1. What’s on the Horizon Anita Corrigan Nurse Director 11.06.2010

2. The National Cancer Programme  Are we making progress?  How are we making progress?  Where should we focus our efforts to become ‘world class’?

3. Progress on cancer mortality By age group (1995-7 to 2005-7)  All ages:14% fall  Under 75 years:18% fall  Over 75 years: 5% fall

4. How are we making progress?  Prevention  Screening  Better service organisation  Better treatment  Better care

5. Where should we focus our efforts?  Earlier diagnosis  Ensuring cost-effective innovations are disseminated rapidly across the NHS  Survivorship care  Reducing inequalities (by race, age, gender etc.)  Developing new treatments

6. Earlier Diagnosis  Late diagnosis is estimated to result in up to 10,000 avoidable deaths p.a.  Late diagnosis is the major reason for poor survival in the UK  Late diagnosis is almost certainly due to a combination of factors:  Low awareness and late presentation by patients  Delays within primary care  GPs having poor access to diagnostics

7. Uptake of new innovations  In general we are slow to take up new innovations within the NHS  Examples include:  Robotic Surgery  New approaches to radiotherapy (e.g. IMRT)  New cancer drugs  This is not simply due to cost constraints or delays in getting decisions through NICE

8. Survivorship Care  There are now around 2 million survivors of cancer in the UK  We need to focus more on their quality of life and their care after primary treatment  Personalised assessment, information and care planning will be central to this.

9. Reducing inequalities  Major disparities in incidence, uptake of screening, stage at presentation, treatment, survival and experience of care according to:  Race  Age  Gender  Social deprivation  Lifestyle factors (incidence) and late diagnosis (survival) are key factors  Collection of detailed information MDT level is essential to assess optimum care is being delivered.

10. Cancer Drugs  Some new drugs are making a very significant impact e.g.  Imatinib in chronic myeloid leukaemia  Rituximab in Non Hodgkins Lymphoma  Trastuzumab in HER2 positive breast cancer  For many other drugs the impact on survival or mortality is at best ‘modest’ – though individual patients can benefit significantly  New drugs have an important role in the ‘war on cancer’, but are only one part of the picture.

11. The QIPP Challenge National Cancer Survivorship Initiative QUALITY PRODUCTIVITY INNOVATION PREVENTION

12. Why do we need QIPP  Predicted £15 to £20bn shortfall in NHS Funding from 2011-2014  Above inflation investment and growth in last decade not sustainable  Increasing demand: Older people; Drugs; A&E;  We need a combination of:  New Care Models  Clinical Excellence  Productivity & Efficiency  Cost control QUALITY UP COST DOWN

13. Engaging patients “ the involvement of the public in the NHS must be embedded in its structures: the perspectives of patients and of the public must be heard and taken into account wherever decisions affecting the provision of healthcare are made” Ref: Learning from Bristol: the report of the public inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984 - 1995

14. Engaging patients “It is self evident, but worth repeating, that the NHS can meet people’s needs better if we listen to what people tell us, instead of relying on existing knowledge and assumptions. We can develop better, more responsive services if we involve and truly listen to not only those who are already using services, but those who are not.” Patient and Public Engagement Toolkit for World Class Commissioning, 2008

15. The Duty to involve and consult NHS organisations must make arrangements to involve users, whether directly or through representatives (whether by being consulted or provided with information, or in other ways) in: planning the provision of services the development and consideration of proposals for changes in the way services are provided, and decisions to be made affecting the operation of services. Section 11. Health and Social Care Act

16. How do we involve the public, understand the patient and carer experience and gain involvement?

17. Department of Health North West Strategic Health Authority Merseyside & Cheshire Cancer Network Taskforce Cancer Network Partnership Group National Cancer Patient Forum Clinical Network Groups Locality GroupsNetwork Projects etc e.g. patient survey

18. What’s next for MCCN building relations with LINks, key stakeholders and partners drawing on patient influence when redesigning services Using patient feedback to improve services Engaging different elements of population

19. We need you! Challenges are what make life interesting; overcoming them is what makes life meaningful. Joshua J. Marine

20. Thank You!