Agenda item

Attending for this Item were:

Worcestershire Clinical Commissioning Groups (Commissioner)

Simon Gartland, Associate Director of Contracting

Dr Clare Marley, Chair and Clinical Lead

Worcestershire Acute Hospitals NHS Trust (Provider)

Mr Adel Maker, Consultant Surgeon

The Committee had asked for this item to be considered in order to follow up a previous review and see what progress had been made.  Mr Maker provided some background on the development of cancer services in Worcestershire, reporting that after a number of years, the large proportion of services was now delivered in Worcestershire across various sites and by a number of health economy partners.  For some aspects of specialised treatment, services continued to be provided in regional centres, such as University Hospital Birmingham.

The Worcestershire Oncology Centre on the Worcestershire Royal Hospital site was opened in January 2015 and was built with five bunkers, four of which were used for radiotherapy treatment and one which could be equipped in the future.

There had been a year on year increase in patient activity of chemotherapy services, which were delivered across all three hospital sites and this trend was unlikely to change. 

The Committee considered the report included with the agenda, which set out further detail about cancer services in Worcestershire.

Commissioners reported on performance, with some targets being met and some not.  It was suggested that some targets could be missed due to patients not taking referral appointments within the target timescales and instead choosing an appointment for convenience rather than speed.  This was also the picture nationally. 

Like other disciplines, workforce was key and positive feedback was received.  New pathways were being introduced, enabling more multi-disciplinary team working and would move towards improving performance which was monitored with partners on a monthly basis.

As part of the Sustainability and Transformation Planning process, a Cancer Steering Group had been established and was clinically led.

In the ensuing discussion, the following main points were raised:

·         In response to a query about types of referrals, it was reported that around half of patients were referred by GPs, with about 10% presenting to A&E with acute symptoms and others through non-specific appointments

·         The introduction of screening programmes had seen numbers rise

·         Public Health had a role to promote healthy living and potentially prevent cancer cases rising

·         Members recognised that first appointments could be missed due to patient choice and learned that once diagnosed performance against targets was met

·         9 out of 10 GP referrals did not result in a cancer diagnosis

·         When asked what would help improve performance, it was very much about staff and equipment.  There was a risk that diverting resources to meet 2 week referral targets would disadvantage the 50% of patients who came to the services via other routes

·         Patient Experience was encouraging, with results from an annual cancer patient experience survey showing that on average 8.7 out of 10 patients rated their care as good.  Lessons could always be learned to improve statistics.

Mr Paul Crawford, a patient representative, was invited to comment on the discussion and reported that the cancer provision locally was welcomed by patients.  However, it was felt that psychological support was in need of strengthening.  Commissioners agreed that this area required improvement and that it was an integrated commissioning service.  Unfortunately, there was no national tariff to fund this emotional support, however, working with County Hospices and organisations like Macmillan Cancer Support, some provision was available.  Alongside this, some self-help groups had formed, with the example given of the County wide Prostate Cancer group.

The Chairman thanked those present for a useful discussion.