SYND&B Cancer Alliance Chemotherapy Services – Case for Change Introduction One of the key areas of focus of the High Value Pathways workstream of the South Yorkshire, Bassetlaw and Derbyshire (SYND&B) Cancer Alliance is chemotherapy. The aspiration of this Workstream is to reflect the considerable developments in chemotherapy in more delivery outside of main acute centres though a new Chemotherapy delivery model - an integrated system wide service model for the delivery of System Anticancer Treatments (SACT) that will optimise patients’ experiences and outcomes by delivering high quality personalised treatment in appropriate environments, incorporating treatment that will be as close to home as possible, at the closest unit specialising in the best care for that individual underpinned by robust guidelines and governance model. The future model needs to be based on five key underlying principles from the tertiary centre: An outreach model in the major hubs underpinned by robust governance arrangements Retention and expansion of the catchment population Delivery of chemotherapy as close to home as possible, at the closest unit specialising in the best care for that individual A sustainable and transparent financial model which supports a partnership approach to future service developments across the network Maintaining and increasing recruitment to research trials across the network To be effective this model will need to work in conjunction with a class leading acute oncology service to ensure that patients have access to expert advice and receive appropriate management in a timely manner when there are concerns or complications. To help inform the development a vision for SACT across SYND&B and a new service model the Cancer Alliance commissioned external consultancy support. Support Provided Our work involved undertaking the following key activities: A review of recent work undertaken on the SACT pathway at an Alliance level. Identification of information/data requirements and sources and development and issue of an information/data request. Discussions with all commissioners and providers to garner soft intelligence on current provision and views on the future delivery model for chemotherapy. Consolidation, review and analysis of returns. Integration of the analysis and work to date to develop a series of observations and opportunities to inform a vision and future model. Discussions with providers to validate the consolidated data/information and to share and test evolving observations. A literature review that explores different and innovative models of chemotherapy delivery and potential new treatments that are on the horizon. Drafting a baseline review six dimensions - service model, finance and contracting, quality and performance, workforce, Infrastructure (Estates, ICT & Pharmacy) and research. The review built on the recent work undertaken by Weston Park Cancer Centre to develop a case for change for solid tumour oncology and complements it by including the interface with haematology and pharmacy. Summarising the salient points of the review into a concise Case for Change. Value Delivered To Client A shared understanding across providers and commissioners of the challenges facing provision now and in the future. Greater transparency around contracting and payments arrangements. Clarity on the true drivers constraining delivery. A recognition of the need to consider the impact on haematology and pharmacy in future model discussions. Identification of opportunities for efficiencies across the system. Stakeholders who are informed of alternative models in practice and future treatments that could impact a preferred service model. Buy-in and commitment from all providers and commissioners to the need for a new model.