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The Sheffield Transformational survivorship project

The Sheffield Transformational survivorship project. NCSI - drivers. Cancer Reform Strategy 2007. Breast Colorectal Prostate. Revised pathway (NTCN 2011). Old. New. ‘One size fits all approach’ CEA 3/12 (2yrs) 6/12 (3yrs) CT 9 and 24 months Colonoscopy

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The Sheffield Transformational survivorship project

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  1. The Sheffield Transformational survivorship project

  2. NCSI - drivers Cancer Reform Strategy 2007

  3. Breast • Colorectal • Prostate

  4. Revised pathway (NTCN 2011) Old New ‘One size fits all approach’ CEA 3/12 (2yrs) 6/12 (3yrs) CT 9 and 24 months Colonoscopy OPA 3/12 (2yrs) 6/12 (3 yrs.) 5 years secondary care led Clinical components same OPA frequency reduced Transfer of care to PC

  5. End of life care Diagnosis & Treatment Early monitoring Progressive illness Later monitoring Recovery What happens here?

  6. Macmillan Health and Well Being Survey 2008

  7. Where we think people are…. Is not necessarily the case…

  8. New Colorectal Pathway 2011 Treatment Summary HNA colon Risk Stratification Health and well-being event HNA + Care Plan Colonoscopy 5 yrly HNA review CT CT 15m OPA + CEA 18m CEA 21m CEA 24m OPA CT result CEA 6/52 OPA + CEA 3 m OPA + CEA 6 m CEA 9m OPA CT result CEA 12m CEA Level 1 CEA 6 m Colonoscopy Colonoscopy 6m OPA for 1 yr. CEA HNA rectal Level 2 CEA 6 m + Review Cancer Care Review

  9. NCSI ‘immediate benefit to patient experience and quality of care along the pathway’

  10. Project work-streams

  11. A complete picture The Recovery Package Revised follow up pathway Locally commissioned scheme Self-management Clinical effectiveness

  12. Cost benefit analysis - colorectal • Forecast No. of potential eligible patients per year = 450 • Old pathway (visit) > 2 x OPA per yr. @ £72 each = £64,800 • 70% Level 1 = 315 > 2 x CEA per yr. @ £18 each = £11,340 • 25% Level 2 =112.5 > 2 x CEA per yr. @ £18 each = £4,050 + 1 x review per yr. @ 41 each = £4,612 Total under scheme = £20,002 Saving per year = £44,798

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