1. SWAG Cancer Alliance Update

2. 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

3. 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

4. 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.

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

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

7. 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

8. 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

9. 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