Lung Cancer Best Timed Pathway Greater Manchesters approach

Overview • National and Regional ‘best timed pathways’ • GM Cancer Project • Live Clinician-led tracking @GMCEducation I #GMCHead. And. Neck 2019

Lung Cancer: The Facts @GMCEducation I #GMCHead. And. Neck 2019

Greater Manchester Cancer Current National Targets ! E S O Target: 85% T NO T I F Target: 93% R O F P R PU Target: 96% https: //www. nuffieldtrust. org. uk/news-item/cancer-waiting-times-how-has-nhs-performance-changed-over-time

Lung Cancer Challenges • Poor outcomes compared with European Countries • Significant variation in practice/outcomes • Failure to meet NHS England Cancer Targets • RCT evidence that shorter diagnostic pathways associated with significantly improved long term outcomes @GMCEducation I #GMCHead. And. Neck 2019

Greater Manchester Cancer National ‘Optimal’ Pathway Triaging Test

Greater Manchester Cancer National ‘Optimal’ Pathway Clinical Triage/ Filter out non-cancer Staging/Diagnostic tests MDT discussion

Greater Manchester Cancer National ‘optimal’ pathway

Greater Manchester Cancer National ‘optimal’ pathway • 52 day pathway • Taken a ‘pragmatic approach’ to timings • Sets out clear principles with which to work • But is 52 days really ‘optimal’? (Optimal: adj. best or most favourable)

Greater Manchester Cancer GM ‘Optimal’ Lung Pathway

Greater Manchester Cancer GM Optimal Lung Pathway

Standardised staging bundles @GMCEducation I #GMCHead. And. Neck 2019

GM Cancer Best timed Pathway Project • Resource Gap Analysis • Investment of £ 1. 3 M • Clinical Leadership with Project Management Support @GMCEducation I #GMCHead. And. Neck 2019

GM Cancer Best timed Pathway Project • Invested in all Secondary care trusts in GM & East Cheshire + specialist treatment centres • Pathway Navigators (9 across GM) • Specialist Nurses (11 across GM) • Clinical Fellows (1 @ MFT) • Point of care e. GFR testing @GMCEducation I #GMCHead. And. Neck 2019

GM Cancer Best timed Pathway Project Outcome measures: • Complete achievement of 62 day standard • 90% staging CT within 72 hrs of referral • 80% discussed at MDT by day 21 • Reduced median time from referral to treatment @GMCEducation I #GMCHead. And. Neck 2019

Clinician Led Web-based Tracking @GMCEducation I #GMCHead. And. Neck 2019

Web-based Tracking • Sharepoint Software • Job planned time for ‘virtual’ DCC • Team approach • • Clinicians Specialist Nurses Cancer Trackers Pathway Navigators @GMCEducation I #GMCHead. And. Neck 2019 • Case details input by clinician • Diagnostic bundle assigned Case Added Daily Tracking • Dates tests • Scheduled • Completed • Reported • Results actioned • Delays highlighted • Referral made Daily Clinical Review

@GMCEducation I #GMCHead. And. Neck 2019

Lessons Learnt • Prompt access to initial ‘diagnostic test’ essential • Immediate Specialist triaging • Job planned ‘virtual DCC’ • Set ‘Gold Standards’ at the outset • Thorough resource gap analysis • Web-based tracking is very helpful! @GMCEducation I #GMCHead. And. Neck 2019