The Living with and Beyond Cancer Programme Launch

The Living with and Beyond Cancer Programme Launch 19 April 2016

Will Cleary-Gray, Commissioners Working Together Programme Director TRANSFORMING HEALTH

John Towers MACMILLAN CANCER SUPPORT

Partnership programmes across the UK

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Need for stronger collaboration Short-term to Longterm Small-scale to Largescale Solutionsled to Codesign Funder to Redesign partner Integrated & Personalised Care & Support

The dawn of system leadership

Macmillan’s Partnership Offer • • Holistic approach Convening power of a trusted brand Co-design Clinical leadership Freedom to innovate Insight & evidence Funding and volunteers

Sources of Learning – Community of Practice – Sharepoint – External Evaluations – Insight Work – Annual Learning Report – Learning Events – Knowledge Resource Modules

External Evaluations Evaluation of the South Yorkshire, Bassetlaw and North Derbyshire Survivorship Programme: Final Report Macmillan Cancer Support May 2015

Annual Learning Report

Knowledge Resource Modules

Ten success factors for partnerships 1. Have a clear purpose 2. Choose your partner(s) 3. Respect different cultures 4. Clarify roles and responsibilities 5. Find ways to share data 6. Develop a clear identity 7. Manage external messages 8. Ensure regular feedback 9. Seek to learn not blame 10. Let go of control

The whole is greater than the sum of its parts

Richard Metcalfe, Programme Lead THE PROGRAMME AND YOU

About the programme Our aim is to: “enable every adult living with breast, colorectal or prostate cancer in each of the eight CCG areas to have access to the LWABC model of care from diagnosis onwards by 2020”

The LWABC model Diagnosis Risk stratification • Care pathway based on individual needs • Identification of options for complex, shared and self-care pathways Recovery Package • Holistic Needs Assessment • Treatment summary • Cancer Care review • Education and support Supported Self-management • Enable understanding and management of the consequences of treatment • Promoting healthy lifestyles and well-being • Sign-posting to other services/support

Guidance – April 2016 • • • Cancer Taskforce strategy Stratified pathways of care Recovery package Whole person, whole pathway approach Long term conditions Commissioning for the individual rather than cancer in isolation Services may not be cancer specific Some exemplars and tools Follow the principles of PERSON CENTRED CARE

Seven in ten people with cancer have at least one other long term condition – 1. 8 million people No long-term conditions (LTCs) 1 LTC 0. 6 M 2 LTCs 0. 5 M 3+ LTCs Mid-2014 1. 8 M

By 2030 the number of people with cancer and at least one other LTC will increase by around 1 million 0. 9 M 1 LTC 0. 6 M 2 LTCs 0. 5 M 3+ LTCs 0. 8 M

Cancer often co-exists with a range of other conditions Hypertension Obesity 31% 42% Mental health issues 21% People living with cancer in the UK in mid 2014 Diabetes 14% Arthritis 16% Chronic Kidney Disease 17% Chronic Heart Disease 19%

Failing to meet people’s need has cost implications

The scale of the challenges • • Baseline data for the programme – last 3 years by CCG Patients, admissions, age, length of stay, deprivation Forecast between 2014/15 and 2015/16 increase of over 450 individual patients 15, 900 Breast, Colorectal and Prostate cancers Across the programme footprint a 3% increase: o 6% Prostate o 4% Breast o -0. 9% Colorectal

Phase 2 evaluation • • Strong rationale for LWABC Macmillan add significant value (i) leading the agenda (ii) advocating for patient voices and (iii) bringing different parts of the system together Risk stratification works but takes time Steps towards holistic care and support Holistic culture – iterative ‘change process’ Building more holistic care requires engagement across the system Phase 3 - programme approach with shared aims, different emphasis in different local areas

Why we need a programme • Scope – introducing a new model across 8 CCGs and for 2. 3 million people • Collaborate and co-operate – do it once rather than repeating or duplicating • Sustainability – the model needs to be fully embedded, fully operationalised by 2020 • Complexity - there a large number of components which make up the model • Innovation – we will need to find new ways to solve old problems, including how to commission a model like this

A new partnership • Working with Macmillan Cancer Support – successful history of collaborative working – many lessons learned from previous phases – strength in combining our different skills and knowledge • New ways of working • New partnership with patients, carers and service users

The programme structure

Just some of the people who need to be involved Commissioners CCG Commissioning Leads STP Provider Trust Chairs Non NHS Providers South Yorkshire Housing Association Hospices Public health/prevent ion Commissioners Working Together Yorkshire and the Humber East Midlands Training Providers Royal Colleges Health Education England Yorkshire & the Humber HEE NHS England Strategic Clinical Networks Academic Health Science Networks Yorkshire and the Humber GP leads Breast Cancer Care Mental Health Services Network Bowel Cancer UK Local Partnership Councils Education and Training Network cancer leads North of England region Beating Bowel Cancer Regional Networks Clinical Senate SY&B Cancer Strategy Group Macmillan Cancer Support Prostat e Cancer UK Local Education and Training Boards High Value Pathways NHS England Local Transformation Boards/Groups Public Health Patients England Carers Leisure & Sports Cancer Waiting Times LWABC Programme Local authorities HWB Boards Local government Providers Working Together Mental Health Trusts NHS England Specialised commissioning Programme Board Yorkshire Ambulanc e Service Provider Trust CEOs Advisory & counseling Accountable Officers GP Leads Medical Directors Group Providers GP Chairs Charity & Voluntary Midlands region Age UK Patients and Carers

The Team Lesley Smith Executive Sponsor Richard Metcalfe, Programme Lead Steve Edwards, Macmillan Senior Development Manager Sandra Clarkson, Macmillan Development Manager Will Cleary-Gray Programme Director, Working Together Laura Boyd, Hayley Williams, Communications Pathway Co. Lead ordinator Rachel Gora, Admin Support Project Managers (x 2) – to be appointed as required

The money Five year commitment from Macmillan £ 6. 4 million Funding is phased over the lifetime of the programme Funding proposals for final two years to be developed Funding is to enable transformation to happen Allocations managed through single process

What we’re asking from you B L A W C C Commitment to transform B Bids for funding L A Action plans W Wide engagement L Local implementation group

What we’re offering Local Implementation Local implementation - multi-disciplinary teams working locally to develop the plans which work for local patients, carers and communities. Programme Team Programme support - a centre of excellence to develop and implement sustainable change including providing: resources from the programme team; oversight; planning; control; reporting; information management; policy and guidelines; maintaining standards of practice; and assurance

WHAT WE’RE OFFERING As the start of our offer we can work with you and your colleagues locally to: • help you assess where you are against implementing the LWABC model • work with or help you set up a local group where one doesn’t exist • support local patient and clinical engagement where necessary Before you leave today we need to know who is the named contact for the programme in your area? … and we will contact you to arrange to start the next step of this exciting journey together.

Every one of our colleagues can help Challenge for your colleagues how the following points are considered in your local area: New models of care • Holistic needs based care – how embedded locally? • Long Term Conditions - supporting people • Risk stratification – all conditions, is cancer considered? • Social prescribing/ use of information prescriptions Technology • Digital road map - shared IT/enhanced data sharing • e Holistic Needs Assessment Workforce • Local ”working together” culture - especially ‘trust’ between organisations Patient engagement • Local experience of co-production and engagement in service re-design • Choice and control; Personal health budgets

Every one of our colleagues can help Carers • Local carers assessment, offer and services • Carers voice Maximising the skills of other sectors/providers • Role of the voluntary/community sectors • including the co-ordinating role - CVS (or equivalent) • Community partnerships Working across health, social care and local government • Single assessment/care planning processes “trusted assessors” • H&WBB awareness of cancer strategy and the importance of LWABC • Local mental health strategy especially access to IAPT and talking therapies

By 2020 breast, colorectal and prostate cancer patients will experience: • A measurable improvement in the quality of care • Agreed clinical pathways for all post treatment management, irrespective of where they live • A clinical and non clinical workforce skilled and trained to deliver new models of care • A standard approach to commissioning which supports new models of care • A successful partnership between health, care and Macmillan Cancer Support

If we’re successful we’ll change lives • • A better experience (of cancer) Better access to information Equal access to care Care closer to home Greater confidence to manage self care Joined-up care And the real benefits: o Family life o Being a parent/grandparent o Resilience o Meaning and purpose o Contributing to social and economic benefit

PATIENT STORIES

NEXT STEPS As the start of our offer we can work with you and your colleagues locally to: • help you assess where you are against implementing the LWABC model • work with or help you set up a local group where one doesn’t exist • support local patient and clinical engagement where necessary Before you leave today we need to know who is the named contact for the programme in your area? … and we will contact you to arrange to start the next step of this exciting journey together.