YCN Executive Rehabilitation Group. Annual Report. April March 2012

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1 YCN Executive Rehabilitation Group Annual Report April March 2012 Agreement Cover Sheet This Annual Report has been agreed by: Position Name Organisation Chair of the NCCG Sherry Mckiniry Yorkshire Cancer Network Date Agreed June 2012 Position Name Organisation Chair of the Network Board Dr M Walsh NHS Calderdale Date Agreed 03/10/2012 NCCG members agreed the Annual Report on: Date Agreed June 2012 Page 1 of 8

2 Introduction The now extended Rehabilitation group had been in existence four years initially under the Chairmanship of the YCN Nurse Director however since April 2010 the group has been chaired by the Macmillan AHP Lead who has worked to develop links with other AHP clinicians and extended the membership to include radiotherapists and key AHP clinicians from Primary and Secondary care across the YCN area. The Network Cancer Executive Rehabilitation Group was established in January 2011 and facilitates the collaboration of providers and users of cancer services in order to provide optimum care. These services will be developed through close liaison with commissioning colleagues and will be based on best clinical practice, including relevant Improving outcomes Guidance. The Group is the main source of clinical advice to the Yorkshire Cancer Network Management Board on all matters relating to cancer rehabilitation. The group liaises through workshops and consultations with the extended rehabilitation group and with AHPs sitting on the network site specific Specialist groups. This Annual Report for the Yorkshire Cancer Network (YCN) Executive Rehab Group covers the period April 2011 to March Following publication of the National Cancer Peer Review Rehabilitation measures a consultation process was undertaken through Network organisation lead cancer nurses and rehabilitation managers to establish appropriate representation from rehabilitation services across the network to address the agenda as set out in the peer review measures. Key Achievements for April 2011 March 2012 The following are the Executive Rehab Group s key achievements: Development of the Executive Rehabilitation Group. An updated baseline mapping exercise was undertaken during October 2011 and included collecting data for both specialist cancer and generalist AHPs (08-1E-101v) (see appendix 1). Wide clinical engagement in the development of rehab pathways. Continuing the development and refining of the Site specific cancer Rehab pathways. Brain & CNS, Head & Neck, Breast, Upper GI & Pancreatic, Colorectal, Gynecology, Lung, Urology, MSCC (08-1E- 103v,104v, 105v,106v,107v,109v, 111v). Developing the generic rehab pathway that supports the Holistic Needs assessment, this has been adapted at a national level. The group are also developing a condensed trigger sheet for referral to rehab services that supports the holistic needs assessment. Further establishment of site specific specialist groups whose membership include Specialist nurses and relevant AHPs in Breast to as well as the continuation of those already established for Upper GI, Pancreatic and Head and Neck Cancer. Key Challenges for the Future Increase AHP representation and input into NSSGs. Complete and agree the remaining site specific pathways. Ensuring the site specific and generic pathways are implemented into practice using audit to monitor implementation and identify gaps. Establish Network Leadership for Rehab across the network. Maintain the Executive Rehab group with reduced AHP leadership role to ensure effective representation from all localities across the network and lymphoedema. Maintain the engagement of the extended cancer rehabilitation group. Page 2 of 8

3 Continue to ensure the AHP members of the Network Site Specific Specialist Groups have effective links with and into the Network Executive Rehabilitation Group. Develop and support the implementation of the education and training strategy for cancer rehabilitation. Complete the service specification, needs assessment and development strategy for cancer rehabilitation. Ensure the ongoing emphasis on the rehabilitation needs of cancer patients with in the NHS reform and emerging Strategic clinical networks. Meeting Schedule/ Attendance Locality areas Trust Name 08/09/ /11/ /03/2012 Leeds Bradford and Airedale Calderdale Kirklees and Wakefield Harrogate York Yorkshire Cancer Network Service User Representative 1 AHP professional groups AHP Professional Group 08/09/ /11/ /03/2012 Dietician 1 1 Physiotherapist 1 1 Occupational Therapist Speech and Language Therapist Lymphoedema Specialist Chair For this period Sherry Mckiniry, AHP Lead, Yorkshire Cancer Network chaired the group. Vice Chair For this period the vice chair of the group was Nicola Byrne. Page 3 of 8

4 Category 1 Group function and fitness for purpose 2 Service developments 3 Service improvement and redesign 4 Governance and audit 5 Workforce development and Progress The group has agreed constitution and Terms of Reference which are reviewed in conjunction with the Network Programme for the review and development of Network Groups. The Executive Rehabilitation Group has agreed the work programme. The Network has continued to support and develop combined specialist nursing and AHP groups to formulate and gather the appropriate information and contacts required to help inform the rehab pathways. A further group for Breast has been established this year. The Executive group have maintained engagement with the wider rehabilitation group via consultation and collaborative working by the network AHP Lead. The Executive group has developed over the last year becoming more focused on the work to be achieved. Service user representative became a member and attended the group. The group continues to develop and refine a generic rehabilitation pathway based on and aimed to support the Holistic needs assessment and to cut across all cancer sites. The generic pathway has been shared and adapted for national use. Triggers for referral to support the HNA are being agreed. Work continues to develop refine and agree the site specific rehabilitation pathways to ensure they are fit for purpose: Breast, Lung, Colorectal Gynecological, Pancreatic and Upper GI, Urological Haematology, Head & Neck, skin, Brain and CNS, Sarcoma and MSCC (08-1E103v, 104v, 105v, 106v, 107v, 108v, 109v, 110v, 111v, 112v). These pathways highlight the rehabilitation needs specific to the cancer site and to the point in the patient pathway. These pathways will be used in conjunction with the generic cancer rehabilitation pathway. The pathways are based on the national rehabilitation pathways Where specialist site specific groups exist the pathways have been developed in collaboration with those groups. All the pathways have been developed with collaboration with AHPs across acute and primary care. Work has commenced on the development of the service specification and needs assessment (08-1E-113v, 114v). In June 2010 a meeting was set up between AHPs and lymphoedema specialists working with Breast cancer patients across both the YCN and HYCCN to kick start the pathway work for both networks with the aim of formulating the appropriate clinical indicators and interventions. The YCN have Initiated a review of existing rehabilitation services referral criteria. Began the development of key questions to support the identification od rehabilitation needs as part of the Holistic needs assessment process. The establishment of Network Site specific Specialist groups with Specialist nurses and relevant AHPs for Upper GI, Pancreatic and Head and Neck. These groups provide nursing and rehabilitation advice directly to the relevant NSSG. Commenced the development of the cancer rehabilitation education and training strategy (08-1E-116v) Page 4 of 8

5 Category education Progress Carried out an update of the baseline mapping exercise of current cancer rehabilitation services across the network. (08-1E-101v) (see appendix 1). 6 Research and development Page 5 of 8

6 Appendix 1 Summary of the 2011 AHP Mapping (08-1e-101v) A further update of the 2009 baseline mapping took place across the network localities in 201. This attempted to gather data across both specialist and generalist rehab services in order to identify the broader cancer workforce; however, data gathering was difficult due to a number of factors: poor return of information, the recent restructuring of services and the transfer of provider organisations from PCTs to alternative host organisations. There appeared to be a general lack of knowledge regarding numbers of staff and location of posts involved. Therefore the numbers used in these predictions should be viewed with caution. Table 2 shows Cancer/Palliative Care AHP specialist posts this does not represent the WTE of specialist s working in cancer. A number of posts only have a limited dedicated time for cancer care making it difficult to identify the exact WTE across the Yorkshire Cancer Network in Oct Table 2 OT Physio SaLT Dietetics Lymphedema Total With regards to practice setting for specialist cancer services within the Yorkshire Cancer network the majority of services are based wholly within the acute sector and hospices. Community based cancer services are very limited with the majority of rehabilitation being provided by non cancer specialists as part of their general case load. A small number of staff provide services both within acute/community, acute/hospice or community/hospice. Fig 2 graph shows YCN Cancer Specialist/dedicated AHP posts (Sept 2011) Series OT PT SLT D LY Page 6 of 8

7 Table 3 mapping exercise 2011, shows workforce data for Yorkshire cancer Network for all registered AHPs across all bandings by locality (levels 1-4) & includes community staff who spend various periods of time with cancer patients but are not necessarily specialist s in cancer care i.e. level 2 These figures also represent AHPs working in mental health and LD. It is not currently possible to estimate what percentage of their time is spent delivering cancer specific interventions. Organisation OT Physio SaLT Dietetics Lymphoedema Airedale FT (Acute services) Skipton Bradford Teaching Hospitals FT (Acute and community) Bradford Bradford District Care Trust (Community, Mental Health & LD) Saltaire/Bradford Calderdale & Huddersfield FT (Community & Acute care) Halifax & Huddersfield Harrogate & District Hospitals Harrogate Kirklees/Locala Community/PCT Includes Batley, Dewsbury & Huddersfield Leeds TH Leeds & Wharfedale Leeds & York Partnership NHS FT (Mental health & LD) Leeds, North Yorkshire) Leeds Community Health Care ? Mid Yorkshire NHS Trust South Leeds, North Yorkshire, Barnsley & Doncaster South West Yorkshire Partnership F T (Community, Mental Health & LD) Barnsley, Calderdale, Kirklees, Wakefield-& the Humber York Teaching Hospitals NHS FT York, Harrogate, Selby, Scarb/Ryedale Totals (Mapping exercise October 2011) Page 7 of 8

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