1. Supporting people with active and advanced disease Need better data collection Discussion at MDT – new diagnosis support Identify best practice Early palliative care support improves quality and quantity of life

2. What is the economic evidence behind survivorship? ‘Routes from Diagnosis’ is a way of linking and analysing routinely collected data Maps the cancer journey from diagnosis through to death Describing health outcomes i.e. survival times, incidence, prevalence of cancer and non related cancer morbidities. Tells us how patients interact with the system e.g. interaction with health care services, when, how long and cost

3. All patients reach one of these outcome groups – taking different routes from diagnosis Diagnosis 0-12 months 1-7 years, cancer complications 7+ years, no complications This is a survivorship outcome framework 1-7 years, other morbidities 1-7 years, no complications 7+ years, morbidities 25.3% 29.7% 5.9% 20.4% 6.3% 12.4% SIMPLIFIED EXAMPLE Everyone diagnosed with prostate cancer in England in 2004

4. What does RfD tell us? We know more about clinical outcomes – beyond just survival We know more about how they interact with the system

5. Insight – Health economics

6. Different ‘Routes from Diagnosis’ 3 final CR survivorship pathways for testing Interventions tailored for each ‘Route from Diagnosis’ Designing effective Service Solutions

7. Exciting new research Macmillan working with NCIN and Imperial College London to produce evidence on main drivers of cancer costs. Cost data will allow comparison of alternative pathways of care. Investigate variation in costs in England across lung, breast, prostate and bowel cancer: Economic burden of cancer Differences in the cancer care pathways and their effects on patient survival and costs Cost of emergency admissions of patients with cancer

8. Supporting people with active and advanced disease Need better data collection Discussion at MDT – new diagnosis support Identify best practice Early palliative care support improves quality and quantity of life

9. Key survivorship messages A shift in professional culture is essential to enable supported self management. New models of cancer aftercare gives opportunities to improve quality and reduce cost. Many people can self manage their health with support, with rapid access to professionals when needed. There is significant unmet need arising from consequences of treatment, which can be successfully addressed through prevention and treatment. Good survivorship care requires timely communication across boundaries.

10. Aligning with the NHS Mandate in England

11. Taking Action - a ‘how to guide’