1. Cancer provider network workshop 2 nd March 2011

2. Agenda TimeSession 2.00pmWelcome and objectives 2.05pmThe model of care 2.15pmProvider network development 2.25pmWorkshop session 1 Provider network scope and governance 2.55pmFeedback and discussion 3.10pmCoffee 3.30pmWorkshop session 2 Provider network incentives and culture 4.00pmFeedback and discussion 4.15pmClosing remarks and next steps 4.30pmEnd of session

3. Objectives To inform providers of the implementation programme To engage providers in the development of the provider network model and specification To outline to providers the timeframe for specification development and provider network bids To prompt providers to begin provider network discussions and bid development

4. The model of care Chris Harrison

5. Developing the proposals 45 clinicians working over 12 months Three work areas: early diagnosis; common cancers and general care; rarer cancers and specialist care Case for change: December 2009 Model of care: August 2010 Extensive 3-month engagement on proposals – over 85 per cent of survey respondents supportive

6. The case for change Later diagnosis has been a major factor in causing poorer relative survival rates There are areas of excellence in London but inequalities in access and outcomes exist Treatment and care should be standardised Specialist surgery should be centralised: common treatments should be localised where possible Comprehensive pathways should be commissioned; organisational boundaries should not be a barrier

7. The model of care Improve early diagnosis by addressing public awareness, GP access to diagnostics, screening uptake rates and health inequalities Extended local provision of common cancer services, such as chemotherapy and non-complex surgery Further consolidation of surgical services for rarer cancers into specialist centres A small number of networks of providers delivering standardised pathways

8. Implementation workstreams

9. Provider network development Rachel Tyndall

10. Provider network designation Providers will be asked to respond collaboratively to a provider network specification Which network they are in will be the provider’s choice The model of care states that there will be fewer than five in London Only providers in a network will provide cancer services Legal status required for contracting

11. Services Provider networks will be required to demonstrate how they will contribute to the delivery of the model of care: – Early diagnosis – General care – Common cancer – Rarer cancers and specialist care

12. Specification In addition to services, the provider network specification will cover 5 areas: – Scope – Governance – Information – Incentives – Culture

13. Standards Commissioners will set measures and thresholds to assure quality and drive excellence

14. Timeline Event/taskBy London Delivery Group31 st January 2011 Announcement of specification development process8 th February 2011 Individual meetings with providersFeb/Mar 2011 Specification development eventsEarly March 2011 Publication of specificationsApril 2011 Support for bid developmentApr/May/Jun 2011 Individual or group meetings with providersApr/May/Jun 2011 Deadline for bid submission30 th June 2011

15. Workshop 1 Scope and governance Rachel Tyndall

16. The givens Only those part of a provider network will provide cancer services Will contain as a minimum all secondary and tertiary care providers Will demonstrate commitment to implementing model of care for common and rarer cancer services An overarching governance board will manage network as single entity Clinical leadership and management support

17. Some questions Should all providers in the pathway be part of the provider network? Should the network governance board include representation from all organisations? Where will ultimate clinical and contracting accountabilities will sit? Group session (30 minutes on tables) How tight or loose should the overall specification be? Do certain areas require a tighter spec than others?

18. Workshop 2 Culture and incentives Chris Harrison

19. The givens Provider networks will be clear about how they will incentivise constituent parts of the network Incentives should be linked with achieving the best patient outcomes and experience Competition and co-operation rules should be adhered to and patient choice should be maintained Research, education and innovation should be fostered

20. Some questions What can be done to incentivise providers to work differently? How will the network share information across organisations to manage patients along the pathway? Where might competition be used to incentivise improved patient outcomes and experience? Group session (30 minutes on tables) What commissioning incentives would drive the model? What incentives could be used within networks?

21. Next steps Three further workshops with your teams Ongoing work in March on commissioning a provider network Outline specification published in April Ongoing development of the model beyond April Bidding stage from April to June Tailored support available during bid development For further information on the case for change and model of care visit www.csl.nhs.uk/publicationswww.csl.nhs.uk/publications