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Children and Young People Improving Outcomes Guidance Key aims of guidance and age specific requirements Designation of Principal Treatment Centres Development and designation of Shared Care Timeframe for delivery Challenges and opportunities
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Key aims of CYP IOG and age specific requirements “Age appropriate, safe and effective services as locally as possible, not local services as safely as possible” All children and young people under 19 yrs old must be referred for definitive diagnosis and treatment in age appropriate facilities in the PTC Young People between 19-24 should have unhindered access to age appropriate facilities and support when needed. They can choose to receive treatment at a PTC, locally, or a combination of both through shared care. (dependant on tumour and treatment)
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Configuration, co-ordination and care SCG required to designate PTCs identified for Children and Teenagers and Young Adults to provide sustainable services with facilities and workforce Children’s Cancer Measures (2009) require Children’s Cancer Network Co-ordinating Group (HYCCN & YCN) responsible for ensuring delivery, leadership and co-ordination Clear governance and leadership: Clinical leadership of PTC with agreed protocols and agreed areas of responsibility Co-ordinated pathway of care delivered by MDTs, providing information and support for patients and carers All patients must have access to tumour-specific expertise, access to clinical trials, or treatment on agreed protocols Registration of cancers in 15-24 year olds
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Shared care SCG designate Shared Care Units, with Cancer Commissioners and Networks. Commissioners should ensure that shared care arrangements are established which have approved clinical protocols for treatment and care define areas of responsibility with the PTC identify a lead clinician and a lead nurse Shared Care for children aged 0-16: nationally agreed levels of care, levels 1 – 3; In HYCCN & YCN : Hull and Scarborough, Airedale, C&H & York - all Level 1, apart from Hull Level 2
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Shared Care components Coordinated care supported by appropriate structures, processes Named lead consultants, nurse, pharmacist in PTC and at local level Robust 2-way systems of communication Age appropriate environments Written guidelines to support the level of care agreed Education and training programmes for staff in all settings Arrangements for unexpected admissions Identified contacts for families Identified funding
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Shared Care components Shared Care for TYA: PTC need to work with both child and adult services for shared care 3 shared care levels defined as per children’s services - practicality and safety Need to develop a ‘Network care’ service model in collaboration with Trusts who provide cancer services for adults Require prompt referral and response to ensure informed choice for all 19-24 yr olds and that treatment is not delayed
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Timeframe For full implementation by Dec 2010 0-16: PTC and Shared Care Units designated, MDT in place, pathways agreed. Formal agreements to be completed by Dec 2010 TYA: PTC designated, MDT in place, pathways agreed. Formal agreements to be completed by Dec 2010
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Challenges and opportunities For Commissioners: to ensure effective and safe provision of shared care services for Children and TYA For PTC: Children’s measures require formalising protocols, MDT and shared care For Shared Care Units: Children’s measures require shared Care Units to formalise arrangements, ensure cover, safe facilities and services, monthly MDT Aiming for Peer Review 2011/12
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