1. Children and Young People Improving Outcomes Guidance  Key aims of guidance and age specific requirements  Designation of Principal Treatment Centres  Development and designation of Shared Care  Timeframe for delivery  Challenges and opportunities

2. Key aims of CYP IOG and age specific requirements  “Age appropriate, safe and effective services as locally as possible, not local services as safely as possible”  All children and young people under 19 yrs old must be referred for definitive diagnosis and treatment in age appropriate facilities in the PTC  Young People between 19-24 should have unhindered access to age appropriate facilities and support when needed. They can choose to receive treatment at a PTC, locally, or a combination of both through shared care. (dependant on tumour and treatment)

3. Configuration, co-ordination and care  SCG required to designate PTCs identified for Children and Teenagers and Young Adults to provide sustainable services with facilities and workforce  Children’s Cancer Measures (2009) require Children’s Cancer Network Co-ordinating Group (HYCCN & YCN) responsible for ensuring delivery, leadership and co-ordination  Clear governance and leadership: Clinical leadership of PTC with agreed protocols and agreed areas of responsibility  Co-ordinated pathway of care delivered by MDTs, providing information and support for patients and carers  All patients must have access to tumour-specific expertise, access to clinical trials, or treatment on agreed protocols  Registration of cancers in 15-24 year olds

4. Shared care  SCG designate Shared Care Units, with Cancer Commissioners and Networks. Commissioners should ensure that shared care arrangements are established which  have approved clinical protocols for treatment and care  define areas of responsibility with the PTC  identify a lead clinician and a lead nurse  Shared Care for children aged 0-16: nationally agreed levels of care, levels 1 – 3;  In HYCCN & YCN : Hull and Scarborough, Airedale, C&H & York - all Level 1, apart from Hull Level 2

5. Shared Care components  Coordinated care supported by appropriate structures, processes  Named lead consultants, nurse, pharmacist in PTC and at local level  Robust 2-way systems of communication  Age appropriate environments  Written guidelines to support the level of care agreed  Education and training programmes for staff in all settings  Arrangements for unexpected admissions  Identified contacts for families  Identified funding

6. Shared Care components Shared Care for TYA:  PTC need to work with both child and adult services for shared care  3 shared care levels defined as per children’s services - practicality and safety  Need to develop a ‘Network care’ service model in collaboration with Trusts who provide cancer services for adults  Require prompt referral and response to ensure informed choice for all 19-24 yr olds and that treatment is not delayed

7. Timeframe  For full implementation by Dec 2010  0-16: PTC and Shared Care Units designated, MDT in place, pathways agreed. Formal agreements to be completed by Dec 2010  TYA: PTC designated, MDT in place, pathways agreed. Formal agreements to be completed by Dec 2010

8. Challenges and opportunities  For Commissioners: to ensure effective and safe provision of shared care services for Children and TYA  For PTC: Children’s measures require formalising protocols, MDT and shared care  For Shared Care Units: Children’s measures require shared Care Units to formalise arrangements, ensure cover, safe facilities and services, monthly MDT  Aiming for Peer Review 2011/12