Greater Manchester Cancer Taking Stock: challenges, achievements and progress…and looking forward Lindsey Wilby Macmillan Project Manager – Living with and Beyond Cancer December 2018

Greater Manchester Cancer GM Cancer

What are we not doing today? Greater Manchester Cancer Workshop aims Talking about the Recovery Package, in detail, and considering how we can increase the scale and pace of implementation Learning more about: the relationship between GM cancer and Macmillan the national perspective the Prehab4 Cancer project Participating…debating…challenging…sharing What are we doing today? Going over the basics Talking about other aspects of the LWBC agenda in detail* Listening to me talk all day! What are we not doing today?

Chapter 10 devoted to this area of work

What do YOU want to get out of today? Greater Manchester Cancer What do YOU want to get out of today? It’s your workshop! #RecoveryPackage @GM_Cancer @LindseyWilbyMC Sli.do #8967

Past Present Future Objectives Greater Manchester Cancer Objectives Past Remind ourselves of what we’re doing and why Look back at where we’ve come from, 18 months ago Present What progress have we made? Where are we now? What has stopped us moving further, faster? Future Where do we need to get to? How are we going to achieve that? And know when we have? Are there examples of best practice that we can learn from?

What are we doing and why… Greater Manchester Cancer What are we doing and why… Benefits for patients

What are we doing and why… Greater Manchester Cancer What are we doing and why… Cancer Reform Strategy: set up of NCSI NCSI: Living with and beyond cancer: Taking Action to Improve Outcomes National Cancer Strategy 2015-2020 (AWCCO) NHS Operational Planning Guidance 2017-19 GM Cancer plan (AWCCO: Taking Charge in GM) 2017 2016 2015 2008-2013 2007

Greater Manchester Cancer 18 months ago (June 2017)… Only 4 project managers in post – Pennine, Bolton, Wigan, East Cheshire – out of 10 sites (Unrealistic) target announced No standard approach to implementation Patchy knowledge, and little senior/executive engagement Very few people attempting eHNA (3 Trusts signed up?) No data No agreement as to who was responsible for the delivery of each intervention

Progress to date/current work (and challenges) Greater Manchester Cancer Progress to date/current work (and challenges) Project managers in post in 8 out of 10 sites …10 out of 10 until this week Implementation group Macmillan leads and lead cancer nurses Steering group: standard approach to implementation Needs updating? Further dissemination? GM dataset; third quarter of data due this week capturing c.1500 HNAs per quarter national dataset in progress

Progress to date/current work (and challenges) Greater Manchester Cancer Progress to date/current work (and challenges) Strong engagement with all Trusts, including senior leads and executive leads – clear expectations challenges persist with individual teams and clinicians 9 out of 10 sites signed up to eHNA; varying degrees of implementation time, hardware, connectivity, compatibility, culture 100% target remains in place But remains unrealistic…

Progress to date/current work (and challenges) Greater Manchester Cancer Progress to date/current work (and challenges) Treatment summaries Finally making progress (details later) Health and wellbeing Lots of examples of good practice but no definitive model; resourcing/sustainability User involvement PABC on steering group, implementation group, involved at Trust level, and at all pathway mapping workshops and LWBC events Pathway mapping

Pathway Mapping Workshops Greater Manchester Cancer Pathway Mapping Workshops Planning one for every site-specific pathway board: 7 completed, 1 more planned, ambition to do more Sometimes with charity or industry support Attended by a CNS from every Trust, plus AHPs, PABC, and GM Cancer For each treatment pathway/sub-diagnosis, we map out: when, where, who, whether or not? for each of 1st HNA, 2nd HNA, and treatment summary

Greater Manchester Cancer What else?.....

Where do we need to get to? Greater Manchester Cancer Where do we need to get to? 100% of patients receiving the Recovery Package? HNA? No Formal change request to GM Cancer Board? …backed up by data What (HNA or eHNA), who, where, and when Treatment summaries? Yes!

Where do we need to get to? Greater Manchester Cancer Where do we need to get to? 100% of patients receiving the Recovery Package? Health and wellbeing? Events, no? Information and support, yes Links with Prehab4Cancer Cancer Care Reviews? Yes But quality and timing of these

How are we going to achieve that? What are we doing well? Greater Manchester Cancer How are we going to achieve that? What are we doing well? What could we do better? How will we know when we have? Measurement…NHSE metrics? Other? QoL metric? ePROMS? Are there examples of best practice that we can learn from? What are some sites doing well? What are the barriers to other sites doing the same? Over to you…