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Item 8
19 March 2014
Subject:
Report of:
Summary
The purpose of this report is to inform the Health and Wellbeing Board of the
development of the Manchester Cancer Commissioning Board, to provide an update
about the Manchester Cancer Improvement Partnership (MCIP) Programme and
outline of a proposed launch for consideration.
Recommendations
The Board is asked to:
To endorse the aims and objectives of the Manchester Cancer Commissioning
Board
To endorse the aims and objectives of the Manchester Cancer Improvement
Partnership Programme
To approve the MCIP programme launch as described
Contact Officers:
Name:
Position:
Telephone:
E-mail:
Janet Tongue
Manchester Cancer Improvement Partnership
0161 765 4051
janet.tongue@manchester.nhs.uk
Name:
Position:
Telephone:
E-mail:
Coral Higgins
City Wide Commissioning Team
0161 765 4051
coral.higgins@manchester.nhs.uk
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The following documents disclose important facts on which the report is based and
have been relied upon in preparing the report. Copies of the background documents
are available up to 4 years after the date of the meeting. If you would like a copy
please contact one of the contact officers above.
Macmillan Cancer Improvement Partnership in Manchester: DRAFT baseline report
2013
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1.
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Background
1.1 The Greater Manchester and Cheshire Cancer Summit in 2012 agreed a
vision for world class cancer care which included:
Manchester is 150th out of 150 for premature mortality from cancer(June 2013
data from the Longer Live website)
that are based on population needs as well as clinical evidence for best
practice
that offer value for money, that can be re-invested to further improve the
experience and outcomes for our patients.
1.5
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1.6
1.7
North Manchester
CCG
NW Specialist
Commissioning / NHS
England GM / Strategic
Clinical Network
Central Manchester
CCG
South Manchester
CCG
Manchester Cancer
Commissioning Board
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Greater Manchester
Cancer Commissioning
Strategy Board
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1.8 The Macmillan Cancer Improvement Programme (MCIP) forms part of the
work of the new Commissioning Board, further information is given below.
2.
2.1 The MCIP Programme aims to deliver changes to help achieve the vision
agreed at the Manchester Cancer Summit along with the Macmillan 9 outcomes.
MCIP is funded by Macmillan Cancer Support and has been designed in 2 Phases.
Phase 1 invests 2.35m in primary, palliative, community and end of life care. It
includes enhanced training for the health and social care workforce and the
development of new palliative care services. This is expressed diagrammatically
below and further information is given in Appendix 1.
Figure to show Work stream outputs
From p.41 ICF GHKEvaluation of Phase 1 of the Macmillan Cancer Improvement
Partnership in Manchester: DRAFT baseline report
2.2 Phase 2 invests a further 1.1m into local redesign work and is focused on
reviewing and improving breast and lung pathways. The funding agreement for the
second phase of the MCIP programme was signed by the Chief Officer of South
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The rationale to redesign the lung pathways is based on: pathway complexity,
higher lung cancer incidence and mortality levels in Manchester than
elsewhere.
The rational to redesign breast cancer pathways is based on unsustainability
of current follow up models and need to respond more to issues related to
survivorship.
2.3 The commencement in post of the MCIP Programme Lead and agreed shape
of a Programme Team marks a shift towards implementation for the MCIP
Programme. The Phase 1 staff structure has now been agreed and is being recruited
to (posts are fixed term until December 2015).To create some delivery capacity in
advance of filling the fixed term posts, a skeleton Programme Team has been
created.
2.4 A number of key deliverables in Phase 1 have been identified and work is
progressing to implement these:
While, further work is required to create fully developed plans, good progress is
anticipated for all of the key deliverables identified.
2.5 Work has also started to consider how best to implement Phase 2. An
initiation meeting will be held involving key stakeholders to ensure agreement to the
way forward and clear linkages to other initiatives. The Phase 2 team leader post
(called Deputy Programme Lead) has been agreed and is also out to recruitment.
3.
3.1
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3.2 The MCIP Board has considered a launch format to include a morning focused
on more strategic areas and afternoon geared towards an event. It is proposed that
this takes place on 26 June 2014, 10am-2.30pm. Key features of the launch are
proposed as:
A prominent city centre venue Town Hall combined with outside space
(Albert Square) for street teams; publicising cancer screening, information
stalls.
3.3
3.4 Invitees will include: People affected by cancer; community groups; voluntary
sector, Information stalls key services to provide information on their role in cancer
care; clinicians / healthcare managers, Public Health; local MPs, Local councillors,
NHS England and the media.
3.5
It is anticipated that given the focus on user involvement at this event that:
3.6 Communications to clinicians and key partners will be in place ahead and after
the launch to provide tailored information.
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Appendix 1
MCIP Outcomes and additional information
Primary care work stream
Background
Patient experience surveys show that there is a wide variation in the levels and
standards of support received in general practice in terms of early recognition of
signs/symptoms of cancer, early referral and subsequent support offered during and
post diagnosis. The proportion of patients with a cancer diagnosis within a practice is
relatively low in comparison with other disease specific groups. It is also accepted
that where patients are diagnosed at a late stage via primary care or diagnosed via a
medical emergency route their relative survival rates are compromised.
It is acknowledged that the use of cancer registers is sporadic and are frequently out
of date so they are of limited use to the practice to support patients.
Cancer care reviews are not undertaken consistently across the 102 general
practices and nor do they assist in helping practices support the holistic needs of
patients. This is compounded by GPs and practice staff often feeling ill prepared in
supporting and talking to patients affected by cancer. This situation is exacerbated
by the lack of information and support surrounding cancer in general practice
available to patients, carers and primary care staff.
Activities
Activities and service delivery targets have been selected as a result of Macmillans
extensive experience of cancer care best practice and their endorsement of a
number of national health initiatives.
Outcomes
GPs have increased knowledge to enable early referral and regularly use
national cancer decision tools.
People affected by cancer are more informed about their condition, how to
manage it and where/when to seek support.
Community Care Work stream
Background
There is a growing recognition that cancer after care is not as effective as it could be
due to fragmentation between the various providers. This can cause patients to feel
disempowered to manage their own condition and often feel isolated.
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People living with cancer have on-going unmet needs from their cancer and
treatment, for example late side effects of treatment, greater risk of other long term
conditions and risk/fear of cancer recurrence.
There is also a drive to deliver care in the community and closer to home, to improve
patient experience and meet needs after treatment.
Outcomes
Improved quality of care and patient experience. People with cancer feel that
their individual needs are thoroughly assessed and understood.
People are more informed about their condition, how to manage it and
where/when to seek support.
Improved health and well-being and quality of life for people affected by
cancer.
Supported, Palliative and End of Life Care Work stream
Background
The evidence shows that the system in Manchester needs improving and that there
is inequity in end of life care where 63% of patients die in hospital. From the 2012
patient experience survey only 38% of patients felt they were given enough support
by health and social care services following hospital discharge.
Outcomes
All GP practices establish a robust palliative care register and have monthly
palliative care practice meetings.
Increase the number of patients who have a recorded preferred place of care.
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MCIP Phase 2
Expected outcomes
The agreement is for 1.1m of Macmillan Cancer Care support funding to be used to
improve outcomes for breast and lung cancer patients as set out below.
Intended outcomes following Lung Pathway redesign:
Redesign of the diagnostic pathway which will improve efficiency and improve
patient experience and out comes
Lung cancer patients will be well informed and have the right information and
support that is right for them. When new problems emerge patients will be
supported through anticipatory planning
Patients and their carers will feel supported in both palliative and end of life
care
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Patients are offered information about their cancer, and their support and
treatment options, including the short and longer term consequences of
treatment
Patients are given support through treatment itself, including support for life
style changes
Carers support needs are addressed
People living with and beyond cancer are empowered to self-manage their
condition based on their needs and preferences and are informed to do so
There is a greater focus on recovery and health and wellbeing after cancer
treatment
Movement away from a single model of follow up to tailored support that
enables early recognition of the consequences of treatment and the signs and
symptoms of further disease
Patients are offered tailored follow up to meet their needs which will ensure
that their needs will be better met and resources used more effectively
Patients know how to maintain a healthy lifestyle including the benefits of
physical activity
User groups for people affected by cancer understand what should be
available and can participate with confidence in local discussions with
commissioners and providers
Patient who are concerned about a recurrence know how to re-access
specialist care
Patients who are at EOL have choice in their preferred place of care and
access to the right professionals and support at the right time.
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