1. LWBC: Implementation of the Recovery Package
Somerset, Wilts, Avon and Gloucester Cancer Alliance
LWBC: Implementation of the Recovery Package
Dr Dorothy Goddard
Chair, SWAG Alliance LWBC Group
Consultant Breast Radiologist
Macmillan Associate Medical Director for Cancer Strategy
Royal United Hospital NHS Foundation Trust BATH

2. Why? . The problem… The solution… Increasing demands Unmet needs
Somerset, Wilts, Avon and Gloucester Cancer Services
Why? .
The problem…
Increasing demands
Unmet needs
The solution…
Living with and beyond Cancer (Survivorship)
Recovery package
Stratified follow up

3. The problem: increasing demand
Somerset, Wilts, Avon and Gloucester Cancer Services
The problem: increasing demand
Increasing number of people
developing cancer
Increasing number of survivors

4. The problem: unmet needs
Somerset, Wilts, Avon and Gloucester Cancer Services
The problem: unmet needs
Conventional follow up not
meeting people’s needs
Recurrent or new disease not
picked up at routine follow up visit
National Cancer Patient Satisfaction Survey
The Cochrane Review

5. Living with and beyond Cancer
Somerset, Wilts, Avon and Gloucester Cancer Services
What?
Living with and beyond Cancer
Supporting people (to live well with and beyond cancer) from cancer diagnosis through treatment and beyond…
Recovery and Rehabilitation: Recovery Package
New models of after care: Stratified Pathways of Care
Supporting people with active or advanced disease

6. . Breast cancer pathway Recovery package and stratified follow up
Diagnosis
Treatment(s)
After care
HNA and care plan
Treatment summary
GP cancer care review
Health and well-being event
Self management
Ongoing care

7. Somerset, Wilts, Avon and Gloucester Cancer Services
When? .
2017/ / Metrics

8. Implementation How? LWBC Group – Alliance approach
Somerset, Wilts, Avon and Gloucester Cancer Services
How?
Implementation
LWBC Group – Alliance approach
Cancer Transformation Funding

9. Cancer Transformation Funding
Somerset, Wilts, Avon and Gloucester Cancer Services
Cancer Transformation Funding
£6 million for SWAG – over two years:
Cancer transformation taskforce (leadership)
Recruit additional support workers to implement RP and free up CNS capacity
Training for support workers, primary care and psychology support
IT infrastructure to enable RP including remote surveillance, tablet devices, patient portals
Bid for funding – submission September 2017:
Dependent on 62day performance and recovery plan

10. Implementation Workforce:
Somerset, Wilts, Avon and Gloucester Cancer Services
Implementation
Workforce:
Improve workforce skill mix – band 4 workers supporting CNS’s
Psychological training programme for CNS’s and support workers
Training for GP’s and practice nurses for Cancer Care Review
HNA’s and care plan:
Performed soon after diagnosis and at end of treatment(s)
Referral to other services as required

11. Implementation Treatment summary:
Somerset, Wilts, Avon and Gloucester Cancer Services
Implementation
Treatment summary:
Patient (&GP) receives TS following every phase of completed acute treatment
South West best practice TS template in development
GP Cancer Care Review:
LWBC training for GP’s and practice nurses to improve quality of cancer care reviews

12. Somerset, Wilts, Avon and Gloucester Cancer Services
Implementation
Health and well-being event:
Use existing programmes and resources to co-ordinate and develop a rolling programme, incl. community and online resources – Macmillan, We Hear You, Penny Brohn
For access at point of need, not just start or finish of Rx
The South West vision is for all patients to receive the four key elements of the recovery package regardless of geographical location or tumour site

13. Somerset, Wilts, Avon and Gloucester Cancer Services
For?
Outcomes:
Patient experience improved with access to support they need, when they want it
Patient empowered and confident to self-manage
Consequences (or side effects) of treatments or recurrence identified earlier
Life style changes lowers risk of recurrence and improved quality of life
Financial savings with less follow up
Recovery package essential to support patients stratified to self-management

14. Thank you: any questions?
Somerset, Wilts, Avon and Gloucester Cancer Alliance
Thank you: any questions?