SWAG Cancer Alliance Update

Agreed Terms of reference SWAG Cancer Network Site Specific Groups: Brain Breast CUP Colorectal Gynae Haem Head & Neck Lung Sarcoma Skin Upper GI Urology Five Year Forward Cancer Strategy Bath, Wiltshire and Swindon Cancer Steering Group Agreed Terms of reference Managerial Lead: James Rimmer Gloucestershire CEO Clinical Lead: Amelia Randle Somerset CCG Macmillan GP Somerset Cancer Steering Group Midlands Alliance SWAG Cancer Alliance Board Bristol, North Somerset, South Gloucestershire (BNSSG) Cancer Steering Group User Representatives Charity Representatives Gloucestershire Cancer Steering Group All Cancer Steering Groups map to the local STP geography Members: CCGs, General Practitioners, Cancer Managers, Lead Cancer Nurses, Clinical Leads for Cancer

Alliance STP coverage Population Number of CCGs Cancer Alliance Lead Somerset, Wiltshire, Avon & Gloucestershire (SWAG)   Spans 4 STPs**: -Gloucestershire - Somerset - Bath, Swindon and Wiltshire (minus Swindon CCG) - Bristol, North Somerset and South Gloucestershire 2.7 million NHS Gloucestershire NHS Somerset NHS Bath and North East Somerset NHS Wiltshire NHS Bristol NHS North Somerset NHS South Gloucestershire James Rimmer Chief Executive Weston Area Health Trust

Scope The SWAG Cancer Alliance will drive delivery of equal and excellent quality of care including: Prevention and diagnosis for those at risk of cancer; Treatment and support for those living with or beyond cancer; Clinical outcomes and patient experience.

Transformation Bid provisionally approved for starting in approx. Q2/3 of 2017 Early Diagnosis – Lung, FIT testing Recovery Package Stratified Pathways of Care

Causes of Premature Death SWAG 2011-2013 healthierlives.phe.org.uk

Somerset Radiology Decision Tool Code Result   Standard text with report and Management Plan CX1 (Normal) Normal CXR     A normal CXR does not exclude malignancy. If there is still a strong clinical suspicion referral to the clinic is advised With haemoptysis: A normal CXR does not exclude malignancy but minor/resolved haemoptysis without other symptoms has a low risk CX2 (Other Pathology) Other Pathology – not normal CXR but abnormality that does not need further investigation No further action required - ? same standard text as CX1 CX3 A) Infection CX3 B) (probably benign but ? malignant) A)Infection B) Abnormal uncertain pathology A) Repeat CXR in 6 weeks. B) CT Scan CX4 probably malignant but ?benign Abnormal uncertain pathology – or pathology that needs further evaluation Recommend CT scan and 2ww referral CX5 Lung Cancer

Lung Bid CXR decision tool Understand the workload impact of a straight to CT pathway Facilitate phased introduction of straight to CT – implementing it for CXR5 reports initially and broadening to CXR4 in a second phase. Enable radiologists to maintain oversight of CT requests and ensure the new pathway is consistently managed. Set up reporting of CXR codes and relate to outcomes as quality assurance of CXR reporting across providers Work towards implementation of the National Optimal Pathway for Suspected Lung Cancer Pilot initiatives to streamline pre-CXR part of the pathway

SWAG Radiology Walk-in Appointment Only PACS MPH 2 3 Care Stream in 1m YDH 5 Care Stream Weston 1 Insignia BRI NBT 4 Fuji RUH 6 Gloucestershire 7 Phillips Care UK Total 16 20