester

Event – 2nd November 2017

Lisa Janiec - Macmillan Cancer Pathways Programme Manager

Stephanie Day - Macmillan Recovery Package CNS


#TakeAwayMessages

• Background of the NUH cancer pathways

redesign programme

• Implementation approach

• Lessons learnt to date


Overview of Cancer in Nottinghamshire

• Incidence and mortality is higher than the national

average for some tumour sites

• Every day 16 people will hear that they have

• cancer

• Every day 8 people die from the illness

• In 2016/17 4411 people were diagnosed with cancer

• By 2030 over 69,000 people will be living with

cancer

NB: Data does not included non-melanoma cancers


Cancer

Pathway

Programme

Journey

Need to improve

communication

between primary

and secondary care

Need for integrated care

pathways

One size fits all approach to

follow up care

Care closer to home agenda


What we did

• Inclusive Steering Group

• Leadership support from Cancer Lead Clinician

• Task & finish groups to take work forward

• Expansion of implementation team

• PPI engagement to understand local needs

1. Information and Support

2.

Managing my condition

3. Professionals working with

me

4.

Work


What we have achieved to date

Treatment Summaries

Being developed/in place as part of each follow up pathway for Breast, Colorectal,

Gynaecology, Lung, Oncology, Upper GI and Urology

Electronic Holistic Needs Assessment (eHNA) Project

Rolled out to all tumour sites Evaluation completed

Impact mapping tool developed to inform local service developments

Health & Wellbeing Events

Nottingham patient/carer conference Apr 17

HOPE courses running throughout the year

Moving Forward Programme for Breast & Prostate Cancer patients

Maggie's Centre

Cancer Care Reviews

Working alongside Macmillan GP Cancer Leads to support testing of the newly

developed template linked to the recovery package

Four stratified follow up pathways in place (Colorectal, Breast, Gynaecology & Prostate)

Four to be developed by 31/03/2020

(Lung, Upper GI, Urology & Ovarian)

NUH seen as national leader for this work


Treatment Summary Approach

1. Vital part of the stratified follow up pathways

2. Team have to meet up and agree it and then

review it regularly

3. Developed a report with IT to monitor

implementation

4. Can help reduce work but its getting that

message across that’s the hard part……

Challenge = getting all consultants on board

‘What's in it for me?’


Value for GPs?

“Everything in one

place

Contact telephone

numbers and

Alert symptoms”

“Straightforward with

clear instructions for

monitoring and

documentation by

both GP and patients

& earlier identification

of patients needs“

“Treatment aim i.e.

curative/palliative is

excellent as often this

isn't clear on GP

letters/discharges”

"clear

summary of

diagnosis and

treatment and

section on GP

actions"


Value for Patients • 80% of endometrial cancer patients surveyed

recalled receiving the treatment summary

• All of these patients rated it as helpful, with most

reporting it is very helpful

• Patient Quote:

“Received after discharge most helpful thing was

that the treatment aim was defined as curative”


Benefits / The Good

• Provides information and support for patients

symptoms and/or concerns that they may have

• Helps prioritise what’s important to them

• Supports referrals to other services that may be

closer to their home

• Helps them plan ahead from diagnosis to life after

treatment


The Bad

• HNA –not needed ‘we already do it’

• Opening the ‘can of worms’

• Reliant upon key people

• Lone worker CNS

• Sickness

• Ipad's maintenance


The Ugly / Challenging

• Sustainability

• Scope Creep

• ‘Its not a fad’

• ICT

• Migration

• Time


4%

21%

58%

2%

10%

5%

2015-2017 Patients Concerns

I have questions about mydiagnosis/treatment that I would like todiscuss

Emotional/Psychological Concerns

Physical Concerns

Spiritual Concerns

Practical Concems

Relationships/family

Count of concerns raised

Severity score of concerns raised


Cancer Impact Maps in

Nottinghamshire


Health & Wellbeing events


Cancer Care Review & Primary

Care Engagement


Lessons learnt • System wide steering group to support development

of integrated care approaches

• Clinical Leadership as part of the implementation

team to influence peers

• Engage staff to work alongside them to understand

and develop their patient pathways e.g. where to offer

eHNA

• Partnership working is key to develop pathways,

new models of care and support for onward referrals


Contact Details Lisa Janiec – Macmillan Cancer Pathways Programme Manager

Email: [email protected]

Mobile: 07812 268 498

Twitter: @LJaniec

Stephanie Day – Macmillan Recovery Package CNS

Email: [email protected]

Mobile: 07812 268 779

Twitter: @stephday56

Macmillan Cancer Partnership in Nottinghamshire webpage

http://www.macmillan.org.uk/Aboutus/Healthandsocialcareprofessionals/M

acmillansprogrammesandservices/MacmillanCancerPartnershipinNottingh

am.aspx

mailto:[email protected]

mailto:[email protected]

http://www.macmillan.org.uk/Aboutus/Healthandsocialcareprofessionals/Macmillansprogrammesandservices/MacmillanCancerPartnershipinNottingham.aspx



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