Cant Wait to Beat Cancer – First national briefing on cancer by asafwewe


Cant Wait to Beat Cancer – First national briefing on cancer

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									Can’t Wait to Beat Cancer – First national briefing on cancer
waiting times in England

Summary of SHA workgroup responses to “Do you have a key message
for Sir Liam Donaldson regarding the challenges ahead?”

Background: Participants at the briefing we divided into 28 SHA based
workgroups to consider key questions relating to the achievement of the 2005
cancer waits targets. The groups were also invited to submit a ‘post it note’
with one key message or question for Sir Liam Donaldson, who would be
chairing the closing panel session (some groups submitted more than one).
The responses were summarised into a 10 point powerpoint slide, which was
discussed by the panel.

The National Cancer Waits Project will look to address these key messages in
the coming weeks.

Please note that these are “raw” comments - drafted by hand with limited time
– we have chosen to type them up as provided to ensure participants can be
confident in the process. The order is random.

•   “That achieving the 31/62 day targets which apply only to some cancer patients
    will not be at the expense of other cancer patients, who could be disadvantaged
    by other patients being ‘fast-tracked’.”

•   “The cancer waiting times are as important as the 4 hour A&E wait. We can do
    with better patient information and ongoing efforts in service redesign.”

•   “How do we ensure other key policy initiatives like ‘Choice’ will not undermine the
    work in Cancer?”

•   “Is there work going on nationally with NPfIT that will bring all these information
    issues together?”

•   “Redesign makes a difference, but extra investment is essential for clinicians’
    continued commitment.”

•   “Timescale for EPR not synchronised makes cancer data collection a lot easier.”

•   “CE’s making cancer a priority may have an impact but too many competing
    priorities. Main priority is financial survival and red light target puts focus on
    performance not service/quality improvements.”

•   “Choose and book make it difficult to make changes.”

•   “No waiting list initiatives for any speciality counter productive knock on effect to

•   “CE priority – competing with financial balance issues.”

•   “Specific funding for cancer data collection.”
•   “15% target to shift work to private sector – disincentive to NHS and only shifts
    simple work and procedures.”

•   “Stop any/all waiting list initiatives – orthopaedic backlashes on cancer and
    diagnostics. Financial disincentives.”

•   “PBR – impact on funding for cancer service improvements.”

•   “”How will Sir Liam help us control demand, and involving/educating GP

•   “Dear Sir Liam, Support Networks/CSCIP to deliver cancer waiting times and the
    18 week wait will be achieved in advance of 2008. Need joined up thinking!”

•   “The NPfIT programme needs to support and enable the delivery of the cancer
    waits targets. We do not have confidence that this will be the case.”

•   “Need to quantify the cost of implementation of higher standards, increased
    requirement for diagnostics and treatment capacity requirements to meet

•   “Clarification of allowable exceptions asap. Eg immediate breast reconstruction =
    bre3ach. First disagnostic tests are benign. Best practice eg 3-4/52 post-TRUS
    for MRI.”

•   “Cancer waits and performance rating for primary care.”

•   “There appear to be so many ‘top 4’ priorities – what advise would Sir Liam give
    us in prioritising the priorities?”

•   “Closer co-ordination of national programmes that impact on monitoring – eg
    cancer waits, booking and choice, NPfIT.”

•   “Be as magnanimous in resources as we are gratuitous in challenging.”

•   “Importance of increasing appropriateness of fast-track referrals from GPs (look
    forward to new guidelines).”

•   “Please help us to gain executive involvement.”

•   “”How can the NHS ensure that only the best clinical practice is the Norman and
    poor practice is not funded or applied?”

•   “Gain clinical engagement by resolving issue around current fixation on waiting
    times data rather than clinical information (with waiting times being a secondary
    outcome from good clinical management).”

•   “Help us engage clinical teams in the cancer waiting times agenda.”

•   “Engaging clinicians – up the ante and increase CE buy-in.”

•   “Key to success is to engage clinical teams. This must lead to not only timeliness
    of care, but the quality of care must be measurably enhanced. Patient outcomes
    are not to be overlooked – access is only one aspect.”
•   “Can you ensure clinical engagement and active support across all regulatory
    bodies, eg royal colleges, RCN, AMPs, etc.”

•   “The targets are not achievable without investment in data collectors – in the form
    of patient trackers.”

•   “How to provide patient empowerment to high quality cancer care rather than the
    option of patient choice.”

•   “What is the policy on patient’s first considered benign but later found to be
    malignant? This being counted as a breach creates aggravation for clinicians.”

•   “Need to support the shift in accountability for delivery from individual
    organisations to whole communities to focus on the complete care pathway.”

•   “Dear Sir Liam, Let us consolidate the current agenda and allow us to be locally
    accountable for delivering (not over-prescriptive monitoring).”

•   “Challenge is to get PCT agreement with the vision for cancer service and
    support this commissioning process.”

•   “Would you consider reflecting the cancer waiting times targets in PCT
    performance ratings?”

•   “What are you views about the effectiveness of cancer networks in
    commissioning for the improvement of cancer services.?”

•   “Please try to influence private sector procurement of diagnostics to ensure that it
    optimises cancer throughout.”

•   “Link the cancer waits target with saving lives/patient safety. Cancer cells grow
    so speed is essential. More chance of clinician buy-in if this emphasis not
    political targets. Reproduce lead clinicians in service redesign at network level.”

•   “Clearer strategy to be delivered for delivery of cancer plan targets post-2005.”

•   “What advice is Sir Liam giving Richard Douglas with regards the composition of
    the tariff under PbR to reflect the new quality standards (cancer waiting times)
    given that 80% of Trusts are currently not achieving the 31 and 62 day targets
    and tariff reflects current practice and costs.”

•   “Information systems eg ASW system (monitoring tool) should be available to all
    networks if endorsed by CSC as recognised model.”

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