Cancer 62 day rapid recovery plan South region

Objectives Objective Current state (end March data) Improvement required For 70% of providers in the South to be delivering the 62 day cancer standard by end July 2017 21 of 36 providers in the South (58%) achieved the 85% operational standard in March 2017 To deliver 70% performance, an additional 5 providers need to be delivering the operational standard by end July. To achieve 85% performance in aggregate across the South by the end of September 2017. In March, 81.04% of patients in the South were treated within 62 days By September, we therefore need to see a minimum improvement in aggregate of 1 percentage point

Approach Ensure the 10 High Impact cancer Actions are embedded across all providers Monitor performance improvement against an agreed set of tumour pathway specific trajectories Focus on cancer PTLs locally and regionally to ensure these are being used effectively to deliver performance improvement, including carrying out PTL validation and training Deploy Cancer Support Teams in a number of providers and local systems to support sustainable performance improvement Provide targeted leadership, coaching and organisational development support Support local systems and cancer alliances to make specific pathway improvements across all trusts in key tumour pathways with highest number of breaches (Lung, Prostate and Upper and Lower GI) Pilot multi-pathway MDT co-ordinators in local systems with the most significant number of breaches on multi-provider pathways Investment in additional activity to clear backlogs, where it can be demonstrated that this will support longer term plan for pathway transformation that will lead to sustainable performance delivery Support the Establishment of Rapid Diagnostic and Assessment Centres and implementing digital diagnostic services and networks across Alliance geographies.

Phases The South Cancer 62 day recovery plan can be broken down into three broad phases: Phase 1: Immediate – Operational improvement actions with providers and CCGs Phase 2: June to October – targeted support to CCGs and providers, utilising some of the £2.9m available to the South Phase 3: August onwards – use of funding increasingly shifting towards on cancer alliances with a focus on embedding sustainable change.

Phase 1 – Operational Improvement These actions have already being set in to motion by NHS Improvement (South) – See appendix A for details of specific providers Group Group description Actions 1 10 Trusts in the South with minimal number of excess breaches Weekly PTL reviews Assurance and monitoring of speciality level recovery plans 2 7 Trusts with the highest number of breaches 3 10 Trusts with the most number of breaches between 63 and 76 days 4 Trusts with the highest number of >104 day breaches Assurance and monitoring of 104 day recovery plans 104 day cancer summit meeting to be held with these providers in June 2017 All All providers Baseline assessment of implementation against the 10 high impact cancer interventions Assurance and monitoring of 62 day trajectories

Phase 2 – targeted support to CCGs and providers Action Action description Indicative cost Timescales 1 NHS Elect Leadership development programme £130,000 June to December 2017 2 Rapid improvement team (team of approx 10-12 staff with a mix of cancer specific, operational management and service improvement/transformation skills) £650,000 Coming on stream from beginning of July 2017 to end March 2018 3 Regional clinical leadership for the four key cancer pathways £75,000 From June onward 4 Pilot cancer PTL validation work, delivered through North of England CSU £10,000 (for 2 pilots – c£5,000 per additional trust if scaled up) Two pilots to be carried out in June, with further work if successful from July - September 5 Pilot multi-provider pathway MDT co-ordinators in 5 areas £150,000 July 2017 to December 2018

Phase 2 – targeted support to CCGs and providers (cont) Action Action description Indicative cost Timescales 6 Purchase additional short term capacity/activity to support delivery of standard by September, provided this is part of a sustainable pathway transformation plan £500,000 - £1m July - October 7 Accelerate clinical network/cancer alliance led pathway capacity mapping work aligned to the four priority pathways identified nationally (Lung, Prostate & upper/lower GI) £300,000 June – December

Phase 3 – Cancer Alliance focussed support We will work with the Cancer Alliances in the South to identify and agree packages of support, utilising the remaining c£500,000 funding, this will include agreeing any extension of existing work (such as support to accelerate pathway mapping and transformation) as well as any further support to Establish of Rapid Diagnostic and Assessment Centres and to implement digital diagnostic services and networks across Alliance geographies. The design phase of this additional support will take place with alliances between June and August 2017, with the support coming on stream from August/September onwards

Governance We have established a regional NHSI/E cancer performance and delivery group, which is meeting weekly to ensure the south recovery plan is rapidly deployed and that the anticipated benefits are realised. CCG, provider, cancer network and Alliance representation is being built into the group. The group is reporting into the South Elective Care Board and both NHSI and NHSE Medical Directors are providing leadership to the programme. NHSI are leading on weekly cancer PTL reviews with the Trusts identified in Phase 1. Local bipartites will be expected to prioritise cancer 62 day recovery and to have oversight of performance recovery and PTL progress locally We are looking to bring in additional project support regionally (using the £300,000 available) to support the work of the programme

Appendicies A: PROVIDERS IN PHASE 1

Group Description Trusts 1 10 Trusts in the South with minimal number of excess breaches Ashford Dorset North Bristol IOW Bucks QVH Taunton & Somerset Yeovil Weston 2 7 Trusts with the highest number of breaches Oxford RD&E Gloucestershire E Sussex Brighton E Kent Medway 3 10 Trusts with the most number of breaches between 63 and 76 days Southampton Plymouth RUH Bath Portsmouth 4 Trusts with the highest number of >104 day breaches R Surrey Bournemouth