Local networking sessions Midlands

Midlands Geography Networking Session Maxine Astley-Pepper & Sue Sanderson

WHAT DO YOU KNOW ABOUT MACMILLAN IN THE MIDLANDS? It’s make-up It’s strategic direction It’s priorities It's principles for supporting service developments

THE MIDLANDS GEOGRAPHY What is the population of the Midlands Geography 2. How many CCGs are there in the Midlands Geography? 3. How many STP areas are there in the Midlands Geography?

NATIONAL STRATEGY 4. How many identifiable stages are there in Macmillan’s Times of Need Framework

LOCAL STRATEGY 5. How many Geographical Strategic Priorities (GSPs) are there? 6. Name them…. 7. Which two are the current priority GSPs?

MACMILLAN IN THE MIDLANDS TEAM 8. How many people are employed by Macmillan and make up the Midlands Geography Team? 9. Who is the Midland’s Geography Head of Service?

MACMILLAN PROFESSIONALS 10. How many Macmillan Professionals are there in funding across the Midlands Geography? 11. How many Macmillan GPs are there in the Midland’s Geography?

Macmillan Spend 12. Macmillan’s financial year runs from January to December; to date how much has the Midlands geography spent on service developments in 2017?

THE MIDLANDS GEOGRAPHY What is the population of the Midlands Geography 10.5million 2. How many CCGs are there in the Midlands Geography? 43 3. How many STP areas are there in the Midlands Geography? 11

NATIONAL STRATEGY 4. How many identifiable stages are there in Macmillan’s Times of Need Framework? 9

Times of need framework Although each person’s cancer journey is individual and varies in timescale, we recognise there being 9 identifiable stages Each stage could be considered a period when a patient has greater need for intervention in some form, be it care, information, support, etc The types of need have been classified: Financial: Income, expenditure, work and administration Physical: Health status and physical fitness Practical: Personal care, tasks of daily living, independence Emotional: Emotions, feelings and social interactions Systemic: Access to / provision of support and services Information: Information and support as an end in its own right As you’d expect, these needs may be experienced in any number of ways, and to any greater or lesser extent – see lists for 2015 estimates of numbers and reach Looking at TON, including level & severity of need and reflecting reach to consider how best change can be effected for each TON, e.g. nurses at Tx Mapped against GSPs, with 3 emerging priorities: LWABC. Develop better understanding of this beyond RP. Also understand sub breakdown and needs(cancer coming back, consequences, living well) Incurable but Treatable into EOL – Transition. Maximise historical investment and existing position. Support transition to help improve outcomes for those patients. (NB EOL commissioning often condition agnostic so difficult to influence extensively) (Diagnosis – 2 geographies referenced. More around point of diagnosis, recognise existing market around signs/ symptoms etc) TON work started later than GSP so no neat fit (Also Tx but recognised already in line with direction/ covered)

LOCAL STRATEGY 5. How many Geographical Strategic Priorities (GSPs) are there? 6 6. Name them…. 7. Which two are the current priority GSPs? 3 & 4

End of Life Care Prevention and Diagnosis Cancer Care Teams Workforce Living with and Beyond Cancer GSP 1: Macmillan has a comprehensive understanding of the needs, behaviours and preferences of People Living with and Beyond Cancer (PLWBC) across the Midlands End of Life Care GSP 6: We need to work more closely with Macmillan Supportive and Palliative Care Services in the Midlands to enable improved transition from living with and beyond cancer to supportive care and End of Life Care (EoLC)Services Prevention and Diagnosis Treatment and Recovery GSP 2: To maximise the impact of the significant investment that Macmillan has invested in Acute Oncology Services in the Midlands in order to understand the needs of PLWBC when presenting inappropriately within Accident and Emergency (A&E) Departments GSP 3: People Living with and Beyond Cancer (PLWBC) in the Midlands have access to holistic person centred care that enables them where possible to manage their own condition and the system is also enabled to deliver care and support according to the level of need Quick show of hands – who heard of GSP? who heard of TON? Background: Aware Macmillan gone through significant reconfiguration, partly to improve ways of working and enable better focus on local needs for PABC UK split into 9 geographies, and each geography developed its own strategy. Geographic Strategy Based on extensive review and analysis of local provision and need Identifies up to 7 geographic priorities to focus on over next 3-5 years, aligned with Macmillan’s overall aims (Reach and improve lives of everyone affected by cancer, and inspire millions of others to do the same…) Enables Macmillan to maximise impact and influence Joined up offer and ways of working e.g. RP/ holistic person centred care, Finance offer, Transition/ EOL, address inequalities, workforce GSP 3 (8/ 9 geographies with something relating RP/ holistic person centred care): Enable PABC to have access to holistic person centred care, enabling self management. System enabled to deliver care and support based on need Midlands cancer patients and their family perhaps less likely to seek help through treatment and beyond = higher unmet need Traditional systems of care not necessarily geared to prepare patients well in order to self manage, get involved in shared decision making (clinical and holistic) GSP 4 (7/ 9 geographies with something ref workforce development): Workforce is equipped to enable PLWBC to self manage Developing & enhancing current L&D for workforce involved in supporting PLWBC Enabling workforce to support PLWBC to self manage Influencing system approach, not just 2Y/ 1Y/ commissioners… not just specialist services hence GPFs etc Ensuring Macmillan offer easily accessible GSP 6 (5/ 9 geographies with a GSP covering transition/ EOL related): Work closely with Macmillan services to enable improved transition from LWBC to supportive care and EOL Develop better understanding of transition to EOL, and Macmillan’s role in supporting Enhancing support available to inform better planning for death, e.g. 50% die in preferred place of death, families may not receive information to enable them to die well Establish if/ How Macmillan works alongside existing service providers delivering palliative care GSP 5: PLWBC in the Midlands receive an early, high quality and integrated financial offer from Macmillan Helping People Take Control GSP 4: The current workforce in the Midlands is equipped to enable PLWBC to self manage their own condition Midlands Geographic Strategic Priorities aligned to the Macmillan Sub Strategies appendix

What we are not prioritising and why…. Prevention and Diagnosis Paediatrics Supportive and Palliative Care (new investment) Stand alone Clinical Posts Bereavement Services Rarer Cancers Carer Services Prison services Cancer environments that do not support delivery of I&S Where Macmillan GPs might be involved in service development/ transformation, and work with Macmillan for new services…list of broad principles for areas we would tend not to support in our service development prioritisation: We will not prioritise prevention and diagnosis but continue to influence and work with our CRUK colleagues with regard earlier diagnosis. We will continue to influence and improve supportive and palliative care services especially with regard the transition from living with cancer but there will be no new investment. The focus of the strategy will be on adults whilst recognising that where teenage and young adults transition to adults and are living with cancer we will support improvements that enable this transition to occur more effectively (Not children’s Cancers). We will not be prioritising new developments for the need of people with rarer cancers but will support improvements to services if they are meeting the needs of PLWBC. The rationale for this is that we want to ensure in the next 3-5 years that we have delivered new services and improvements for people living with breast, colorectal and prostate cancer. We will continue to influence for improved access to bereavement services until we better understand the needs and gaps in current service provision. We will not support any ad-hoc, stand-alone clinical posts. We will not extend any services that do not meet our strategic priorities or are able to demonstrate impact for PLWBC. We will not invest in cancer environments that do not support the delivery of Information and Support services. We recognise that there are specific groups and areas where we will only be able to make a limited offer and contribution and these include:- Carers – We recognise there is a need to understand the needs of carers so we can explore the opportunities to develop skills of carers to enable them to care. We will influence and work with services that support carers and will sign post carers to other services where appropriate. We will continue to provide information and support for carers about their role as a carer and the cancer of the person they are supporting. Prisoners- we are aware of a significant expansion of prison services in Midlands. However, we anticipate providing an advisory role with no active involvement.

MACMILLAN IN THE MIDLANDS TEAM 8. How many people are employed by Macmillan and make up the Midlands Geography Team? 60+ 9. Who is the Midland’s Geography Head of Service? Jo Judges

Team Macmillan in the Midlands (minus Fundraising)

The Midlands Senior Leadership Team Jo Judges Head of Services Midlands Elaine Wilson Strategic Partnership Manager East Midlands Vacancy Strategic Partnership Manager West Midlands Phil Hetherington Engagement and Volunteering Manager Midlands Eric Davies Programme Manager Midlands Lorna Allen Communications Manager Midlands Libby Potter Senior Learning and Development Manager Midlands

MACMILLAN PROFESSIONALS 10. How many Macmillan Professionals are there in funding across the Midlands Geography? 376 11. How many Macmillan GPs are there in the Midland’s Geography? 31 31

Macmillan Spend 12. Macmillan’s financial year runs from January to December; to date how much has the Midlands geography spent on service developments in 2017? £7.3million