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Cancer Network Review

Cancer Network Review. Peter Gent & Peter King. Do We Need A Regional Overview Of Cancer Services?. Collectively we account for less than 20% of the national cancer incidence – strength in partnership rather than in isolation

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Cancer Network Review

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  1. Cancer Network Review Peter Gent & Peter King

  2. Do We Need A Regional Overview Of Cancer Services? • Collectively we account for less than 20% of the national cancer incidence – strength in partnership rather than in isolation • Affects 1:3 of the population in a lifetime and has a significant health burden on families and individuals • Escalating costs associated with diagnosis, staging and treatment (chemotherapy treatments have gone up from 8000-28000 in Grampian alone) presenting challenges around delivery, capacity & affordability

  3. Regional costs associated with chemotherapy treatments alone are £30m (excluding research funded treatments) with considerable evidence that efficiencies can be achieved through a collective approach • Workforce distribution issues and evidence of imbalance that could be addressed through joined up planning and redesign • Island clinical services will be at risk if not part of a wider clinical network of care

  4. Current & emerging governance issues in relation to clinical care which should be regionally and or nationally agreed, thereby stripping out unnecessary duplication of effort at Board level e.g. CEL 17, HDL (29) 2005, NCEPOD • Addressing recommendations arising from ‘Radiotherapy in Scotland’ 2010 that have a regional context, particularly for the north • Some clinical services are delivered and managed regionally e.g. gynae, lung • A formal footprint & structure for regional planning & working exists – i.e. NoSPG • WOSCAN have demonstrated the value of taking on difficult service configuration decisions

  5. Requirement for service contingencies when either manpower issues or key equipment failures force alternative patient pathways or capacity / service support through neighbouring Boards • Too many excuses are made of the ‘3 Cancer Centre’ position in the north • Major service planning and delivery issues in relation to remote and rural geography

  6. A Case For Change? • Board priorities are different from when NOSCAN was established and the current workplan is not necessarily aligned to the major pressing issues • Networks no longer a conduit for funding which has changed the dynamics with services • Major focus initially was preparing the Boards for the 2005 waiting times targets which has now moved on • The ‘brand’ is bigger than the service – NOSCAN is actually a region and not a department

  7. Increasingly good argument to move some tumour specific networks into a national forum • Increasingly best practice clinical guidelines and clinical standards are marginalising locally available services e.g. breast cancer services • Clinical engagement has improved but key decision makers are missing i.e. finance, senior management and planning leaving keys gaps in representation to deal with the major and pressing priorities • Too many ‘information’ meetings

  8. What Might We Retain • Regional Planning Forum • Strengthen alignment to NoSPG • Default to national tumour specific MCN’s & regional only where explicitly justified • Central Government link - Government use the existing network structures as a major communication conduit and co-ordinating point for multiple national workstreams concerning cancer • Cancer information services & governance • Clinical engagement

  9. What Ought We Add? • Improved regional forum, with revised membership, fewer meetings but empowered to make decisions and provide the Boards with high-level advice around a more focused and challenging workplan • Re-branding • Open dialogue with WOSCAN & SCAN around more nationally organised MCN’s (it’s what most clinicians seem to want)

  10. Improved links to Board information services to generate the important data (activity, finance etc) that will support the efforts of a regional planning forum and allow greater insight and challenge of existing systems & services • Support constituent Boards in cross Board service developments which may be outwith the north grouping • Monitoring of regionally agreed SLA’s and relevant ongoing service evaluation of these

  11. Suggested Priorities • Fewer workstreams more focused around the current Board priorities • Lead on regional efficiency programmes in relation to cancer services • Performance monitoring & QA of the key cancer CEL & HDL’s (external peer review) • Address the regional issues emerging from Radiotherapy In Scotland • A detailed cancer services benchmarking exercise • Pursue some national alignment of current work

  12. Example of approach • A requirement that any cancer service specific development costing e.g. £75k or above includes evidence of regional consideration • Test out that regional solutions have been considered and appropriately evaluated • Instil business as usual approach to regional planning • Improved transparency of investment and help address some of the imbalance and existing equity issues • Engages operational teams with regional planning processes

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