Dr Dorothy Goddard Chair, SWAG Alliance LWBC Group Consultant Breast Radiologist

1. Somerset, Wilts, Avon and Gloucester Cancer Alliance LWBC: Implementation of the Recovery Package Dr Dorothy Goddard Chair, SWAG Alliance LWBC Group Consultant Breast Radiologist Macmillan Associate Medical Director for Cancer Strategy Royal United Hospital NHS Foundation Trust BATH

2. Somerset, Wilts, Avon and Gloucester Cancer Services Why? . • The problem… • Increasing demands • Unmet needs • The solution… • Living with and beyond Cancer (Survivorship) • Recovery package • Stratified follow up

3. Somerset, Wilts, Avon and Gloucester Cancer Services The problem: increasing demand Increasing number of people developing cancer Increasing number of survivors

4. Somerset, Wilts, Avon and Gloucester Cancer Services The problem: unmet needs Conventional follow up not meeting people’s needs Recurrent or new disease not picked up at routine follow up visit National Cancer Patient Satisfaction Survey The Cochrane Review

5. Somerset, Wilts, Avon and Gloucester Cancer Services What? Living with and beyond Cancer Supporting people (to live well with and beyond cancer) from cancer diagnosis through treatment and beyond… • Recovery and Rehabilitation: Recovery Package • New models of after care: Stratified Pathways of Care • Supporting people with active or advanced disease

6. . Breast cancer pathway Recovery package and stratified follow up HNA and care plan HNA and care plan Treatment summary GP cancer care review Health and well-being event Self management Ongoing care • Diagnosis • Treatment(s) • After care

7. Somerset, Wilts, Avon and Gloucester Cancer Services When? . 2017/18 2018/19 Metrics

8. Somerset, Wilts, Avon and Gloucester Cancer Services How? Implementation LWBC Group – Alliance approach Cancer Transformation Funding

9. Somerset, Wilts, Avon and Gloucester Cancer Services Cancer Transformation Funding • £6 million for SWAG – over two years: 2017-19 • Cancer transformation taskforce (leadership) • Recruit additional support workers to implement RP and free up CNS capacity • Training for support workers, primary care and psychology support • IT infrastructure to enable RP including remote surveillance, tablet devices, patient portals • Bid for funding – submission September 2017: • Dependent on 62day performance and recovery plan

10. Somerset, Wilts, Avon and Gloucester Cancer Services Implementation • Workforce: • Improve workforce skill mix – band 4 workers supporting CNS’s • Psychological training programme for CNS’s and support workers • Training for GP’s and practice nurses for Cancer Care Review • HNA’s and care plan: • Performed soon after diagnosis and at end of treatment(s) • Referral to other services as required

11. Somerset, Wilts, Avon and Gloucester Cancer Services Implementation • Treatment summary: • Patient (&GP) receives TS following every phase of completed acute treatment • South West best practice TS template in development • GP Cancer Care Review: • LWBC training for GP’s and practice nurses to improve quality of cancer care reviews

12. Somerset, Wilts, Avon and Gloucester Cancer Services Implementation • Health and well-being event: • Use existing programmes and resources to co-ordinate and develop a rolling programme, incl. community and online resources – Macmillan, We Hear You, Penny Brohn • For access at point of need, not just start or finish of Rx The South West vision is for all patients to receive the four key elements of the recovery package regardless of geographical location or tumour site

13. Somerset, Wilts, Avon and Gloucester Cancer Services For? Outcomes: • Patient experience improved with access to support they need, when they want it • Patient empowered and confident to self-manage • Consequences (or side effects) of treatments or recurrence identified earlier • Life style changes lowers risk of recurrence and improved quality of life • Financial savings with less follow up • Recovery package essential to support patients stratified to self-management

14. Somerset, Wilts, Avon and Gloucester Cancer Alliance Thank you: any questions?