Survival rates for cancer in this country have never been higher, but there is more we can do to ensure patients are diagnosed early and to tackle variation in access to care and workforce. The NHS is committed to improving the care, treatment and support for everyone diagnosed with cancer. This includes taking specific steps to increase prevention, speed up diagnosis, improve the experience of patients and help people living with, and beyond the disease and investment in a high quality modern service

Making sure patients across the ICS receive excellent and timely cancer care is a top priority for BOB ICS. We understand that waiting for a specialist assessment, for diagnostic tests and for treatment can be a major cause of anxiety for patients who suspect they may have cancer and for their families.

Chief executives from across the BOB ICS partnership took an in-depth look at how cancer services were performing against national targets set for access to appointments, diagnosis and treatment. They found that more could be done to ensure the delivery of high quality patient care across all parts of the ICS, and specifically for gynaecological, lung and urological (bladder, kidney and prostate) cancers. As a first step, there will be one pathway across the whole of the ICS for prostate cancer, based on established best practice.

To improve standards chief executives have also agreed to focus on delivering NHS England’s “10 High Impact Actions”. These are a set of recommended improvements that have been shown to be effective and make the biggest difference to services and care by reducing waiting times and improve patients’ experience of care.

These practical steps include:

Actions to reduce the number of visits for investigations and consultant outpatient appointments by introducing a single visit or “one stop shop” approach”. This would tackle situations often faced by patients who end up having a number of appointments for different tests, causing delays and anxiety while waiting for a diagnosis. Better co-ordination and streamlining of the number of appointments will mean that patients receive all their tests prior to first consultant appointment.

Creating multi-disciplinary teams to speed up decision making about treatment making sure all relevant clinicians, staff involved and the patient themselves are involved in decisions about a person’s treatment and care. Making these decisions together ensures a patient is on the right treatment path for them, having considered together all the available options. 

Improved follow up procedures such as having clinics closer to where patients live, increasing the number of nurse led follow-up clinics offering more time.

In the BOB ICS area our objectives to help us deliver on improved care, treatment and support include:

  • achieving and maintaining the 62 cancer standard
  • reviewing system capacity (staffing and non-staffing)
  • increasing the proportion of cancers diagnosed at stage 1 and 2
  • reducing smoking prevalence
  • implementing the national best practice cancer pathways for lung, LGI and prostate

To help achieve our objectives we have been looking at ways in which we can support early diagnosis and provide support for 'living with and beyond cancer'.

Early diagnosis : Vague Symptoms Multi-Disciplinary Centres Working with stakeholders across the Thames Valley, a baseline assessment has been developed to help identify changes that need to be made to improve the SCAB pathway in Oxford

Early Diagnosis: Quality Improvement Scheme (QIS) for Primary Care A toolkit for primary care has been developed, in collaboration with local stakeholders, including those who have had cancer. This toolkit provides resources and information to support primary care teams to deliver the QIS, increase in screening uptake and two-week cancer detection.

Early Diagnosis: Pathway Redesign and Building Longer Term

Each Trust (hospital) has been requested to produce plans detailing the tasks and resources required to implement best practice pathways. They are also recruiting of Pathway Improvement Project Managers to help build capacity and resources within their hospitals. A process mapping workshop is under development with NHS Improvement.

Living with and beyond cancer (LWBC)

LWBC has continued to make good progress. Stakeholders have formed local delivery groups to define plans for delivery and reporting for the HNA and care plan, treatment summaries, cancer care reviews and health and well-being events.

Monitoring of progress towards achieving minimum standards has started with baseline reporting from each locality.

Stakeholder engagement and mapping started for Prostate Risk Stratified Follow-up Pathways.

LWBC leads liaising with ‘front end’ 62 day pathways workstream leads to avoid duplication and ensure the work dovetails.