Agenda item

To receive a report submitted on behalf of the Lincolnshire Sustainability and Transformation Partnership on the progress with the delivery of the NHS England National Cancer Strategy (Achieving World-Class Cancer Outcomes) in Lincolnshire.  This report was written by and will be presented by Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West Clinical Commissioning Group.  

The Chairman welcomed to the meeting Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West CCG, Dr Sunil Hindocha, Chief Clinical Officer, Lincolnshire West Clinical Commissioning Group and Louise Jeanes, Cancer Programme Manager.

The Chairman also advised that a member of the public, Mrs Penny West had made a request to address the Committee with regard to the report.  The Chairman invited Mrs West to speak for a period of 3 minutes to address the issues set out in the report.

In her short statement to the meeting, Mrs West expressed concern relating to the de-skilling of the workforce; and as a result of the de-skilling how many wrong decisions had been made; the need to diagnose faster; whether complaint processes were fit for purpose; and that each patient needed to have their own individual pathway; and what methods of quality control were in place to monitor performance.

The Chairman invited the representatives to respond to the matter raised by Mrs West.

Reassurance was given that pathways were put in place by a clinician when a patient was thought to have cancer and that Lincolnshire was working to reach the constitutional standards and thus improve referral times.  The report presented made reference to workforce challenges.  It also highlighted that performance was monitored through the various CCG governing bodies. 

The report presented advised the Committee of the progress made in delivery the NHS England National Cancer Strategy across Lincolnshire, as part of the Lincolnshire Sustainability and Transformation Partnership.  The Chief Operating Officer, Lincolnshire West CCG thanked Mrs West for her questions; and advised that she would meet her after the meeting to discuss some of the issues further. 

Councillor Mrs P F Watson (East Lindsey District Council) advised that she was currently a patient of United Lincolnshire Hospitals NHS Trust.

The Committee was advised that in January 2017, Lincolnshire had held its first ever Cancer Summit, which had brought colleagues from across the Lincolnshire health and care system together with colleagues from the East Midlands Cancer Care Alliance, patients and members of the public together to consider a Case for Change. It was noted that work was ongoing with public health colleagues to encourage people to change their lifestyle to minimise risks to certain cancers.  It was noted further that making the public aware of how they can help themselves, for example by taking up screening programmes.  It was highlighted that screening programmes were well attended across Lincolnshire.  As part of the screening, it was highlighted that steps were being taken to look at the way the tests were being carried out, to quicken up the process of receiving results.

The Committee was advised of the priorities that had been developed and agreed at the Lincolnshire Cancer Summit.  These were:-

·         Improve delivery of the 62 day constitutional standard (details of the changes made were shown on pages 111/112 of the report presented).  There was an understanding that there was more to do to reduce delays.  It was reported that an independent audit of the Trust's review had been arranged to ensure that processes in place were robust enough.  Details of the key findings of the independent audit were show in bullet points 1 to 3 on page 113 of the report;

·         Improve the patient experience.  The Committee was advised that support had been given from patients, support groups and Healthwatch to understand how the patient and family experience could be improved.  Details of specific changes were shown on page 113 of the report; and

·         Improve the service in the community for people living with and beyond cancer.  It was highlighted that until recently the focus for cancer services had been on providing a prompt diagnosis and treatment for cancer.  This emphasis would remain, but it was highlighted that the programme aimed to transform the way people with cancer were supported, by providing support to people throughout each phase of their illness.

During discussion, the following points were raised:-

·         Members personal experience of local services, which highlighted the need for professionals to explain processes and procedures better; and to ensure that patients were aware of who to contact if they had any issues or needed any further support or guidance;

·         Some members expressed their support to the proposals for treating people as being on individual pathways;

·         That there needed to be an understanding of the distress the diagnosis of cancer had on the patient and their family;

·         The need for a consistent approach for tests, particular reference was made to the availability of PSA tests;

·         The need to do more prevention work across all areas, one member enquired as to whether smoking cessation was still being promoted.  The Committee was advised that smoking cessation was still being promoted.  Some concern was also expressed to the risks of vaping;

·         One member enquired whether the gap was closing.  The Committee was advised that this was dependent of the type of cancer; as some were doing better than others.  It was highlighted that lifestyle changes were a key driver; as was how services were designed around patient;

·         The need to make sure that every contact with a patient counted; which was part of the public health message; 

·         One member enquired as to what learning had been taken from the five breaches flagged in the independent audit; and whether there was any move to increase the level of cancer trials in Lincolnshire.  The Committee was advised that processes were being reviewed to reduce the time that patients had to wait throughout their journey; and

·         Page 116 – A question was asked if the results of the recovery package test had been received; and what the outcome had been?  The Committee was advised that the results were due to be out by January 2019.

RESOLVED

That the progress made on implementing the National Cancer Strategy in Lincolnshire be noted; and that a further update be received by the Committee in six months' time.