London cancer
workshop
8th March 2011
Agenda
Time
Session
2.00pm
Welcome and objectives
2.10pm
The model of care
2.25pm
Provider network development
2.45pm
Question and answer session
3.00pm
Coffee
3.15pm
Workshop session
Provider network scope, governance and incentives
4.00pm
Feedback and discussion
4.20pm
Closing remarks and next steps
4.30pm
End of session
Objectives
• To inform providers of the implementation programme
• To engage providers in the development of the
provider network model and specification
• To outline to providers the timeframe for specification
development and provider network bids
• To prompt providers to begin provider network
discussions and bid development
The model
of care
Chris Harrison
Developing the proposals
• 45 clinicians working over 12 months
• Three work areas: early diagnosis; common cancers
and general care; rarer cancers and specialist care
• Case for change: December 2009
• Model of care: August 2010
• Extensive 3-month engagement on proposals – over
85 per cent of survey respondents supportive
The case for change
• Later diagnosis has been a major factor in causing
poorer relative survival rates
• There are areas of excellence in London but
inequalities in access and outcomes exist
• Treatment and care should be standardised
• Specialist surgery should be centralised: common
treatments should be localised where possible
• Comprehensive pathways should be commissioned;
organisational boundaries should not be a barrier
The model of care
• Improve early diagnosis by addressing public
awareness, GP access to diagnostics, screening
uptake rates and health inequalities
• Extended local provision of common cancer services,
such as chemotherapy and non-complex surgery
• Further consolidation of surgical services for rarer
cancers into specialist centres
• A small number of networks of providers delivering
standardised pathways
Provider networks
• Model of care recommends the split of commissioning
and provider networks
• Provider networks to deliver comprehensive pathways
in response to fragmentation of services
• Concept right but language of networks clouds issue
• Integrated cancer systems containing all NHS orgs
delivering cancer care from diagnosis to end of acute
Implementation workstreams
Workstream
Workstream
1. Public health
and primary care
1. Public health
2. Best practice
and primary care
2. Best practice
3. Radiotherapy
commissioning
3. Radiotherapy
4. Provider network
commissioning
designation
4. Integrated system
5. Provider network
designation
development
5. Integrated system
development
Phase one
Dec 10–Mar 11
Phase one
Dec 10–Mar 11
Phase two
Apr 11–Mar 12
Phase two
Apr 11–Mar 12
Phase three
Apr 12–Mar 13
Phase three
Apr 12–Mar 13
Integrated system
development
Rachel Tyndall
Integrated system designation
• Providers will be asked to respond collaboratively to a
integrated system specification
•
•
•
•
There will be more than one and fewer than five
Which system they are in will be the provider’s choice
Only providers in a system will provide cancer services
Legal status required for contracting
Services
• Integrated systems will be required to demonstrate
how they will contribute to the delivery of the model of
care:
–
–
–
–
Early diagnosis
General care
Common cancer
Rarer cancers and specialist care
Specification
• In addition to services, the integrated system
specification will cover 6 areas:
–
–
–
–
–
–
Scope
Governance
Information
Incentives
Culture
Research and education
Standards
• Commissioners will set measures and thresholds to
assure quality and drive excellence
Patient
experience
Structure
Process
Outcome
Patient safety
Effectiveness
Timeline
Event/task
By
London Delivery Group
31st January 2011
Announcement of specification development process
8th February 2011
Individual meetings with providers
Feb/Mar 2011
Specification development events
Early March 2011
Publication of specifications
April 2011
Support for bid development
Apr/May/Jun 2011
Individual or group meetings with providers
Apr/May/Jun 2011
Deadline for bid submission
30th June 2011
Workshop
Scope, governance and incentives
Rachel Tyndall
The givens
• We will change the way we commission to
commissioning by pathways
• Only those part of an integrated system will provide
cancer services
• Will contain as a minimum all secondary and tertiary
care providers
• Some pathways will cross systems
• Will demonstrate commitment to implementing model
of care for common and rarer cancer services
• Clinically led with an overarching governance board
will manage system as single entity
Group session
• How could orgs in the system hold each other to
account? What are the interface performance measures?
• What can be done to incentivise providers to work
differently?
• How could MDTs be made accountable to both patients
and the system?
• How would the system hold MDTs to account?
• What impedes system-wide working at the moment?
Next steps
• Further workshops with your colleagues
• Ongoing work in March on commissioning an
integrated system
•
•
•
•
Outline specification published in April
Ongoing development of the model beyond April
Bidding stage from April to June
Tailored support available during bid development
• For further information on the case for change and
model of care visit www.csl.nhs.uk/publications