Welcome and setting the scene Dr Tony Branson Personalised care and - PowerPoint PPT Presentation

Welcome and setting the scene Dr Tony Branson

Personalised care and the NHS Long Term Plan https://www.youtube.co m/watch?v=jkzLP1_Y6Mw &feature=youtu.be

3 3 6 12 36 48 18 24 60 Collaborating to improve cancer care

3 3 6 12 36 48 18 24 60 Collaborating to improve cancer care

Personalised Care • Every patient should have access to personalised care interventions • Stratified follow-up after treatment should be rolled out for breast cancer, and piloted in other tumour types • New metric should be developed to measure quality of life • National target - 66% of eligible patients on new pathway by 2020

SUPPORTED SELF MANAGEMENT PATHWAY ATTEND BCN CLINIC HOLOSTIC NEEDS ASSESSMENT TREATMENT SUMMARY 3 ACCESS TO CLINICS INFORMATION BOOKLET BOOK ANNUAL SURVEILLANCE MAMMOGRAPHY FOR 5 YEARS Collaborating to improve cancer care

PATIENT WITH SYMPTOMS/PROBLEMS/ENDOCRINE THERAPY SIDE EFFECTS/LYMPHOEDEMA/WISHES TO DISCUSS RECONSTRUCTION CONTACT BCN TRIAGE VIA TELEPHONE PROFORMA 3 REASSURANCE/ADVICE GIVEN OR APPOINTMENT ARRANGE FOR APPROPRIATE CLINIC BCN CLINIC BREAST SURGERY CLINIC ONCOLOGY CLINIC LYMPHOEDEMA SERVICE RECONSTRUCTION SERVICE Collaborating to improve cancer care

'Why Should the Devil Have All the Good Music'?“ 3 Attr Charles Wesley Collaborating to improve cancer care

'Take Back Control’ 3 Dominic Cummings Collaborating to improve cancer care

Patients perspective of Personalised Care Michelle Thompson Collaborating to improve cancer care

Digital Solutions and Considerations Robin Blythe Collaborating to improve cancer care

Digital Solutions: Remote Monitoring -a patient app Robin Blythe

Remote Monitoring Collaborating to improve cancer care

Current situation • NHS Operational and Planning Guidance “ Must Do” • 3 pathways - Breast, Prostate and Colorectal • Key stakeholders – Academic Health Science Network (AHSN) – Health Call (Trust collaboration) – ICS Digital Programme – Trust (Clinical and Digital) and patients • National collaboration – Cancer Alliances • Technical specification confirmation. Collaborating to improve cancer care

Why? • Ensure patients are supported to live with and beyond cancer • To improve survival for people by detecting recurrence earlier • Provide a clinically safe process of remote monitoring with no demonstrable impact on the lead time to recurrence detection. • To reduce hospital led follow up • Support a stratified model of care for low risk cancer patients Collaborating to improve cancer care

Example Breast Pathway Collaborating to improve cancer care

Eligibility criteria example - Breast Patients classified as suitable for patient-led follow up will be identified at the breast MDT. Eligible patients may include: • Patients whose surgical treatment is complete – Patients treated for a Ductal Carcinoma In Situ (DCIS) – Patients receiving radiotherapy and/or hormone therapy without chemotherapy Patients who may not be suitable for patient-led follow up are: • Patients who have received chemotherapy • Patients on Herceptin • Metastatic patients • Patients on primary endocrine therapy • Patients where there is a concern re compliance • Patients requiring MRI as surveillance • Patients still undergoing surgical treatment (e.g. reconstruction) • Patients where there is clinical concern Collaborating to improve cancer care

Key points • 1 st phase • Work in progress • Patient and clinical requirement • Trust / patient engagement • Trust interoperability • Finance available. Collaborating to improve cancer care

Potential functionality Pre Assessment information Secure Messaging Appointment to Management (Book/Cancel) Consultants /Clinicians Appointment Patient Management Tracking (Reminders) Self Care Shared Test Advice Results Patient Treatment Summary Collaborating to improve cancer care

Function Description Pre Assessment Ability for patients to input into and system to capture pre information assessment information online such as Holistic Needs Assessment which can be forwarded to clinician prior to an appointment Appointment Surveillance appointments should be available for patients to Management book or cancel online. This could also be a solution to reminder patients about their appointments Shared Test The consultant should be able to see mammogram / colonoscopy Results test results online, review and where negative forward to the app where the patient can view their test results online. Where the test results are positive the consultant may wish to contact the patient directly prior to making them available on the app Patient Treatment This would include a summary of patients treatment summary at Collaborating to improve cancer care Summary discharge which will include allergies, medications etc.

Function Description Self Care Advice A knowledge base of advice linked to patient condition & treatment e.g. diet, should be available to read online as well as signposting to agreed volunteer / social groups Patient Tracking Consultants / Nurses should be able to see the progress of a patient within a pathway and a flagging system should be used to ensure the consultant can view when their patient has been seen by another specialist clinician within the hospital. Secure There should be the ability for patients to message medical Messaging to professionals via a generic inbox which clinicians can access as Consultants / appropriate as well as the ability for medical professional to email Clinicians each other. Collaborating to improve cancer care

The survey says…. Self Care Advice Patient Treatment Summary Appointment Management - Reminders Shared Test Results Pre Assessment information Patient Tracking Appointment Management - Book/Cancel Secure Messaging to Consultants/Clinicians 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Yes No 6 Trusts + 1 CCG Lead Cancer Nurse / Specialist Nurse / Consultant / Breast Colorectal Prostate Breast Physician / Patient group / Screening Practitioner / Macmillan GP Lead / Cancer Manager / Lead Cancer Nurse / Specialist Nurse / Consultant / Breast Physician Collaborating to improve cancer care

Nationally… Patient Tracking ✓ Shared Test Results ✓ Pre Assessment information ✓ Self Care Advice ✓ Patient Treatment Summary Secure Messaging to Consultants / Clinicians  ✓ Appointment Management 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Does + Will have Could / Should Other statuses Collaborating to improve cancer care

Next steps • Clinical, digital and patient engagement • Confirmation of technical spec • Health Call deployment – Project planning – Trust roles and responsibilities • Alliance collaboration Collaborating to improve cancer care

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Personalised Care and the Breast Cancer Pathway Challenges and Opportunities Clare Doney Personalised Care Clinical Lead NENC

National Measurables • All patients offered an HNA +/- care plan (within 31 days of DTT) recorded on COSD • Treatment summary • Cancer Care review • Opportunity for health and wellbeing support • Stratified follow up to self management for 66% of patients Collaborating to improve cancer care

Patients Challenges Opportunities • • Increased opportunity to have Reassuring patients who may be needs listened to and met anxious about unrelated • Receive follow up care closer to symptoms home • Navigating IT solutions or • Reduce the anxiety associated with attending events a secondary care clinic • Moving away from the emotional appointment safety net of a regular follow up • Empowered to self manage follow up appointment • Clear re-access and signposting for • Terminology and understanding any concerns what is expected and by who • Increased choice of information sources • Co-design services Collaborating to improve cancer care

Workforce Challenges Opportunities • Opportunity to set up targeted • Reassuring clinicians that safety clinics for groups of patients - eg netting is robust – relinquishing side effects of endocrine treatment control • Integration between primary and • Perceived additional workload secondary care • Focus on patients with complex • Change clinical needs • Integration between primary and • Innovative team structure secondary care modelling to bridge the community • gap Saturated clinics with complex • Embrace the voluntary sector patients support available • Potential impact of re-access • Personalised care clinical • Resource variation between Trusts champions • • Closer working between trusts Equal importance as timed pathways Collaborating to improve cancer care