Commissioning cancer survivorship

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1 Transforming Cancer Services for London Commissioning cancer survivorship - an overview Paul Chiles, Programme Manager, Transforming Cancer Services for London programme, NHS England

2 Key areas of focus for 2013/14 onwards a) Having a clear implementable Early Detection strategy (building on the findings of the emergency audits, early detection workstream and other clinical expertise). b) Reducing variation by implementation of standardised services using clinically agreed protocols aligned to Best Practice Commissioning Pathways c) Improving patient experience and care coordination through implementation of the new high impact tools for living with and beyond cancer (Holistic Needs Assessment, Care Plans and Treatment Summary) It is proposed that there should be phased approach, initially applied to specified pathways e.g. breast and lung. d) Implementation of a clear chemotherapy commissioning strategy e) Implementation of a radiotherapy commissioning strategy f) Reduction in variation in palliative care across London

3 What are the challenges/issues for survivorship? Influencing NHS commissioners to support development Influencing CCGs to support cancer services Influencing CCGs to support cancer service development Influencing primary care

4 Commissioning timetable for 2014/15 round Developing proposals for discussion with CCGs End June 2013 Discussion/engagement with CCGs July/August 2013 Draft Commissioning Intentions 2014/15 issued 30 th September 2013 Completion of any detailed planning End November 2013 Contract negotiation period January to March 2014

5 From commissioning to contracting to delivery Commissioning preparation phase Commissioning governance Contracting phase W/stream W/stream W/stream Draft Cancer Commissioning Intentions Sp. Comm. Screening CCGs Cancer leads Commissioner governance PLCUP CCGs CCLAG NHS Eng. Note:- CCLAG = Cancer Clinical Leadership Advisory Group PLCUP = Pan-London Cancer User Partnership Cancer Commissioning Board CCGs NHS Eng. CSUs Spec. Comm. Screening Primary care Health and wellbeing boards Community care providers Secondary care providers Primary care providers

6 Influencing CCGs Operating Plans 2013/14 (1) Plans should demonstrate how the following priorities, recommended for adoption for 2013/14, are being taken forward: Improving Early Detection Improving GP access to diagnostic testing for suspected cancer, ensuring direct access for specific tests (including endoscopy) Delivering care closer to home Implementation of four Best Practice Commissioning Pathways Improving the provision of chemotherapy services Improving the consistency of palliative care services Consolidating specialist care Delivering appropriate consolidation of services in line with the Model of Care Planning consolidation of highly-specialist services

7 Influencing CCGs Operating Plans 2013/14 (2) Improving consistency in care provision Reduce unwarranted variation in care along pathways and ensure compliance with IOG standards Recognising cancer as a long term condition Improving services for people living with and beyond cancer, including implementing the National Cancer Survivorship Initiative recommendations Improving communication between secondary/tertiary and primary care Working towards the provision of seamless care for people with cancer Delivering productivity and efficiency Ensuring the effective use of financial and performance data for commissioning purposes

8 Using the contracting process to deliver service improvement

9 Best Practice Commissioning Pathways

10 Quality Requirements included within the 2013/14 contract documentation

11 Extract from Quality Requirements in 2013/14 contract documents Domain 3: Helping people to recover from episodes of ill-health or following injury Quality requirement Threshold Method of measurement Implementation of the 50% of patients to National Cancer have been offered a Survivorship Initiative HNA requirements Holistic Needs Assessment by March 2014, 50% of patients to have been offered a HNA Implementation of the National Cancer Survivorship Initiative requirements Treatment Plan by March 2014, 50% of patients to have a Treatment Plan Implementation of the National Cancer Survivorship Initiative requirements Treatment Summary by March 2014, 50% of patients to have a Treatment Summary 50% of patients to have a Treatment Plan 50% of patients to have a Treatment Summary Providers to report via local data flow, with COSD being discussed as a longer term data flow Providers to report via local data flow, with COSD being discussed as a longer term data flow Providers to report via local data flow, with COSD being discussed as a longer term data flow Consequence of breach Provision of action plan and improvement trajectory (data). Provision of action plan and improvement trajectory (data). Provision of action plan and improvement trajectory (data).

12 Quality Requirements being developed for 2014/15 contract documents Extensions of 2013/14 metrics:- Holistic Needs Assessment:- Offered to 75% of people (50% in 2013/14; 100% in 2015/16) Taken up by x% of people Care Plan:- Offered to 75% of people (50% in 2013/14; 100% in 2015/16) Taken up by x% of people Treatment Summary:- Offered to 75% of people (50% in 2013/14; 100% in 2015/16) Taken up by x% of people New metrics being proposed/developed:- Health and wellbeing event Monitoring physical activity Managing the consequences of treatment Improving patient experience

13 Cancer commissioning in London 2013/14 Transforming Cancer Services for London programme team Integrated Cancer System PCT PCT CCG Provider Commissioning Support Unit Cancer Commissioning Team Provider Provider

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