Posted on: 22 April 2021
Tackling inequalities will be at the heart of the recovery and restoration of cancer services across West Yorkshire and Harrogate, says Cancer Alliance Clinical Lead, Professor Sean Duffy.
Once again, we have reached that point in the year when all eyes, ears and energies are focused on planning and priorities for the year ahead – working to national guidance but by building our plans ‘bottom up’ , with a focus on delivering at place what’s really important to local communities.
But as we all know, things are different this year as we look back on more than 12 months since the start of the pandemic, and look forward to restoration and recovery in the context of Covid against the backdrop of an ongoing mammoth vaccination programme. We are grateful to all our colleagues in cancer services across West Yorkshire and Harrogate who have worked so hard to minimise the impact of Covid and to prioritise cancer care and treatment over the past year, in such extraordinary and challenging circumstances.
Clarity around what is expected during 2021/2022 has now been published by NHS England. We have an ambitious but achievable work programme to deliver over the next 12 months and beyond. Working alongside our colleagues in local places, will focus over the next six months on reducing the number of patients waiting more than 62 days, back to the levels they were at in February 2021. We will push for 75 per cent of patients to be told whether or not they have cancer within 28 days of a referral, in line with the new Faster Diagnosis Standard. The shortfall in first treatments will be addressed by March 2022.
We will continue to roll-out the exciting innovations technology on which we have partnered with medtech partners, including the Pinpoint Test, Colon Capsule Endoscopy and Cytosponge. These technologies will improve the diagnostic pathways not just for those who are have a positive cancer diagnosis, but also those who face an anxious wait before finding out that they do not.
NHS Plan priorities such as the restoration of the Targeted Lung Health Check programme, paused as the pandemic took hold, and the accelerated use of the Rapid Diagnostic Centre model in the most challenged pathways will also be high on our list of priorities. Across the West Yorkshire and Harrogate system, we are working hard to reduce the numbers of patients who are waiting longer than they would have done had it not been for Covid. However, although waiting lists are an issue, they will not deter us from actively seeking out those people who have not yet come forward.
In line with the rest of the country, GP referrals across a number of tumour sites fell considerably in the first stages of the pandemic. Those numbers have been steadily increasing as the months have gone on, although we still have work to do in some specific areas, such as lung cancer.
Early diagnosis saves lives. With a focus on tackling inequalities, across tumour sites and across communities, we will look to boost the numbers of people who are informed and feel confident enough to talk to their GP if they have worrying signs and symptoms.
We will also encourage more people to take up their invitation for breast, bowel and cervical screening – particularly those in groups who the evidence shows are the least likely to take part in simple tests that help save lives. Underpinned by the principle of ‘leaving no-one behind’, we are now looking beyond crude high level activity and backlog statistics so we can tackle the divisions and disproportionate impact that Covid has had on specific communities and particular cancer pathways.
Our dedicated analysts will now regularly present detailed breakdowns for consideration by our Cancer Alliance Board, to help ensure that our attention and resources – and those of our cancer colleagues in local places – can be focused where they are most needed, and can make the most difference.
As we reset and restore, we will be proactive in working with the affected communities, as well as the clinical and other members of our tumour site Optimal Pathway Groups, to tackle the inequalities that lead to compromised outcomes and poorer quality of life for those living with and beyond cancer.
In short, to coin a phrase, we will be driven by the data, alongside another critical factor –the voices of people affected by cancer, the experiences of patients needing to access care, treatment and support during the pandemic and beyond.
Over the last 12 months, we have continued to work alongside members of our Cancer Alliance community/patient panel – hosted in partnership with Healthwatch Wakefield - who have embraced digital technology with enthusiasm and still meet regularly to ensure our Alliance workstreams are informed by their experiences and views.
Mindful of the need to avoid digital exclusion, we also engage with individual panel members in other ways – by phone for example - to make sure that their experiences are not lost and they also have the opportunity to influence our work.
Recently, the panel have been informing the restoration of services system-wide by revisiting the insight report they produced in May/June 2020 about the barriers to accessing services during the pandemic and what is needed to build patient confidence.
These include the need to ensure cultural competence and sensitivity when people are asked to access a different hospital site to usual; recognition of the role of family members in delivering care to people from ethnic minority communities; the importance of connections across all tiers of care, and in particular, the need to look at patient experiences in primary care at a system level.
As a Partnership, we can draw upon our well-established commitment to collaboration and link with other priority programmes to ‘join the dots’ on these and other issues. For example, our community/patient panel will work closely with the proposed Planned Care citizens’ panel to avoid duplication and ensure consistency. We are reviewing the role and remit of our Patient Experience Advisory Group to ensure we are achieving maximum influence and impact, particularly in terms of linkages with primary care.
The launch of our Cancer SMART programme, in partnership with Yorkshire Cancer Community – promoting the uptake of cancer screening; raising awareness of signs and symptoms and sharing prevention messages – enables us to achieve greater reach through the personal and professional contacts and networks across our area of our Cancer Champions and Digital Champions.
The graphics and content of three forthcoming campaigns to encourage uptake of bowel, breast and cervical screening are based on specific insight from people who have traditionally chosen not to take up their invitation.
We know that people with a learning disability experienced six times the COVID-related mortality of the general population, and the Cancer Alliance is keen to act to reduce health inequalities for this population group.
In December we worked with the Health and Care Partnership to produce and distribute a “Top Tips” document for patient-facing primary care staff. It contained key points of advice and resources around cancer issues – including screening - for patients with learning disabilities.
Our Healthy Communities Programme is working to improve collaboration between primary care and the bowel screening hub to offer more proactive support for people with learning disabilities to facilitate their participation in the bowel screening programme. We also implemented a new EasyRead FIT screening leaflet into clinical systems, with was co-produced with the target audience with assistance from accessible media organisation BTM.
This week, after gathering insight and research about the barriers that cancer patients from ethnic minorities face in accessing health and wellbeing support, we brought together primary care teams and colleagues from the Third Sector to talk about how improved links between them could help overcome those barriers. We will now be looking to set up a pilot to take this work forward.
In driving this work, we are always conscious that our Cancer Alliance is the sum of its parts – all elements of our system that play a part in the experience of people affected by cancer. As we move forward into the ‘new world’ of innovation and integration as outlined in the White Paper, that connectivity will be more important than ever before.
Have a safe, good weekend everyone.
Sean
What else has been happening this week?
10 million second dose milestone
The following statement was issued on Monday to mark the 10 million second dose milestone. Sir Simon Stevens, NHS chief executive, said: “This is another significant milestone and major achievement for the NHS vaccination programme, the biggest in the health service’s history and fastest in Europe. “Since England’s NHS became the first health service anywhere in the world to administer a Covid-19 vaccine, the programme has gone from strength to strength, with everyone in the top priority groups given the opportunity to get jabbed ahead of target. “The success of the NHS vaccination programme is not a happy accident. It is down to careful planning coupled with the sheer hard work and determination of doctors, nurses and countless other staff ably assisted by volunteers and many others.”
The Health Secretary, Rt Hon Matt Hancock MP, gave a statement to Parliament and provided an update on vaccinations, variants of concern and the appointment of Professor Lucy Chappell as Chief Scientific Adviser to the Department of Health and Social Care.
West Yorkshire and Harrogate People Board
The Partnership’s Board is made up of colleagues from NHS, council, Health Education England, universities and the voluntary community social enterprise. Members met on Monday.
The Board is chaired by Brendan Brown, CEO for Airedale NHS Foundation Trust who is our workforce lead. Colleagues discussed progress on the health and social care observatory proposal, which is all about delivering workforce development in its broadest sense to provide staff sustainability and planning into the future. This is a long term project which will be co-designed with partners.
Operational Planning 2021/22 and workforce recovery was also on the agenda as well as an update on global partnerships and our race inequalities review action plan. This included co-designed, ethically appropriate advice and support for people who are in high risk roles and development of the anti-racism movement.
Restoring planned care services
At its Board meeting on 19 April, the Planned Care Alliance approved the proposal to establish a Planned Care Citizens’ Panel.
The aim of the panel is to support the Alliance with communications around its strategy for restoring planned care services. The panel’s input and expertise will help ensure that public information is relevant, clear and that it gets to the people who need it – patients and their families, carers and services users across West Yorkshire and Harrogate.
A small campaign to recruit panel members will launch on 27 April. The panel will be in place for 12 weeks from 21 June to 10 September and will meet online every two weeks. Look out for the campaign and for more details in this update on 30 April.
The Joint Committee Patient, Public Involvement Group
The Joint Committee of Clinical Commissioning Groups' Patient and Public Involvement Assurance Group met on Monday. The group discussed the Government’s White Paper proposals and the importance of public involvement. There was also a discussion on improving planned care and engaging with patients and the public to improve cancer outcomes as well as campaigns to increase uptake of national screening programmes, with a specific focus on addressing inequalities.
There was also a conversation on vaccination engagement, the development of the Partnership’s anti-racism movement, climate change and the asset based community engagement work taking place with Nurture Development which is all about the latest thinking to support Asset Based Community Development.
System Oversight Assurance Group
This group is made up of our health and care sector leaders and is supported by NHS England colleagues. This month members discussed an item led by Healthwatch on feedback from people on dentistry. There was an update on the progress we are making to tackle health inequalities, which includes working with hospital trusts and voluntary community social enterprises for non-clinical priorities which is all about ensuring people have support to keep as well as possible.
Work is also ongoing to improve uptake for people with learning disabilities regarding health checks and increased digital inclusion. This involves looking at practical steps which includes learning from one of our local places which has set up a community digital hub. Some good work is taking place to capture information for people from ethnic minority groups on waiting lists for planned care and this model is being shared. A finance update was also given.
Health and Care Champions
The Learning Disabilities Health and Care Champions project, in partnership with BTM completed its Q1 report to the Partnership and made a presentation about their work and plans.
The group is actively recruiting for new members across West Yorkshire and Harrogate and can support people who don’t have access to devices or Wi-Fi data so that they can take part. Training in how to use Teams and Zoom is also available. The project also wants to include the voice of those people with learning disabilities who do not have capacity by listening to their carers. To join the group or nominate someone who may be interested, email susan.
Mental Health, Learning Disability and Autism Programme Board
The Mental Health, Learning Disabilities and Autism Programme Board met this week. In addition to
updates from all areas of the programme, members also discussed the work of the Autism programme, including follow up from the #AutismAllies event and report; the Staff Mental Health and Wellbeing Hub; perinatal mental health; workforce, and suicide reduction. The next programme board meeting is on Tuesday 11 May.
Staff Mental Health and Wellbeing Hub
The Hub is hosting a “summit” event on 26 May to involve colleagues in the continuing development of the Hub’s support offers. Rob Webster, CEO of South West Yorkshire Partnership NHS Foundation Trust and Lead CEO for the West Yorkshire and Harrogate Health and Care Partnership will open the event and share his own experiences.
Great Minds
The suicide prevention team has produced a poster to capture the work of the now concluded Great Minds project. You can read more about the project and our suicide prevention work on the Partnership website.
The National Suicide Prevention Alliance has launched its new website, www.nspa.org.uk. The website has a refreshed look and feel and allows for easier navigation so you can quickly find the latest news, events and resources related to suicide prevention, self-harm and bereavement support.
Urgent and emergency care programme board update
The urgent and emergency care programme board (UEC) was held on Tuesday and was chaired by Dr Adam Sheppard, Clinical Chair for Wakefield Clinical Commissioning Group. The board’s ambition to be increasingly data driven was evident in the discussions and presentations given throughout the meeting. Our business intelligence and metrics show a real channel shift being seen in 111 in reducing the numbers of people being referred to emergency departments which is a focal point in our work as a system. Presentations about A&E re-direction were given from Bradford, Leeds and Mid Yorkshire Hospitals Trust. This work is very much about redirecting people to the most clinically appropriate service and ensuring their needs are met. Presentations allowed for the sharing of best practice and the different approaches taken at place to be heard.
Members of the board also heard about the recent directory of services insight event (DoS) into urgent care from a 111 perspective. Members heard that is was a very successful event with good attendance and the message being spread around the importance of the DoS being kept under review and up to date.
Proposals for ‘Looking out for our neighbours’ Phase 4 of the campaign and recommendations were seen and supported by the programme board. The target audience will focus on young people and is a new audience for the campaign. This will include young adult carers, young people with special educational needs and disabilities, young people not in education, employment or training and young people from ethnic minorities. The campaign will be fully co-created with young people.
Calderdale colleagues positive about digital maturity
We held a Calderdale Place based digital maturity workshop with local colleagues on Wednesday, 14 April to help enhance and improve the use of digital across the system. Colleagues from across the partnership, including local government, health informatics, primary care and hospital trusts joined the event to consider the findings from the PA Consulting Digital Maturity Assessment by Place.
The workshop provide the opportunity to kick start a local action plan and covered themes such as leadership, integrated care, infrastructure, population health management and strategy. Over 80 colleagues have joined one of the five digital maturity workshops held so far involving Bradford, Calderdale, Harrogate, Kirklees and Leeds. For more information, please contact our Digital Programme Manager dawn.
No Butts – Symptom Awareness Campaign launched through ITV’s ‘Lorraine’ For Bowel Cancer Awareness Month
A symptom awareness bowel cancer campaign has been launched this week, in conjunction with Bowel Cancer UK, through a high profile association with the popular ITV morning show ‘Lorraine’, hosted by Lorraine Kelly.
The campaign, called No Butts, is aligned to April as Bowel Cancer Awareness Month. It is being led by Bowel Cancer UK patron Deborah James (@bowelbabe).
The campaign runs from 19 April to Thursday 6 May. There is obviously potential to impact during that period and beyond on demand related to bowel cancer symptoms, and our colleagues in local cancer teams (lead cancer managers and nurses), in primary care and the Cancer Alliance colorectal Optimal Pathway Group are being notified about the campaign.
Bradford Act as One
The Act as One Festival is a four week run of events, activities, discoveries and opportunities to get together for a bit of fun and celebrate the projects, teams and individuals across Bradford District and Craven. While the events are designed for people in paid or unpaid roles across our place, there are sessions which will appeal to those across our Partnership and colleagues welcome you joining in to find out more about the work going on that is helping people to live ‘happy, healthy at home’. The Festival will conclude with a recognition event celebrating teams, projects and services that are already bringing ‘Act as One’ to life.
Colleagues are delighted that not only will they be able to showcase their work, but will also be joined throughout the Festival by national colleagues including Dr Habib Naqvi, Director of the NHS Race and Health Observatory, Chris Hopson, Chief Executive for NHS Providers and Prerana Issar, Chief People Officer for NHS England and NHS Improvement. The event calendar is being regularly updated, keep checking the Eventbrite page for the latest updates or follow @ActAsOneBDC on Twitter.
New referral tool to support primary care with fast track referrals for suspected prostate cancer
Our Cancer Alliance has recently worked in collaboration with Prostate Cancer UK, local primary and secondary care clinicians, patients and their families to develop a new referral tool to provide detailed information and support around their fast track referral to patients with suspected prostate cancer. This work has been progressed through the Urology Optimal Pathway Group. A co-production approach has ensured that the leaflet incorporates:
- Clear language and images
- Editable fields supporting digital use which can be personalised for patients
- Black and white design for easy printing practices
- Explanation of stages of the prostate cancer diagnostic pathway
- Links to further information and support from Prostate Cancer UK
Prostate Cancer UK have this week successfully rolled out the tool regionally and nationally for use in primary care. The resource can also be found on the Prostate Cancer UK webpage by accessing this link: https://prostatecanceruk.org/for-health-professionals/guidelines/supporting-patients-being-referred-for-suspected-prostate-cancer For further information, contact Charlotte Houston, Urology Optimal Pathway Group Project Manager, charlotte.