To consider a report from Leeds City Council’s Head of Governance and Scrutiny Support that introduces a report from the West Yorkshire and Harrogate Cancer Alliance providing an outline of the activity relating to the identified cancer priority / programme, as part of the overall West Yorkshire and Harrogate Health and Care Partnership.
The Joint Committee received a report from the West Yorkshire and Harrogate Cancer Alliance providing an outline of the activity related to the identified cancer priority programmes, as part of the overall West Yorkshire and Harrogate Health and Care Partnership (WYH HCP). The Joint Committee was also in receipt of supplementary information in the form of two reports to the West Yorkshire and Harrogate Cancer Alliance Board dated 30th October 2018 and 23rd January 2019.
The following were in attendance and contributed to discussions:
- Professor Sean Duffy, Clinical Director and Alliance Lead, West Yorkshire and Harrogate Cancer Alliance (the Alliance).
- Carol Ferguson, Macmillan Programme Director, West Yorkshire and Harrogate Cancer Alliance.
In introducing the report, the Clinical Director and Alliance Lead, West Yorkshire and Harrogate Cancer Alliance, emphasised that the Alliance sought to focus on outcomes and service provision within the parameters of available funding, and highlighted the following key issues:
· The Alliance focussed on ensuring early diagnosis and a consistent approach to subsequent treatment.
· Collaboration between primary care, specialist services and acute treatment providers was key to providing effective diagnosis and treatment.
· The Board was provided with information on the Tackling Lung Cancer initiative which successfully targeted resources to areas of deprivation and high smoking levels in Wakefield and Bradford, and promoted healthy living and the use of cessation services.
· Through greater collaboration the Alliance had successfully accessed additional regional and national funding.
· The Alliance continued to identify areas which required further focus and funding.
In considering the matter, the Joint Committee had regard to the information provided in the report; and discussions included the following matters:
Local performance against the 62 day cancer waiting time target - The Joint Committee was informed that the 62 day target related to patient flow, rather than diagnosis following initial presentation. Following diagnosis, patients were placed on care pathways specific to their needs. It was acknowledged that patients not on a specific cancer care pathway received a variable service across the Partnership area. Specific challenges to meeting the target in West Yorkshire included a 27% increase in referrals for Prostate cancer since March 2018, resulting in additional pressures in diagnostic and treatment services. The Joint Committee noted a comment that there had also been a specific and unexpected increase in breast cancer referrals which had also increased pressure on the system.
The role and use of ICT innovation and Yorkshire Imaging Collaboration (YIC) to support early diagnosis - In response to a comment regarding the benefits of the new reporting system, the Joint Committee received an example of how use of new technology would enable a GP or dermatologist to send photographic images or scans of a patient presenting with possible skin cancer to the relevant consultant for consideration, in order to promote an earlier diagnosis and allocation to the right care pathway. It was reported that 80% of dermatology practices had taken up the new technology which was now being rolled out to Pathology.
Engagement and Consultation with patients and the public – In response to a comment regarding the information available on the Cancer Alliance website and the over-reliance on electronic forms of patient and public engagement, it was noted that no literature seeking patients’ views or information on service/care pathways was readily available in treatment centres to help signpost patients/their families.. The Joint Committee identified this issue as a matter for action by the Alliance to pursue.
Representation on the Cancer Alliance Board – While it was noted that the Board consisted of 2 representatives from each place, concern was expressed regarding how effectively the patient voice was represented. The Joint Committee believed that the breadth of patient experience across West Yorkshire could not be effectively provided by only two public representatives. Comments also highlighted the lack of patient representation and local Healthwatch members. The Joint Committee identified this issue as a matter for further consideration by the Alliance.
Treatment and Care and the route to diagnosis and care pathways – The Joint Committee noted £14M of non-recurrent Transformation funding would be targetted towards Cancer by the WYH HCP to deliver specific care pathways and noted a comment that investment should be mindful of the whole referral process as most referrals began in general practice, highlighting the role and usefulness of local GP health checks.
Upskilling practitioners – A comment on the work required to ensure that skilled practitioners are available to identify symptoms and make an early referral was noted; particularly in General Practice.
Upskilling aimed to relieve the pressure on specialists by providing other skilled professionals to perform certain tasks. The Joint Committee was provided with an example of similar change – endoscopy procedures used to be performed by a Doctor with a nurse present; including the completion of necessary administration, however, the service had been restructured to provide Band 3 to 8 staff to perform the procedure without impacting on the service to patients or accurate diagnosis.
Smoking cessation services and vaping – The Joint Committee heard that as a nicotine replacement, Vaping was the most effective way to stop smoking. Cessation services were funded through Local Authorities, however the Alliance had previously funded support for Wakefield/ Bradford and Mid Yorkshire cessation services.
Behaviour and lifestyle changes monitoring – The Joint Committee considered whether monitoring residents on low incomes/in areas of deprivation would be useful without monitoring environmental factors as well. It was noted that the Alliance currently did not have a specific work stream looking at environmental issue impacts.
a) To note the contents of the report, the supplementary information and the discussion at the meeting.
b) To note the progress made by the Cancer Alliance since its inception in 2016.
c) To note and support the ongoing priority to recover performance against cancer waiting times standards
d) To note and support the priorities for the Cancer Alliance as determined by national policy, specifically the ongoing focus on finding more cancers at a stage when they are potentially curable and developing more personalised, integrated health and wellbeing support to people living beyond their diagnosis in their own communities.
e) That the Cancer Alliance give further consideration to its approach to public / patient involvement, including measures to improve the patient voice as part of its governance arrangements.