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

2. 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)

3. 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

4. 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

5. 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 ed / CDS to GPs / link to Treatment Summaries

6. 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

7. CNS introduction to the day

8. DVD from Penny Brohn to set context

9. Physio session, getting active again

10. Information and refreshments

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

12. Health and Wellbeing Events

14. 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

15. Treatment summary

16. UHBristol
Treatment Summary activity

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

18. 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

19. Thank you
Any questions?