1. National Cancer Agenda Jan Chalkley Macmillan Cancer and Palliative Care Lead Nurse

2. National Policies and Guidelines • Calman Hine Report • Cancer Plan • Manual of Cancer Services Peer Review • Cancer Reform Strategy • Improving Outcomes Guidance • Improving Outcomes: A Strategy for Cancer

3. Impact ? • MDT working • CNS workforce • Supportive and Palliative Care guidance: - Holistic Needs Assessment - User Involvement - Patient Information Prescriptions

4. Health Service Reforms • Parliament: Health and Social Care Bill • Commissioning • Public Health • C C Gs • Networks and Senates • NHS Improvement

5. Focus on Outcomes • Reduce premature mortality rates. • Enhance quality of life for people with long term conditions. • Recovery from episodes of ill health. • Ensure people have a positive experience of care. • Protecting people from harm.

6. Prevention and Early Diagnosis • Public Health. • Primary Care prevention ie. smoking cessation • HPV vaccination service. • Cancer Screening Programmes, including QA. • Targeted campaigns to raise public awareness of symptoms and to encourage early presentation. • Cancer Registries.

7. Early Diagnosis • GP’s role. • A risk assessment tool to support GPs is being developed. • GPs – better access to diagnostic tests eg. CXR, Ultrasound, Endoscopy, MRI. • Guidelines to be developed.

8. Quality of Life andPatient Experience • Advanced Communication Skills Training (ACST). • Information Prescriptions. • National Cancer Survivorship Initiative. • Cancer Patient Experience Survey.

9. Quality of Life andPatient Experience cont/. • Results of Survey will be used to incentivise improvements. • Patient Related Outcome Measures (PROMs) will be piloted for cancer. • New tariffs will be developed to incentivise better “aftercare” for cancer patients.

10. Better Treatment (1) • Surgery – better techniques, variations in intervention rates especially in older people. • Radiotherapy – investment to expand capacity.

11. Better Treatment (2) • Implementation of NCAG Report: - quality and safety for chemotherapy delivery; - acute oncology services; - improve chemotherapy data; - Cancer Drugs Fund.

12. In-patient Stays /Emergency Admissions • Most cancer patients do not want to be admitted to hospital. • Scope to reduce in-patient admissions and length of stay. • Enhanced recovery. • This could save over £200m per annum.

13. Supporting Quality Services • Ongoing commitment to multi-disciplinary working. • Cancer Peer Review provides important quality. • National Clinical Audits to be maintained.

14. National Cancer Survivorship Initiative • Promoting recovery: • risk stratification; • treatment summaries/care plans; • rehabilitation and exercise programmes; • work and finance; • Sustaining recovery: • self management programmes; • alternatives to routine follow up ie. remote monitoring; • Consequences of treatment: • late effects;

15. Acute Oncology • Toxicities of treatment. • Complications of cancer. • Cancer of Unknown Primary (CUP). • emerging models; • peer review measures.

16. Summary • Strategy builds on previous guidance • Ambitious and quantifies lives to be saved. • Information, choice, stronger commissioning, new incentives/tariffs will be critical for delivery. • Existing expertise will be critical to success, but with new ways of working.

17. Thank You A busy future for Cancer Services with numerous challenges and developments.