Transforming Cancer Services Team for London Excellent Psychological Care for those affected by Cancer Second Consultation event: Key principles and recommendations for a Pan- London psychological care pathway Wednesday 11 th October 2017 1
Agenda 9.30am Registration and coffee 10.15am Welcome and Introduction Liz Price, Associate Director LWBC, Transforming Cancer Services Team Dr Philippa Hyman, Macmillan Mental Health Clinical Lead, Transforming Cancer Services Team 10.20am The emotional and psychological impact of cancer: A service user’s perspective Dr Philippa Hyman, Macmillan Mental health clinical lead and Clinical Psychologist in conversation with Lauren Mahon, Service user. Living With and Beyond cancer context Liz Price, Associate Director LWBC (TCST) Psychological care pathway context and update Dr Philippa Hyman, Macmillan Mental Health Clinical Lead, Transforming Cancer Services Team 11.20am Psychological care pathway- the service user’s perspective and the referrer’s perspectives Dr Philippa Hyman, Macmillan Mental Health Clinical Lead, TCST 11.45am Facilitated table discussion 1) Does the pathway make sense? 2) How do we improve primary (community) and secondary (acute) care collaboration? 12.30pm- Lunch break 13.30pm 13.30pm Feedback on the pathway 14.00pm STP groups table discussion- What do you have in your area? What’s missing? How could this pathway work in your area? What might the obstacles be? 15.00pm Tea break 15.20pm Feedback from STP areas-how can you take ideas forward in your STP area? What support do you need? 15.50pm Next steps and closing remarks-Liz Price and Philippa Hyman, TCST 16.00pm End
01 Emotional and psychological impact of cancer: a service user’s perspective Dr Philippa Hyman, Macmillan Mental Health Clinical Lead and Clinical Psychologist Lauren Mahon, Service User Transforming London’s health and care together 3
02 Living with and beyond cancer context and update Liz Price, Associate Director, Transforming Cancer Services Team Psychological Care Pathway Context and update Dr Philippa Hyman, Macmillan Mental Health Clinical Lead and Clinical Psychologist Transforming London’s health and care together 4
What living with and beyond cancer means to us 5
National drivers 6
London’s strategic planning groups for cancer Cancer Vanguard and Alliance geography *TCST also serves West Essex CCG • which borders Enfield, Waltham Royal Marsden Partners: Forest, Redbridge and Havering Enfield North West & South CCGs. West Essex is part of the Hertfordshire & West Essex STP West Barnet Harrow • London Cancer/UCLH Cancer Collaborative: Haringey North Central, North East Waltham Hillingdon Brent London, West Essex Forest Redbridge • SE London ACN: South City & Camden Camden Islington Hackney East London Ealing Havering Newham Hammersmith Barking & Central London Tower Dagenham & Fulham Hamlets West London Hounslow Commissioning South- wark Richmond Greenwich Wandsworth Lambeth North East STP (WELC) Lewisham Bexley North Central STP Kingston Merton North West STP South West STP Bromley Sutton South East STP Croydon North East STP (BHR) 7
National quality of life metric (in development) As part of the Cancer Dashboard, the new quality of life metric will provide, for the first time, an indication of how well people are living after cancer treatment and not just how long they are alive. 5 pilot sites in England, including UCLH CC (UCLH and Barts Health). Pilot and evaluation period runs from Sep 2017 – early 2019. “One of our key ambitions is to put cancer patient experience front and centre. Everyone is unique, with different views and priorities, so it’s vital that they receive personalised support, this new measure will help ensure local NHS can see where things are going well and where improvements can be made .” - NHSE 8
National Cancer Patient Experience Survey London STPs Overview Barbara Gallagher September 2017
Q15 before you started you treatments were you also told about any side effects of the treatment that could affect you in the future 100 90 80 70 60 2015 50 2016 40 30 20 10 0 NWL SWL SEL NCL NEL NAT It is important that patients have all the information they need to make an informed choice about their treatment and care. The side effects of treatment for certain cancers can be life changing, affecting long term recovery, family relationships, work prospects and future health and wellbeing. The implications for psychological wellbeing are recognised. Patients need to make choices about treatment confident that they know what the likely outcomes will be.
Q22 Did hospital staff give you information about how to get financial help or benefits? 100 90 80 70 60 2015 50 2016 40 30 20 10 0 NWL SWL SEL NCL NEL NAT It is important that patients are given this information as soon as a diagnosis is made to enable them to plan for the short and long term. A diagnosis of cancer can have a serious effect on a patients financial wellbeing. Prolonged periods of ill health can result in loss of wages or unemployment. The employment status now of many people is to be on short term, zero hours or hourly rates contracts meaning that any time taken for appointments, treatment or ill health due to the effects of the cancer or the side effects of treatment can seriously affect a person’s finances. This will create a great deal of anxiety for patients and their families and may lead to a patient missing appointments, cancelling treatment sessions or withdrawing from treatment altogether
Q49 Hospital staff gave the family or someone close all the information needed to help care at home? 100 90 80 70 60 2015 50 2016 40 30 20 10 0 NWL SWL SEL NCL NEL NAT Without this information relatives lack confidence in caring for the patient. This may cause increased worry and anxiety for both the patient and their family resulting in increased access to GP and hospital services .
Q50 Patient definitely given enough support from health or social services during treatment 100 90 80 70 60 50 2015 40 2016 30 20 10 0 NWL SWL SEL NCL NEL NAT Care from community services during treatment will contribute to a patient’s ability to remain at home during their treatment and may contribute to a reduction in the short term side effects of their treatment.
Q53 Practice staff definitely did everything they could to support the patient 100 90 80 70 60 2015 50 2016 40 30 20 10 0 NWL SWL SEL NCL NEL NAT If the patient feels unsupported by the practice staff they may be less inclined to see their GP or practice nurse when a problem occurs. This may have a detrimental effect on their recovery.
Detailed Detailed can cancer pr cer prevalenc valence estima e estimates tes 199 1995-201 2015 in L 5 in Lond ondon on Transforming Cancer Services Team Produced by Molly Loughran — molly.loughran@phe.gov.uk in partnership with Public Health England and Macmillan Cancer Support 21 Sept 2017
Background Aim: To provide a view of prevalent cancer in London (and across England) of all people with cancer and those with subsequent cancers • Request by TCST Living With and Beyond Cancer team • Need data to inform the actions of the LWBC work stream. E.g. modelling service needs, rehab, psychological care • NCRAS request to extend work to all of England 16
Project(s) Status Status • Three workbooks to be published by end of Sept and mid-Oct • Posters: • PHE Conference Sept 12-13 — subsequent tumours London • IACR Oct 17-19 — prevalence England 17
Methods Outputs • Prevalence for England • London cut of prevalence • Prevalence of subsequent cancers for England Prevalence estimates cut by three factors per measure: • Geography — region, cancer alliance, STP, CCG) • Sex • Measure — years since diagnosis, deprivation, age at diagnosis and at 2015, ethnicity (10 yr. prevalence), stage (4 yr. prevalence) 18
Methods • Data source: Cancer Registry • ICD-10 C00-C96 excluding C44 cancers diagnosed 1995- 2015 (21 year prevalence) were included. • Patients needed to be alive on 31/12/2015. • Patients counted once for all cancers. For tumour-specific counts, they are counted once per cancer type. • Demographic data was used from the first cancer diagnosis in time period. • Ethnicity uses 10 years of data, stage uses 4 years. 19
Prevalence — top line results • London • Persons 209,538 (2415.78 per 100,000) • Males: 94,316 (2188.55 per 100,000) • Females: 115,222 (2640.16 per 100,000) • For comparison to England: • Persons: 1,791,366 (3,269.73 per 100,000) • Males: 805,944 (2,981.74 per 100,000) • Females: 985,422 (3,550.17 per 100,000) 20
Prevalence — deprivation by region Deprivation quintile: 1 - least deprived 2 3 4 5 - most deprived 5,000 Crude rate per 100,000 4,000 3,000 2,000 1,000 0 East East of London North North South South West Yorkshire Midlands England East West East West Midlands and The Humber Region in England 21
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