Transcript Developing the NCSI 2012 document
Developing the NCSI 2012 document:
taking action to improve outcomes
National Cancer Survivorship Initiative
What I will cover
• Why now?
• Purpose • Process • Emerging thoughts • What we need from you National Cancer Survivorship Initiative
Why now? (1)
• Cancer survivors needs are not being fully met • Poor survivorship: – Damages outcomes (mortality, quality of life, patient experience) – Costs money (preventable ill health, avoidable emergency admissions more expensive treatment and care) • We can’t do more of the same - from 1.7 million survivors now to 3 million in 2030...
National Cancer Survivorship Initiative
Why now? (2)
• To date focus has been: – Researching – extent, needs, impact – Developing – communities of interest – Testing – new approaches – Evaluating – feasibility, effectiveness • But not many patients have benefitted in the ‘real world’...
• Some interventions are ‘rollout ready’ - now we need to deliver better survivorship support at scale National Cancer Survivorship Initiative
2012 should be a step change
Investigate 2009 Time
National Cancer Survivorship Initiative
We are here Innovate Implement 2015
If we go no further, we’ve failed
National Cancer Survivorship Initiative
Our challenge: Turn promising examples into routine practice
National Cancer Survivorship Initiative
Moving on from uncertainty
National Cancer Survivorship Initiative
Good survivorship will...
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Help people live longer Improve their quality of life Support them in making a faster and fuller recovery from cancer
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Enhance their experience of care Protect them from avoidable harm National Cancer Survivorship Initiative
Developing the document NCSI workstreams Feedback from patients Next steps document NDP workshops
National Cancer Survivorship Initiative
NCSI Symposium Pilots and test sites Research Feedback from clinicians
Testing our thinking
• NCSI project templates • ‘Dragon’s Den’ • NDP workshops • Macmillan clinical advisory board • Today National Cancer Survivorship Initiative
National Cancer Survivorship Initiative
Taking action
Treatment Active & recurrent disease Promoting recovery Managing consequences of treatment
National Cancer Survivorship Initiative
Sustaining recovery
Support from point of diagnosis
• Survivorship starts from the point of diagnosis – work discussions start now • Patient experience and quality of life are linked: taking action to improve one will benefit the other • Critical role of CNSs / AHPs • Peer Review?
• National Cancer Patient Experience Survey?
• Information prescriptions?
National Cancer Survivorship Initiative
Promoting recovery
• The package (assessment and care planning, treatment summary, cancer care review and health and wellbeing clinics) • Prehabilitation • ‘Rehabilitation prescriptions’?
• Tariffs for phases of care? Best practice tariffs? CQUINs?
• Peer Review?
National Cancer Survivorship Initiative
Sustaining recovery
• If physical activity was a drug, its efficacy would mean it was considered a ‘wonder drug’ • Follow-up: tailored and risk stratified • Efficiencies in follow-up need to be matched by investments in other areas of the survivorship pathway – but whose responsibility is this?
• Cancer care review template?
• National Cancer Patient Experience Survey?
• Best practice tariff?
National Cancer Survivorship Initiative
Managing the consequences of treatment
• Most patients will need to manage some consequences of their treatment • The nature of consequences will vary – ‘the Maher classification’ • Failure to manage the consequences costs money and lives • Breast Radiotherapy Injury Rehabilitation Service (BRIRS) • READ codes • CQUIN for use of PROMs National Cancer Survivorship Initiative
Managing the consequences of treatment – key principles
• Prevent or minimise consequences where possible • Inform patients of potential consequences when these are known and document these in treatment summaries • Identify groups at increased risk of late effects (long term follow-up of patients in trials; recording through national datasets) • Monitor at risk patients consistently • Respond where a new risk is identified, utilising PROMs and health service datasets and informing patients • Provide appropriate services for patients suffering from the consequences of treatment National Cancer Survivorship Initiative
Active and recurrent disease
• Key principles for survivorship apply • CNSs and palliative care really matter • Addressing weaknesses in the intelligence is a priority • What does the metastatic MDT look like?
• What are the true costs of active and recurrent disease?
• Which outcomes matter most to patients?
National Cancer Survivorship Initiative
National Cancer Survivorship Initiative
Your task
• Have we identified the right issues?
• How do we get the whole system to prioritise survivorship support?
• Will the levers work?
• What are we missing?
National Cancer Survivorship Initiative
It’s as easy as x, y, z...
X%
of providers implementing rollout ready interventions
Y%
of patients being managed differently at the point of recovery
X%
being managed remotely during follow-up National Cancer Survivorship Initiative