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London Cancer Alliance

London Cancer Alliance. Palliative and End of Life Care Nigel Sykes FRCP FRCGP Consultant in Palliative Medicine St Christopher’s Hospice London. Mission.

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London Cancer Alliance

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  1. London Cancer Alliance Palliative and End of Life Care Nigel Sykes FRCP FRCGP Consultant in Palliative Medicine St Christopher’s Hospice London

  2. Mission London Cancer Alliance will reduce the number of avoidable deaths from cancer in London. Evidence tells us that there are perhaps a 1000 per year, and as we serve 60% of the capital’s resident population this equates to 600 per annum for our system. By combining the clinical and academic strengths of two academic health sciences centres, and one of the country’s leading cancer hospitals and research institutes, with a total of 16 hospitals providing care, we will localise expertise for the common cancers and centralise expertise where appropriate for the rarer cancers to improve outcomes and ensure the best quality patient experience. Late diagnosis is a major problem in London. Our facilities throughout South and Northwest London will enable us to improve access to screening and diagnostics such that treatment at an earlier stage is possible. Some of our harder to reach communities are particularly disadvantaged and we will seek to redress this imbalance. We aim to drive up standards by increasing the numbers of patients enrolled in trials to advance cancer care for all in our community. Above all, we will work collaboratively to deliver safe, kind and effective care.

  3. Objectives • The LCA plans to do this by: • Promoting prevention and early detection of cancer by supporting GPs and influencing public health messages • Improving patient experience with reference to the National Cancer Patient Survey • Ensuring equitable access to excellent clinical care through integrated pathways across primary, secondary, tertiary, community and third sector • Providing local services where possible and centralised services where necessary • Collaboration in world class research and innovation in cancer care • Raising the profile and improving clinical education across the system 

  4. Structure to propose and agree improvements Members/Partners Board Clinical Board Patients Primary Care Research & Development Pathway Group 1 Pathway Group 2 Pathway Group 3 Pathway Group 4 etc Public Health

  5. Pathway Groups will review evidence relating primarily to three areas Outcomes • Pathway groups will review the latest data and evidence to confirm: • The outcome targets that should be set for organisations and individual surgeons • Current performance against these outcome targets, at organisation and individual surgeon level • Outcomes will include survival rates, patient experience measures (and others as appropriate) Other Best Practice (as appropriate) Model of Care Recommendations Pathway groups will undertake a baseline audit of the performance of each organisation against delivery of the relevant Model of Care Recommendations The audit will include review against the model of care co-dependency framework • Pathway Groups will: • Establish and agree current best practice, and develop an exemplar best practice pathway. • Undertake a baseline assessment against the exemplar pathway – confirming the extent to which practice in each organisation is in line with this best practice

  6. Clinical Service Plan

  7. Model of Care Recommendations for Palliative Care

  8. Some challenges for Palliative Care Many of the objectives of the LCA are not directly applicable to palliative care However, some unifying links are the emphases on: Improving the patient experience Education Collaborative research Specialist palliative care involves many providers Most specialist palliative care beds and community provision come from the third sector, not the NHS Outside hospital, a key emphasis is localism Palliative care is much more than cancer Some issues need a pan-London approach, not just LCA

  9. LCA Palliative Care Pathway Group • Core membership now defined • Monthly meetings from March onwards • Finding out what is already done • Baseline audit of palliative care services • Levels of service, to identify variations and inequities • NICE EoLC Quality Standard compliance • User feedback mechanisms • Education outreach • Map the availability of complex palliative care interventions • Review of specialist/generalist interface issues in EoLC

  10. Linking across London Joint meetings arranged with the equivalent London Cancer group Jointly agreed service audit Agreement and action on pan-London issues in End of Life Care, e.g. Standard referral process for Palliative Care Agreed approach to resuscitation decisions Joint input from both groups to the London Clinical Senate EoLC Advisory Group

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