Cancer Care Alliance Perspective in East England
Explore the launch event and initiatives of the Somerset Cancer Register Remote Monitoring System through a patient-centered approach in the East of England. Details include the population statistics, healthcare structure, and distribution among GP practices, CCGs, trusts, and STPs in the region, shedding light on the challenges and opportunities in cancer care.
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Remote monitoring: An Alliance perspective Somerset Cancer Register Remote Monitoring System Launch Event 12thJune 2019 Sarah Miller Macmillan Senior Programme Manager, Head of Information
Today 1. Setting the scene Cancer in the East of England Our Alliance delivery structure 2. Patient-centred and personalised care 3. Our LWBC work programme 4. Remote monitoring Our approach IT systems Funding and timeline Metrics and Somerset data capture
Cancer in the East of England Population of around 6.9 million as of 2019/20 36,600 people diagnosed with cancer annually 215,500 cancer survivors living within the footprint 752 GP practices 20 CCGs 17 acute trusts 6 STPs Cambridge University Hospital Cambridgeshire and Peterborough STP 1 CCG NHS Cambridgeshire and Peterborough CCG 3 trusts 102 GP practices Royal Papworth Hospital North West Anglia Foundation Trust NHS East and North Hertfordshire CCG East & North Hertfordshire NHS Trust Hertfordshire and West Essex STP 3 CCGs 3 trusts 158 GP practices NHS Herts Valleys CCG West Hertfordshire Hospitals NHS Trust NHS West Essex CCG The Princess Alexandra Hospital NHS Trust NHS Basildon and Brentwood CCG Basildon and Thurrock University Hospitals NHS Foundation Trust NHS Castle Point and Rochford CCG Mid Essex Hospital Trust Mid and South Essex STP 5 CCGs 3 trusts 173 GP practices NHS Mid Essex CCG Southend University Hospital NHS Foundation Trust NHS Southend CCG NHS Thurrock CCG NHS Bedfordshire CCG Bedford Hospital NHS Trust Milton Keynes, Bedfordshire and Luton STP 3 CCGs 3 trusts 106 GP practices NHS Luton CCG Luton and Dunstable University Hospital NHS Foundation Trust NHS Milton Keynes CCG Milton Keynes General NHS Trust NHS Great Yarmouth and Waveney CCG James Paget University Hospitals NHS Foundation Trust NHS North Norfolk CCG Norfolk and Norwich University Hospitals NHS Foundation Trust Norfolk and Waveney STP 5 CCGs 3 trusts 111 GP practices NHS Norwich CCG Queen Elizabeth Hospital Kings Lynn NHS Trust NHS South Norfolk CCG NHS West Norfolk CCG NHS Ipswich and East Suffolk CCG East Suffolk and North Essex NHS Foundation Trust Suffolk and North East Essex STP 3 CCGs 2 trusts 102 GP practices NHS North East Essex CCG NHS West Suffolk CCG West Suffolk Hospital NHS Trust
Survivors of 1-5 years All cancers: 9,680 Breast: 2,300 Colorectal: 1,230 Prostate: 2,120 Trust CP STP CCG Trust Trust Survivors of 1-5 years All cancers: 15,140 Breast: 3,690 Colorectal: 1,830 Prostate: 3,560 CCG Trust HWE STP Trust CCG CCG Trust Survivors of 1-5 years All cancers: 12,380 Breast: 3,050 Colorectal: 1,580 Prostate: 2,450 CCG CCG Trust MSE STP Trust CCG CCG CCG Trust Cancer Alliance Survivors of 1-5 years All cancers: 13,190 Breast: 2,920 Colorectal: 1,700 Prostate: 3,350 CCG CCG Trust NW STP Trust CCG CCG CCG Trust Survivors of 1-5 years All cancers: 9,010 Breast: 2,090 Colorectal: 1,120 Prostate: 2,160 CCG Trust BLMK STP Trust CCG CCG Trust Survivors of 1-5 years All cancers: 11,730 Breast: 2,710 Colorectal: 1,550 Prostate: 2,990 CCG SNEE STP CCG Trust Trust CCG
Patient-centred and personalised care for cancer national perspective NHS Long Term Plan vision: By 2021 every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support The NHS National Planning Guidance 2019/20 requests agreed protocols and remote monitoring systems are in place for patients with breast cancer on a person centred follow-up pathway, followed by colorectal and prostate Our Alliance ambition: The self-management follow-up approach will be established in all trusts for breast cancer in 2019 After treatment patients will move to a follow-up pathway that suits their needs, and ensures they can get rapid access to clinical support where they are worried that their cancer may have recurred
Our LWBC work programme Planning Guidance metrics 2019/20: reporting requirements % of Trusts that have clinically-agreed protocols in place % of trusts that have systems for remote monitoring in place Breast only: % of patients on a supported self-management follow-up pathway HNAs Patient experience Outpatient clinic slots Our Alliance transformation funding 2019/20 Focus on breast cancer, then colorectal and prostate Remote Monitoring IT Workforce Personalised care package Health and Wellbeing events Cancer Care in the Community Cancer Care Review pilots Launch of breast cancer patient-centred follow up guidance, 1st March 2019 Lead: Debbie Adger, Senior Programme Manager Guidance available on the Future NHS Collaboration Platform and online Comms plan for local, regional and national stakeholders GP leaflet Patient leaflet
Remote monitoring why? Key focus of breast PCFU for Q2/Q3 2019/20 All Trusts to have robust Remote Monitoring IT systems in place to be able to capture data/produce monitoring reports plus ensure no patient is lost to follow-up What is it? A robust IT remote monitoring system assists specialists to schedule and review surveillance tests for patients who have completed treatment for breast cancer, without the need for face-to-face outpatient appointments Its primary role is to support individuals who are suitable to be on a self-managed pathway, providing reassurance to patients that they will not 'fall through the net' or 'get lost in the system Our approach Build relationships and manage expectations Comms with our STPs and key stakeholders Decide funding for IT systems and workforce Support liaison with Somerset Establishment of timeline for implementation Confirm metrics to address Planning Guidance, assurance reporting and system impact Awareness that data collection will be time lagged i.e. waiting for time to elapse after treatment
Trust CP STP Remote monitoring system Somerset: 3 hospitals CCG Trust Trust CCG Trust HWE STP Remote monitoring system Somerset: 0 hospitals Trust CCG CCG Trust CCG CCG Trust MSE STP Remote monitoring system Somerset: 5 hospitals Trust CCG CCG CCG Trust Cancer Alliance CCG CCG Trust NW STP Remote monitoring system Somerset: 3 hospitals Trust CCG CCG CCG Trust CCG Trust BLMK STP Remote monitoring system Somerset: 2 hospitals Trust CCG CCG Trust CCG SNEE STP Remote monitoring system Somerset: 2 hospitals CCG Trust Trust CCG
Remote monitoring 2019/20 funding IT systems: each trust given equal IT system, maintenance, licensing and server costs Breast, colorectal and prostate Workforce: each trust given equal 0.2WTE CNS 0.6WTE Support Worker Timeline Q1 Q2 Q3 Q4 Confirm funding Confirm metrics, IG + MOU Who has RM in progress? Who needs support? Set up reporting expectations Liaise with Somerset NHSE assurance report RM IT status audit Give support to STPs and trusts Set up metric templates Liaise with Somerset NHSE assurance report RM IT status audit Give support to STPs and trusts Liaise with Somerset Work on funding for 2020/21 NHSE assurance report RM IT status audit First metric audit, baseline Identify issues with data capture RM IT status audit Liaise with Somerset
Remote monitoring metrics: Alliance KPIs: Key metrics we will monitor with expectation these may be asked for nationally Impact metrics: A robust remote monitoring solution has the ability to enable the release of outpatient capacity and can reduce the demand on clinical and secretarial resources Alliance metrics Clear data definitions in Q1 Establish who, how and why to collect Support data quality improvements Consideration of future COSD Aim for Q4 for all trusts to collect data Impact metrics Metric no. Metric 1 New cancer diagnosis: Follow-up ratios for breast patients Number of Surgical outpatient clinics per week Number of Oncology outpatient clinics per week Number of cancer patients seen at each outpatient clinic Average number of new cancer patient slots per clinic Average number of follow-up cancer patient slots per clinic Number of telephone clinics to follow-up cancer patients. Average number of cancer patients reviewed at each telephone clinic which does not require direct patient contact). Average number of cancer patients reviewed at each virtual clinic Re-admission rates for cancer patients Number of planned/unplanned hospital admissions Average length of stay % same day discharge 2 KPIs 3 4 Metric no. Metric 5 6 1 % of individuals on a Patient Centred Follow-Up Pathway % of individuals receiving a Holistic Needs Assessment at diagnosis % of individuals receiving a Holistic Needs Assessment at end of % of individuals receiving a Treatment Summary % of individuals invited to a Health & Wellbeing Event % of individuals attending a Health & Wellbeing Event Number of outpatient clinic slots released 7a 2 7b Number of virtual clinics to follow-up cancer patients (Structured case reviews 3 8a treatment 8b 4 9 5a 10 5b 11 12 6
Remote monitoring metrics: Somerset Somerset Cancer Register system Facility to capture new data items for RM Somerset will be used for capturing some of our KPIs and impact metrics Example:
