Improving Cancer Outcomes in Nottingham City Facilitator Dr

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Improving Cancer Outcomes in Nottingham City Facilitator: Dr Safiy Karim MBA, MPH, MMed. Sci

Improving Cancer Outcomes in Nottingham City Facilitator: Dr Safiy Karim MBA, MPH, MMed. Sci (Ed), FRCGP GP, Robin Hood Cluster Chairman, CCG exec member and Cancer Lead Tuesday 17 th and 24 th April 2012. Working together for a healthier Nottingham

Overview of the PLT 12. 30 -1. 15 – registration and lunch 1. 30

Overview of the PLT 12. 30 -1. 15 – registration and lunch 1. 30 - 1. 50 pm – Cancer diagnosis in primary care by Dr Safiy Karim 1. 50 -2. 15 – Cancer- how are we performing? Public Health Consultant reflections - Alison Challenger/Julie O'Boyle 2. 15 - 2. 45 – Grab some tea/coffee and facilitated small group discussion 2. 45 pm – general feedback and Q&A 3 -3. 20 pm – Early palliative care intervention by Dr Andrew Wilcock 3. 20 -3. 40 pm – Guidelines and practice by Dr David Baldwin 3. 40 - 3. 55 pm – Views from a patient 4 -4. 30 pm – Summary of the day, Q&A – Dr Safiy Karim Working together for a healthier Nottingham

Aims and Objectives 1. 2. 3. 4. 5. To have an understanding on Cancer

Aims and Objectives 1. 2. 3. 4. 5. To have an understanding on Cancer in Nottingham and of the impact of early diagnosis from national audit results How performance indicators show the ‘where we are now’ position in Nottingham What can be done when we keep patients at the centre of cancer healthcare Innovations in diagnosis and management Authorisation and 360 degree feedback. Working together for a healthier Nottingham

Survival One year survival – Early elective diagnosis Five year survival. Impact of treatment

Survival One year survival – Early elective diagnosis Five year survival. Impact of treatment and early diagnosis too. Working together for a healthier Nottingham

Results from the national audit of cancer diagnosis in Primary care 2009/2010. • Acknowledge

Results from the national audit of cancer diagnosis in Primary care 2009/2010. • Acknowledge – Durham University, Department of Health, National Cancer Intelligence network (NCIN), National Cancer Action Team and the RCGP. • 20/28 cancer networks, 1170/8245 practices, 18, 879 patients with cancer • Excluded screen detected cases, non melanoma skin cancers and in-situ tumours Working together for a healthier Nottingham

Key take away messages • • >66% of all patients referred within one month

Key take away messages • • >66% of all patients referred within one month of seeing GP Those who saw GP, 75% after 1 -2 attendances More advanced cancers found in • • • Communication challenges Housebound Emergency presentations Better access to investigations would change GP management in 6% of cases • Brain, Ovary, Pancreas, Kidney, Lung Working together for a healthier Nottingham

GP challenges • Cancer sites for which >20% of patients had >3 consultations were

GP challenges • Cancer sites for which >20% of patients had >3 consultations were • Lung, Ovary, Pancreas, Lymphoma and Stomach • • • 50. 8% men and 57. 3% women were via 2 week wait 17. 1% men and 12. 2% women – routine 13. 2 men and 12. 7% women - emergency Working together for a healthier Nottingham

% Emergency 2 week Routine Private Not by referral practice Brain 39. 3 12.

% Emergency 2 week Routine Private Not by referral practice Brain 39. 3 12. 8 17. 5 4. 7 15. 0 Breast 3. 7 75. 9 5. 8 4. 9 5. 0 Lung 49 8. 2 2. 2 8. 9 20. 3 Working together for a healthier Nottingham

What is the cancer stage at diagnosis? Confined Local to organ spread Distant spread

What is the cancer stage at diagnosis? Confined Local to organ spread Distant spread other Emergency 34. 1% 24. 8% 28. 35 12. 7% 2 week referral 47. 1% 27. 5% 16. 5% 8. 9% Working together for a healthier Nottingham

Early detection of cancer Time to re-frame this as… A medical emergency? Working together

Early detection of cancer Time to re-frame this as… A medical emergency? Working together for a healthier Nottingham What does added years or life to years mean?

The Health and Social Care Act As a clinical commissioning group (CCG), you will

The Health and Social Care Act As a clinical commissioning group (CCG), you will have the freedom to use the NHS budget in the best interests of your patients. You will have the freedom to structure your CCG in the way that ensures all of your constituent practices – and through them, their patients – have a direct influence on the way the NHS budget is spent. You will also have the freedom to pursue innovative ways of delivering care that delivers better results for your patients. Working together for a healthier Nottingham

Involve employers, Tricks or Tweets ………. . can I have a blood in the

Involve employers, Tricks or Tweets ………. . can I have a blood in the urine poster? Working together for a healthier Nottingham

Forest performance improves post CCG. Working together for a healthier Nottingham

Forest performance improves post CCG. Working together for a healthier Nottingham

Be visible; score goals Working together for a healthier Nottingham

Be visible; score goals Working together for a healthier Nottingham

Inform and involve Working together for a healthier Nottingham

Inform and involve Working together for a healthier Nottingham

Cancer PSO (citywide) & patient engagement - 30 p Practices to review screening rates

Cancer PSO (citywide) & patient engagement - 30 p Practices to review screening rates for breast, cervical & bowel cancer and compare performance against the cluster rates, city-wide rates and national rates Practices to discuss with patients at a practices patient participation group meeting or through a patient questionnaire the importance of screening and ask for their views/concerns Practices to develop an action plan to improve practice screening rates (by targeting non attenders), implement plan and monitor results. Working together for a healthier Nottingham

Aims and Objectives 4. To have an understanding on Cancer in Nottingham and of

Aims and Objectives 4. To have an understanding on Cancer in Nottingham and of the impact of early diagnosis from national audit results What can be done when we keep patients at the centre of cancer healthcare How performance indicators show the ‘where we are now’ position in Nottingham Innovations in diagnosis and management 5. Authorisation and 360 degree feedback. 1. 2. 3. Working together for a healthier Nottingham