SWAG Cancer Alliance Rapid Diagnostic Service proposals

1. SWAG Cancer Alliance Rapid Diagnostic Service proposals Project leads: Amelia Randle, Clinical Lead, SWAG Cancer Alliance Sunita Berry, Cancer Lead, SWAG Cancer Alliance Nicola Gowen, Transformation Project Manager, SWAG Cancer Alliance Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Alliance

2. The RDS Service Model Key Components

3. SWAG Specification • In addition to meeting National Specification: • Service to be delivered within PCN geography and exist in space between primary and secondary care. • Money to be spent on clinical time and networking. • Broader scope to include 2ww referrals of limited clinical value without adding additional unnecessary steps where further investigations clearly defined.

4. Phase 1 pilot sites

5. Phase 2 Pilot Sites

6. Phase 3

7. Benefits NHS Patient

8. Potential service models Model 1 GP providing service in their practice for patients in all network practices offering 45-minute appointments on one day a week. GPs working in the practice identify appropriate patients and book them directly into the slot leaving referral information to be accessed on the clinical system. They will organise basic tests, so the results are available for this appointment. GP lead clinician assesses patient in clinic slot, discusses with secondary care and/or arranges rapid access to appropriate investigations at the local hospital. Model 2 Acute trust within geography of three PCNs providing clinic at hospital outpatients for all three networks with GPs referring according to agreed criteria. This gives potential for same day investigation with e.g. CT. Model 3 Advanced Nurse practitioner employed by acute trust provides clinical service for a number of primary care networks – offering clinic slots at different GP practices on different days of the week.

9. RDS Pilot development timeline 1st January 2020 RDS ‘Go-Live’ Monday 18th November 2019 Business plan and funding allocation approval Wednesday 13th November 2019 Implementation support event (operational delivery and evaluation)

10. STPs: • Agree rapid diagnostic pathway across system and SLAs • Agree RDS workforce requirements • Agree specific pathway including access, governance and quality assurance • Develop escalation policy • Develop data sharing agreements • PPE framework CADEAS: • Evaluation methodology CA: • September 10th Implementation support event • Submit detailed plans for next 4 years • Support use of digital decision support and business intelligence tools • 13th November Implementation support event • 18th November Business plan and funding decision SWAG proposal for Primary Care Network Rapid Diagnostic Service – CA Delivery Plan CA: • agree proposals in principle and submit outline plans to region • Business plan template development to support STPs and PCNs to develop specifics of pathway to meet the national specification to include governance arrangements and diagnostic access and provision • support to STPs and PCNs to develop Business Plan • Demand and capacity modelling • Engagement with Stakeholders • Steering Group establishment • Risk register maintenance CA: • Ensure adequate population coverage • Identify additional viable cohorts STPs: • GoLive • Business intelligence pathway reporting • RDC Implementation Specification guidance • Engagement with Stakeholders • Expressions of Interest from STPs Discover Define Define Deliver June 2019 September to November 2019 January 2020 July 2019