Sustainability –

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					Sustainability –
embedding and achieving
outcomes

Local Lung Projects –
building the evidence base
December 2010
 Introduction
                          • Sustainability – what is it?
                          • LAEDI’s –
                             – new evidence to improve cancer
.                              outcomes
.. Public Health and         – Progress and sharing learning
General Practice
                          • 2011 /12 business planning
contribution essential
                             – Transition
for achieving effective
                             – New commissioning and public
outcomes...
                               health services

...10,000 deaths per      • Aligning projects to
year....                    sustainable services
                             – Delivery, reporting & outcomes
               Sustainability
• What do we mean by sustainability?
• Challenges – ‘projectitis’; ‘scaling up for
  population impact’; ‘inequalities’; partnerships;
  evidence; value for money; commercial
  interests; ‘nanny state’
• Healthy Lives, Healthy People: Our strategy for
  public health in England
• And yet – (public support for no smoking
  policies; improving health; world class services –
  screening, smoking)
 Cancer Awareness and Early Diagnosis
   in 2011/12 – what are we trying to
                sustain?
• Local needs assessment
   – Cancer mortality and survival
   – Local information about the NAEDI ‘pathway’
• Clinical leadership
   – Public health and general practice, working
     effectively with secondary care clinicians
• Governance, plans and outcomes
• Commissioning
• Service development and interventions
    NAEDI: The NAEDI Pathway
                                Low public awareness and/ or
Difficulty                         negative beliefs about cancer
    accessing
    primary care

                   Late presentation        Low uptake of    Emergency
                      to a GP                  screening       presentations

Delays in primary care
                            Late presentation to hospital services

Delays in secondary care
                                       More advanced disease
                                          at diagnosis


                                       Poor survival rates

                                       Avoidable deaths
      Interventions for Awareness & Early Diagnosis

                  Safety netting                                                 Community
                                                                                 Initiatives &
                                                 One to one                     Volunteer-led
                                                 interventions                  interventions

Decision aiding
     tools

                           Primary                               Community
                           Care                                  Initiatives             Social Marketing
                           Service
                           initiatives
                                          PULL           PUSH

Improving referral                                                             Communications
   pathways



                   Improving diagnostic
                        pathways
 Cancer Awareness and Early Diagnosis
in 2011/12 – what do we need for services
            and interventions?
• People – to plan and deliver service
  development and interventions
• Recognition of the ‘costs’ – time and
  money
• Clinicians, commissioners and boards – to
  understand cancer needs and pathways
• Learning from projects absorbed –
  processes; people; organisational change
       It is exciting – and tough
• Delivery of the project
• Needs assessment for local public health and GP
  commissioning priorities
• GP delivery of services
• Partnership health improvement programmes
• Budget setting
• National campaign (s) and projects
• And – worries about whether the project will be
  successful; your next job; and teams being reorganised
  around you – and that is before you have ‘life/ work
  balance’
               Practical steps -
         there is no magic bullet
• DPH and GP lead who signed the application
  – Are they being updated regularly and involved?
  – Is cancer on their agenda? If not – needs to be.
  – Do you know how to ‘align to their opportunities’?
• Look forward
  – 2011/12 business plans
  – Legacy and sharing learning – a project objective
• Your project matters
  – Effective delivery, report and learning
    National context and support
• NHS White Paper – and consultations
• GP commissioning
• Public Health White Paper
• DH Business Plan 2011/15-
  Transparency Framework and QIPP
• NAEDI – 4 work streams
• NCAT & Cancer Networks – learning sets;
  capturing and sharing learning
  Accelerating Sharing of Learning
• Key themes
   – social marketing; healthcare economics; influencing and
       engaging PCTs; GP engagement; sustainability going forward
• NCAT supporting
   –   Learning Sets – 4 now started
   –   Report on 09/10 local projects
   –   Responses to individual requests, alongside Networks
   –   Events and workshops at NDP
• NAEDI website and newsletter
  http://info.cancerresearchuk.org/spotcancerearly/naedi/
• NAEDI members, for example the RCGP, NPSA,
  charities, and professional groups

				
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