The UHBristol experience of implementing the ‘recovery package’ Ruth Hendy Lead Cancer Nurse

Recovery Package Risk stratification of care / pathway re-design Holistic Needs Assessments (+ eHNA pilot) Structured assessment / care planning Health and Wellbeing events End of treatment education / information events Treatment Summaries template of information from acute providers, to GPs (UHBristol CQUINs) Cancer Care reviews (GPs)

Impact of the recovery package For people living with and beyond cancer Increased quality of life Improved health and wellbeing More confidence in their ability to self-manage their health Make appropriate use of resources (eg.↓ in ED and GP attendances) Live longer due to healthier lifestyle and better management of consequences of treatment Wider benefit Stratified pathways Fewer face to face follow ups Reallocation of resources, to focus on those with complex needs

Pathway re-design Support from Macmillan Survivorship Lead eg. Lymphoma pathway re-design Clinician buy-in Mitigation of risk Divisional / Finance team support, costed proposal Proposed to CCGs

Holistic Needs Assessments Structured assessment of needs, linked to care planning Different team implementation models to suit patients Gynae / germ cell – HNA clinics Haematology – postal Lung pilot with CSWs eHNA pilot - £11k Macmillan grant (July’15) iPads for patients to do self- assessments in clinic CNSs / CSWs to do electronic care plan following assessments Care plan can be emailed / CDS to GPs / link to Treatment Summaries

Health and Wellbeing Events – ‘Next Steps’ Macmillan grant / BHOC Friends Venues / staff / catering Initially site specific Evaluations (pre and post) Generic site specific sessions market place (PB, CAB) 2 monthly CNSs: ICE / Medway referrals Macmillan Cancer Support Workers coordinate events Medway ‘clinic’ generate letters Penny Brohn DVD

CNS introduction to the day

DVD from Penny Brohn to set context

Physio session, getting active again

Information and refreshments

Break time – market stall information gathering, meeting other patients, CNSs, AHPs

Health and Wellbeing Events

Treatment Summaries 2014/15 CQUIN 25% of all treatment episodes would generate TS. 100% achieved Q4 CQUIN pump priming to fund project manager time Somerset Cancer Register option Clinical dictation templates: surgeons, oncologists, CNSs, physicians, radiographers Saved to Clinical Document System, electronically accessed by GPs 2015/16 CQUIN to 40% + active monitoring 2016/17 CQUIN to 60% of treatment episodes

Treatment summary

UHBristol Treatment Summary activity

Recovery package activity update across SWAG: North Bristol RUH Bath Weston Taunton Yeovil Cheltenham and Gloucester

Commissioning of the Recovery Package Previous CQUINs / block contract / tariff discussions Engaged CCGs – regular cancer meetings with providers, third sector Bristol CCG has a ‘Living with and beyond cancer’ strategy LWWBC project manager (Macmillan funded – 2 years) to develop evaluation of impact of recovery package activity and progress towards sustainable funding model Macmillan Cancer Support Cancer Transformation Fund bid

Thank you Any questions?