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A headshot of Dr Nigel Wells, Clinical Lead for the Humber, Coast and Vale Health and Care Partnership. He's smiling and wearing a black suit jacket over a wh

Health and Care Partnership appeals for public support to help ensure services resume safely and promptly

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NHS and council organisations in Humber, Coast and Vale are appealing for the public’s help as they work together to increase the availability of health and care services, which were restricted, relocated or paused during the coronavirus outbreak.

At the outset of the pandemic, health and care professionals including hospital teams, GPs, health visitors and social care staff responded quickly by changing the way they worked.

While some services are returning to how they were before, many of the changes made in response to the pandemic need to remain to maintain patient and staff safety and ensure services are prepared to handle any future increases in Covid-19 cases.

The public can play a pivotal role in helping to ensure that health and care services can resume safely and promptly. You can support your local NHS by:

  • Attending any appointments booked on your behalf
  • Consulting NHS 111 first if you are unsure which service you need
  • Only using A&E for emergencies
  • Being prepared to travel to a different location for appointments or treatment
  • Helping family and friends to get online so they can access online services if required

A headshot of Dr Nigel Wells, Clinical Lead for the Humber, Coast and Vale Health and Care Partnership. He's smiling and wearing a black suit jacket over a whDr Nigel Wells, Clinical Lead for the Humber, Coast and Vale Health and Care Partnership, said: “We have to make some tough decisions about how we bring back services over the coming months. These decisions are being taken by the doctors and nurses in our hospitals and in the community. Our main concern is and always will be everyone’s safety.

“Many of our staff have been asked to work in new roles and locations; equipment has been moved to where it is most needed to care for people; we have fewer beds in our hospital wards as we have had to move them further apart which takes up more space; and we have to wait longer between procedures in our operating theatres to allow for deep cleaning and for the air to change.

“This all means that while some services are being restored to how they were before the outbreak, we can’t switch them all back on straight away and we hope people can understand the reasons why and bear with us.

“We are thankful for your patience as we resume services safely as quickly as possible and we need your help to do this. If you are asked to come to hospital or your GP practice for treatment, please do everything you can to keep your appointment so that we can see as many people as possible within the current constraints.”

Press image of Professor Stephen Eames CBE, Independent Chair Humber Coast & Vale Integrated Care System.Professor Stephen Eames CBE, System Lead and Independent Chair for the Humber, Coast and Vale Health and Care Partnership, said: “We’d like to thank local people for their patience, understanding and visible support over recent weeks and months. We had to make some immediate decisions for the safety and wellbeing of our staff, patients and their families and we know that, for some, these service changes have caused anxiety and concern.

“As we continue to work differently over the coming weeks and months, we ask for your continued support and patience. We may ask you to travel to a different location, your appointment might be conducted over the phone or online or your care may be provided in a different way than you are used to.”

Cancer Alliance News – January 2020

By | Cancer Alliance, Stakeholder Updates

Welcome to the first Humber, Coast and Vale Cancer Alliance Quarterly Newsletter.

Introduced by Phil Mettam, Executive Chair of the Cancer Alliance, the first edition focuses on work taking place across the Alliance, including the introduction of Digital Pathology, launch of Lung Health Checks in Hull and Treatment Summaries at York Teaching Hospital NHS Foundation Trust.

In this edition, we meet two new Cancer Alliance Project Officers who are helping to increase cancer awareness and uptake of screening across our area and learn more about 5k Your Way, a national initiative that is helping those affected by cancer get active and build friendships.

Click here to view the Humber, Coast and Vale Cancer Alliance Newsletter  – January 2020

If you would like to feature in our next edition, please email comms.hcvcanceralliance@nhs.net

May 2019 Stakeholder Updates

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As part of our communications and stakeholder engagement plans, the Cancer Alliance would like to ensure that our stakeholders are kept informed on the latest news and developments across the Alliance.

Cancer Alliance System Board – 13th May 2019
The Board received a revised performance report focussing on 28 day and 62 day performance as these standards have been prioritised at local, regional and national levels. Increasing attention is, and will continue to be given to demand and performance over time rather than a consecutive month comparison).

Whilst 62 Day RTT performance across HCVCA does not meet the required national 85% standard, the performance differential to that of other Alliances is narrowing. The Alliance providers have in place a wide range of initiatives to improve performance against this standard.

Lung Health Check (LHC)
As previously reported in February, NHS England announced that the Cancer Alliance and NHS Hull CCG had been successful in securing Hull as one of the ten sites across England that has been chosen to deliver the first phase of the NHS LHC. The targeted screening will help improve survival rates by going to areas with the highest death rates from lung cancer.

A LHC Delivery Group has been set-up to oversee the development and roll-out of the LCH across Hull with five working groups established to implement the required products needed to launch the LHC.

Working Group 1: Engagement and Communication with communities and GP Practices
Leads: Emma Shakeshaft Communications & Engagement Lead, Hull CCG and Kay Gamble, Communications & Engagement Lead, CA

Working Group 2: Primary care engagement, identify and invite eligible participants, secure facilities and site to deliver LHCs
Leads: Dr Vince Rawcliffe, GP Board Member, Hull CCG
Dr James Crick, Consultant in Public Health Medicine and Associate Medical Director

Working Group 3: Undertaking LHC Assessments: staffing, operational policy and protocols
Lead: Jo Thompson, Responsible Assessor for LHC Programme, and Respiratory Nurse,
Victoria Sharman, Matron, HUTH

Working Group 4: Secondary Care Investigations & Treatment for LHC participants
Lead: Dr Gavin Anderson, Responsible Clinician for LHC Programme and Clinical Lead for Lung
Cancer Services, HUTH or nominee tbc

Working Group 5: Data & Information Management
Lead: Dr Stuart Baugh, Clinical Director for LHC Programme and Consultant in Respiratory
Medicine, NLAG.

Lung Cancer Services
Aligned to this, the Board also received an update on the work in reviewing Lung Cancer Services and the development of the Rapid Access to Pulmonary Investigation Day pathway (RAPID) to improve patient experience, reduce variation, standardise diagnostic evaluation and eliminate medically unjustifiable delays.

2019/2020 HCVCA Funding Allocation and 2019/2020 Objectives
The Board approved the 2019/2020 Cancer Alliance ‘Plan on a Page’ which provided the details of how CAs had allocated funding locally to ensure delivery of national and local
priorities. HCV CA was allocated £4,355,000 for 19/20 delivery which included £1,429,000 for the delivery of the Lung Health Checks in Hull.

The CA Objectives were also approved at the Board and will now going forward to be discussed further as part of wider Health & Care Partnership event on 11th June.

The NHS Long Term Plan
As briefly mentioned above, Humber, Coast and Vale Health and Care Partnership are holding a HCV Partnership Leaders event on Tuesday 11th June 2019, from 1pm to 5pm at the Lakeside Conference Centre, Sand Hutton, York. The Cancer Alliance and other work programmes will present their long term objectives to senior leaders and other key stakeholders at the event.

Cancer Screening Programmes
Sir Mike Richards has now published his Interim Review of national cancer screening programmes in England

Sir Mike’s interim report, published Friday 24th May, calls for practical measures to be used across the NHS to make screening more convenient and reverse the long-standing decline in the proportion of people being tested. “The NHS should roll out online booking, out of hours appointments and text reminders to boost the uptake of breast, cervical and other screening services”, leading expert Professor Sir Mike Richards says.

Colorectal Rapid Pathway Work Programme
The Humber, Coast and Vale Cancer Alliance held a FIT workshop for clinicians and managers across the locality on the 28.2.19; this was a success with high level plans agreed for FIT roll out for low risk symptomatic patients (VoY/ SR and NL/ NEL CCGs). All Trusts aim to have implemented FIT for low risk symptomatic patients in 2019.

In addition, HUTH is currently evaluating a pilot regarding local implementation of FIT across
ERY CCG and Hull CCG and in York Dr James Turvil is undertaking research regarding the
application of FIT in high risk patients.

A further colorectal business meeting has been booked for the 20th June 2019. The agenda will cover updated Colorectal Rapid Pathway (including Straight to Test), FIT implementation (Low Risk Systematic Patients), Inter-Provider Transfers guidelines for colorectal cancer patients, Implementation of MDT guidance/ Acute Service Provision and refresh HCV colorectal timed pathways. Providers and HCVCA are making use of ‘shadow’ 28 day referral to diagnosis data as a proxy measure of implementation of the colorectal rapid pathway.

A new project manager to support the delivery of the Colorectal Rapid Pathway work has commenced in post and can be contacted on amina.bristow@nhs.net

Prostate Rapid Diagnostic and Assessment Pathway
Work has commenced on the 2018/19 progress report and gap analysis work is underway.
Following the Prostate Focus Group in February colleagues have been discussing adoption of the new access criteria for MRI/CT/Biopsy with their colleagues within each trust, this has now broadly been agreed and with some further work aims to implement new criteria in June.

At the Business Meeting in May IPT protocols across the patch were reviewed and the protocol for Prostate agreed. Also discussed at the meeting was the development of Standards of Care for MDT processes in line with national guidelines. Meetings are taking place across the patch to agree criteria and format of process. A new Project Manager supporting work on the Prostate Rapid Diagnostic and Assessment Pathway has commenced in post and can be contacted on laura.tattersall@nhs.net

Diagnostics
Procurement of the Radiology workflow solution has been completed and the technical roll out has commenced with an ambition to ‘go live’ in the autumn, commencing with the priority pathways: Lung, Colorectal and Prostate. In the meantime, process mapping work is underway with a view to identifying efficiency savings that can be realised through use of the system.

The procurement of digital slide scanners has also been completed and a plan is in place to address training requirements. The ambition is to commence digital reporting on the priority pathways by the autumn.

A HCV wide endoscopy group has now been formed, along with a decontamination sub group. Potential for efficiencies in the procurement of decontamination equipment and the associated maintenance contracts has been identified and is being explored. Right Care data and examples of best practice from other parts of the country are being used to inform a 4 programme of demand management, workforce development and productivity gains, with a further clinical meeting being planned for July to reflect on possibilities.

Work continues on the development and prioritisation of joint asset registers for Radiology and Endoscopy. This will support recommendations about future strategic investment of resources as well as identifying possible joint procurement opportunities.

Workforce planning is crucial to the future of Diagnostics and we are working across the HCP and closely with HEE to identify innovative approaches to bridge current and future gaps in workforce availability. A piece of work to identify potential for extended scope practitioners has also commenced.

A diagnostics end of year report setting out the key achievements in 18/19 and the ambitions for 19/20 has been produced and can be accessed by contacting us comms.hcvcanceralliance@nhs.net

A new Project Manager for Diagnostics commenced in post in April and can be contacted on laura.tattersall@nhs.net

Living With and Beyond Cancer April update
All three hospital trusts are already offering elements of the Living With and Beyond Cancer Programme Recovery Package to some patients, with plans to extend this to others.
However in order to identify gaps and enable them to focus on areas where more work is required, the Living With and Beyond Cancer team have been working with the hospital trusts to ensure that a baseline is established for the numbers of patients receiving different aspects of the Recovery Package (eHolistic Needs Assessment and Care Plan, Treatment Summary, access to a Health and Well-being event, intervention or information) and a high quality Cancer Care Review in their GP practice. It will help identify gaps in provision in different tumours as they work towards the goal outlined in the NHS Long Term Plan of “by 2021, where appropriate every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support.”

The NHS Long Term plan also set a target that after treatment, patients will move on to a risk stratified follow-up pathway that suits their needs, and ensures they can get rapid access to clinical support if they are worried that their cancer may have recurred. For breast cancer this should be established by 2019, for prostate and colorectal cancers in 2020 and other cancers where clinically appropriate by 2023. The trusts are making progress on developing and implementing their risk stratified pathways. York introduced their risk stratified pathway for newly diagnosed breast cancer patients from January 2019 and have a well-established risk stratified remote surveillance pathway for colorectal cancer. Hull also introduced their risk stratified pathway for colorectal and prostate cancers in January and NLAG have established and implemented a pathway for colorectal cancer.

Other news
The Living With and Beyond Cancer Programme Board which meets bi-monthly has welcomed two new patient representatives in 2019 to its meetings. Zoe Bounds from York and Clare Davis-Eaton from N.E.Lincs provide valuable insight into the views of service users. A meeting was held with representatives of Breast Cancer Now to discuss their manifesto for the provision of specialist support for patients with metastatic breast cancer. This was also discussed at the Living With and Beyond Cancer Board. More information about the manifesto can be found at https://www.breastcancercare.org.uk/get-involved/campaignus/secondary
Welcome to:
Laura Tattersall, Project Delivery Manager to the Diagnostics work-stream and Prostate rapid diagnostic and assessment pathway
Jen Hall, Macmillan Patient and Public Engagement Officer, Communications and Engagement Team
Tracey Emmerson, Project Support Assistant
Vicky Walpole, Project Manager, Lung Health Check Programme (3 months)
Martyn Slingsby, Programme Manager

Goodbye to:
Keith Kocinski, Data and Information lead who has now retired. Keith was instrumental in the development of the cancer dashboards and performance reporting to name just a few
and we thank Keith for all the expertise that he brought to the Cancer Alliance. He will be missed but we wish him well in his retirement

In light of the 2019/2020 programme of work and new arrivals to the team, we are reviewing the Programme team structure and will update you shortly with confirmed changes.

Meanwhile for further information please get in touch with us at: comms.hcvcanceralliance@nhs.net

February 2019 Stakeholder Updates

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As part of our communications and stakeholder engagement plans, the Humber, Coast and Vale Cancer Alliance would like to ensure that our stakeholders are kept informed on the latest news and developments across the Alliance.

NHS Lung Health Checks
On 8th February NHS England announced that Cancer Alliance had been successful in securing Hull as one of the 10 sites across England that has been chosen to deliver the first phase of the NHS Lung Health Checks. NHS Hull CCG is one of those CCGs chosen to roll out the NHS Lung Health Check. The targeted screening will help improve survival rates by going to areas with the highest death rates from lung cancer. As we know, Hull has one of the highest death rates from lung cancer.

Dr James Crick, Consultant in Public Health Medicine and Associate Medical Director at NHS Hull CCG, said: “Humber, Coast and Vale Cancer Alliance and NHS Hull CCG welcome the announcement that Hull is one of 10 initial sites, across the UK, chosen to be part of the first phase of the NHS Lung Health Check rollout. The CCG and the Alliance are working with Hull University Teaching Hospitals NHS Trust and local healthcare partners to develop plans for the implementation of the lung health check service in Hull, which will include a mobile lung cancer scanning truck.

“We know that detecting health problems earlier makes the chance of successful treatment much greater, and we look forward to working in partnership to deliver a service that is going to save lives”

Dr Crick was interviewed on BBC Radio Humberside and you can listen to his interview here:
https://www.bbc.co.uk/programmes/p06yz05l

The NHS Long Term plan sets out an ambition that 55,000 more people will survive their cancer. To achieve this, the plan also includes an ambition to increase the number of cancers diagnosed at stages one and two from half to three-quarters of cancer patients. Based on the schemes in Manchester and Liverpool, the project will not just identify more cancers quickly but pick up a range of other health conditions, including chronic obstructive pulmonary disease (COPD).

The scheme means people aged 55-74 who have been identified as being at increased risk of lung cancer will be invited for a lung health check and be offered a chest scan if appropriate, through a mobile unit. The new projects will last initially for four years and NHS England will evaluate the results with possible further roll-out. A second phase will see this service roll-out in other areas of the Humber, Coast and Vale Cancer Alliance. A first stakeholder event is being planned for April – the date will be confirmed shortly.

Clinical leadership event – Humber, Coast and Vale Cancer Alliance Senior Leaders from across the Humber, Coast and Vale Cancer Alliance area came together at the second clinical leadership event on 1st February.

The event was a chance for senior clinicians from across the Cancer Alliance to showcase the work that is ongoing. A showcase presentation, on the research project, Fast Track FIT – Diagnostic Accuracy Study was given by Dr James Turvill, Consultant Gastroenterologist from York Teaching Hospital NHS Foundation Trust.

Dr Gavin Anderson, Lung Clinical Lead and Mr Matt Simms, Prostate Clinic Lead, both presented the Lung Pathway and Prostate Pathway development work; a priority for the Cancer Alliance. Their visions will be built on later this week, on Wednesday 6th February, when the Alliance hosts a patient and carer event. This event aims to get a better understanding of the patients’ experience of the cancer pathways.

In the final session of the Clinical Leadership Event, Lucy Turner, Programme Director, took the opportunity to present the vision and draft Long Term Plan objectives for the Cancer Alliance in 2019/20, followed by a collaborative breakout session for stakeholders to review and build on the vision and objectives set out.

National cancer team’s visit to Humber, Coast and Vale Cancer Alliance
David Fitzgerald met with staff from across the Cancer Alliance when he visited the area on 5th February at The Queens Centre at Castle Hill Hospital. Presentations from senior clinicians and leaders from the Cancer Alliance were given on our vision and objectives for 19/20; 62-day recovery plan; diagnostics; lung and oncology transformational service redesign.

Following the announcement of £88.5m capital funding, the Alliance asked David for National Team support to overcome the lengthy capital clearances and business case submissions. Workforce and recruitment to key positions was also highlighted as an area where the Cancer Alliance would welcome National Team support.

David explained that the National Team is looking at how transformation funding across all Cancer Alliances is allocated with a move from a bidding process to a population-based allocation to reflect deprivation indices. If agreed, this would significantly increase resource for the Cancer Alliance.

The visit finished with a tour of the Queens Centre for Oncology and Haematology.

Oncology Services at York Teaching Hospital NHS Foundation Trust
As of 5th March 2019, the breast oncology outpatient service at Scarborough Hospital will no longer be provided by Hull and East Yorkshire Hospitals NHS Trust, and all patients will instead be seen as an outpatient at York Hospital.

This is a short to medium-term measure which is needed due to issues with medical staffing and increased patient need for access to oncology services. Chemotherapy will continue to be delivered at Scarborough Hospital.

Oncology services have been delivered by Hull and East Yorkshire Hospital NHS Trust for over 10 years. However, due to medical staffing constraints, in recent months the service at Hull is struggling to be maintained. This may have an impact on waiting times and, potentially, clinical outcomes due to delays in reviews and treatments.

There is a national shortage of oncologists and also oncology trainees. The service has advertised numerous times over the past 18 months to recruit both substantive and locum staff with little success.

As you may also already be aware, referrals to Scarborough and York oncology services have increased each year for more than a decade. This is having a significant impact on the demand for the service.

York Hospital is currently in the process of contacting patients who have been referred to the service to make them aware of the changes.

Patients with a current open referral will be contacted by phone by York Trust staff and it will be explained to them that their oncologist will no longer be providing clinics in Scarborough. If they wish to stay under the care of this consultant, they will be given the option to transfer their care to Hull and continue with the same consultant. This will however mean that the rest of their care and treatment would also transfer to Hull (including chemotherapy).

The alternative is that they will be given an appointment at York Hospital. This would mean that their oncology outpatient appointments would take place in York, however they would be able to have chemotherapy in Scarborough or Bridlington. The initial phone call will be followed up with a letter.

For new patients and those referred for appointments from 5 March onwards, the referral pathway remains the same as now. Patients needing a referral into the two week fast track breast cancer pathway can be referred to either York Trust (with diagnostic appointments taking place at York Hospital) or to Hull Trust, as is currently the case, taking into consideration patient choice.

This is a short to medium-term measure which is necessary to continue to deliver a service that meets expected levels of quality and safety.

Our priority is to ensure that patients who need to be seen by a highly skilled specialist can do so as quickly as possible, and the only way to do this within the current resources is to provide the service from a single location.

Diagnostics
Contracts are currently being signed following the procurement of the radiology workflow solution. This is a five-year contract with option to extend for a further five years, one year at a time and an option for Yorkshire Imaging Collaborative to join the contract at a later date if this suits the needs of their stakeholders.

Good progress is being made on the joint asset register for diagnostics with plans for an initial, collaborative exercise planned in early April to support recommendations about strategic investment in replacement radiology kit.

Work is currently being worked up to move from a radiology outsourcing network to develop an insourcing network which aims to make best use of the available resources across the patch and reduce cost and reliance on outsourcing over time.

The Board Assurance Framework has been circulated to key stakeholders for input. The framework will create a combined list of risks that can be evaluated and used to identify priority actions using a collaborative region wide, strategic approach. This will be discussed further at the Endoscopy Working Group on 5th March and the Radiology Group on 7th March and a future Pathology Group and at the Strategic Diagnostics board on 14 th March. The next Strategic Diagnostic Board is being held on 14th March 2019.

Treatment and Pathways

To assist and support the planning and implementation of the Colorectal, Lung and Prostate Rapid Diagnostic and Assessment Pathways, stakeholder events continue to be held across each of the pathways.

The Cancer Alliance held a Colorectal Cancer Event on 28th February focusing on implementation of Faecal Immunochemical Testing (FIT). Participants heard from NHS England about the new FIT screening test being implemented from April, about the use of FIT in symptomatic patients presenting in primary care, and early results of an economic analysis of the weight loss pathway. The event was well attended by staff from primary and secondary care and evaluated well. This is part of the work we are undertaking to agree pathways across the Alliance for low risk and high risk patients. Copies of the presentations are available here

Lung Rapid Diagnostic and Assessment Pathway
Action plans have been drawn up and agreed and a further business meeting was held on 21st January to update and discuss issues affecting all organisations across the Alliance, including workforce shortages and diagnostics. A further education event is being planned for 30th April 2019. Slides from all the previous event can be found here

Prostate Rapid Diagnostic and Assessment Pathway
The next Prostate workshop is currently being planned and a date will be circulated shortly.

Prostate Focus Group
Focus groups were held on 6th February at the County Park Inn, Hessle, where a number of patients and others affected by prostate cancer came together to talk about their experience of prostate cancer from their signs and symptoms, presenting at primary care through diagnostics, treatment to living with and beyond cancer. The event was incredibly well attended and the findings and next steps from the event will be taken forward with those that attended with future co-production events being arranged. The findings from the event will be used to inform the pathway work currently being undertaken. Focus groups sessions are being planned for those affected by colorectal cancer in the near future, to inform the colorectal pathway.

Living with and beyond cancer
Progress is being made with the introduction of risk stratified pathways with all new patients with colorectal cancer beginning to be risk stratified at Northern Lincolnshire and Goole NHS Foundation Trust. Hull and East Yorkshire Hospitals NHS Trust have begun risk stratification for colorectal and prostate cancer (where patients received radical radiotherapy). Patients with breast cancer are also risk stratified. At York Teaching Hospital NHS Foundation Trust, patients diagnosed with breast cancer and colorectal cancer are risk stratified.

Upcoming Awareness Days/Campaigns – March 2019
Ovarian Cancer Awareness month
Prostate Cancer Awareness month
Cervical Cancer Screening campaign
No Smoking Day – 13th March 2019

https://campaignresources.phe.gov.uk/resources

Twitter @HCVCancer

A reminder that Humber, Coast and Vale Cancer Alliance uses twitter and our handle is @HCVCancer Please do send content or tag us in to anything you would like us to share or make us aware of.

If there is anything you would like to include in future monthly updates, please email us at comms.hcvcanceralliance@nhs.net

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