London Cancer Annual Revie · 2016. 7. 6. · Contents 03 London Cancer: A partnership in pursuit...

London CancerAnnual Review 2013/14Excellent care through partnership

Contents

03 London Cancer: A partnership in pursuit of excellence

04 WelcomefromtheChairandChiefMedicalOfficer

06 Objective1:Toincreaseoneyearsurvivalforpatientsbyimprovingearlierdiagnosisofcancer

12 Objective2:Toimprovepatientexperience

16 Objective3:Toincreasepatientparticipationinclinicalresearch

22 Transformingpathwaysofcare

23 London Cancer Board and Clinical Leadership

02 London Cancer Annual review 2013/14 • www.londoncancer.org

Informationcontainedinthisdocumentiscorrectatthetimeofpublishing(July2014)

London Cancerthanksthefollowing organisationsfortheiron-goingsupport:

UCLPartners

NHSEngland

Macmillan Cancer Support

CamdenClinicalCommissioningGroup(CCG)

Our Partners

Established in 2012, London CanceristheintegratedcancersystemfornorthcentralandnortheastLondonandwestEssex.London Cancer is embedded withinUCLPartnersandthecancerprogrammeoftheAcademicHealthScienceNetwork(AHSN),whichextendstoincludemidandsouthEssex,westHertfordshireandsouthBedfordshire.UCLPartners’overallpurposeistotranslatecutting-edgeresearchandinnovationintomeasureablehealthandwealthgainsforpatientsandpopulations.Forcancerpatients,thismeansweaimtoaccelerateimprovementsinallaspectsofacancerpatient’scare:fromdiagnosticpathwaysthroughreducingvariationinaccessto‘stateoftheart’therapiesandinnovation,tostreamliningresearchdeliverysothatmorepatientsareofferedaccesstoandcanparticipate inclinicaltrials. Weareapartnershipbetween12NHShospitaltrusts,andcollaboratewithawideraffiliationofClinicalCommissioningGroups(CCGs)andotherNHShealthcareorganisations,toimprovecancerpatientoutcomesandexperiencebyprovidingexpert,compassionatecareforeverypatient,everytime.

Workinginpartnershipasahealthcaresystem,ratherthanworkingattheindividualhospitallevel,theclinicalleadershipthatdrivesLondon Cancer can mapoutacomprehensive,seamlessclinicalpathwayforeverypatient.Byworkingtogether,patients,providersandcommissioners–supportedbytheacademicandscientificcommunity,andthevoluntaryandcommunitysector–weareabletoimplementimprovementssystem-wideatgreaterscaleandpace.ThisiswhatmakesLondon Cancerapowerfulbrokerforchange.

Why we’re hereLondon Canceriscommittedtosavinglives,improvingpatientexperience,andoptimisingthequalityoflifeofpeoplelivingwithandbeyondcancer.Inaddition,London Canceriscommittedtogivingpatientsamorepowerfulvoiceandactiveinvolvementinsettingprioritiesforserviceimprovementandinimprovingaccesstocuttingedgediagnostics,innovativetreatmentsandclinicaltrials.

Thiscollaborativeapproachenablesustoco-designanddiffusesustainablehealthcaresolutions.Weleadthroughinfluenceandsupportfornewwaysofworkingtogether,tofacilitateandinspire,empoweredbyoursharedgoals. Our objectivesThisannualreviewprovidesasummaryofLondon Cancer’sachievementsoverthepastyear.Itisbasedaroundtheorganisation’sthreeoverarchingobjectives,whichare:

• ToincreaseoneyearsurvivalforpatientsinnorthcentralandnortheastLondonandwestEssexbyimprovingearlierdiagnosis.Toreducedeathsby200peryearfrom2015/16.

• Toimprovepatientexperiencebydelivering90%positivelevelofresponseon10areasmostimportanttopatientsontheNationalCancerPatientExperienceSurveyin2015,withannualimprovement.

• Togivepatientsaccesstoinnovationbyincreasingparticipationinclinicaltrialstooneinthreepatientsoverthreeyears.

ForfurthergeneralinformationaboutLondon Cancer andtoreadboardpapers,pleasevisitthewebsiteatwww.londoncancer.org.

www.londoncancer.org • London Cancer Annual review 2013/14 03

London Cancer: A partnership in pursuit of excellence

Despitealltheadvancesinsuccessfullytreatingthedisease,wenowneedastep-changeinthewaywecareforpeoplelivingwithcancer.London Cancer aims tosavelives,improvepatients’experienceofthecaretheyreceiveandenhancethequalityoflifeforpeoplelivingwithcancer.

Londonerslivinginourregionstillhaveapoorerchanceofbeatingtheircancerthanelsewhereinthecountryandweneedtoclosethatgap.Tacklingthereasonsbehindlatediagnosisofcanceriskeytomakingimprovement,aswellasaddressingtheunacceptablevariationsacrossthecapitalinscreeningratesandaccesstotreatment.

Wehaveworkedinpartnershiptoconsiderthefullpathwayofpatientcare,fromdiagnosistolivingwithandbeyondcancerand,forsomepatients,end-of-lifecare.Allcolleagues–chiefexecutives,medicaldirectors,clinicalleaders,cancermanagers,nurses,GPsandotherhealthprofessionals–arefocusedonaddressingpatients’needs,enablingustogenuinelyputpatientsattheheartofeverythingthatwedo.

Inthisannualreview,wepresenttheprogressLondon Cancerhasmadeinoursecondyearoffunctioningasanintegratedcancersystem.Theseachievementsareatestamenttothepeopleactivelyinvolvedinourworkwithoutwhomthischangewouldnotbepossible.WewishtoparticularlyacknowledgetheessentialcontributionfromMacmillanCancerSupportandourveryconstructivejointworkingwiththeLondonCancerAlliancetotackleareasthatrequire aco-ordinatedeffortacrossLondon.

Earlier diagnosis Inthepastyear,London CancerhasworkedinpartnershipwithMacmillanandmanyotherorganisationstoimproveearlierdiagnosisofcancer.WehaveupdatedtheprocessesGPsusetoreferpatientstohospitalsandsupportedaninnovativemodelatBartsHealthNHSTrustthathasstreamlinedthediagnosticpathwayforGPstoreferpatientswithlowerbowelsymptomsforassessment.

WehavepartneredwithCamdenCCGtodevelopacomprehensiveapproachtoimprovingearlierdiagnosis,whichisasignificanthealthneedintheirlocalpopulation.Wehavealsoworkedcloselywithcommunitypartnerstodiagnosehigh-risk,hardtoreachpatients.

Wecompletedananalysisofnearly1,000patientswhosecancerwasfirstdiagnosedaftertheypresentedtoA&E,tobetterunderstandreasonsforlatediagnosis.Thisanalysisinformedaseriesofeducationaleventsinvolvingprimaryandsecondarycarecolleaguestopromotepartnershipworkingtotacklethisimportantissue.

Creating a patient-focused systemInconjunctionwithMacmillanandtheLondonCancerAlliance,wehavedeliveredanumberofprojectstoimprovepatientexperience.Alltrustsworkedinpartnershipinapan-LondonanalysisofthefreetextcommentsmadebylocalpatientsintheNationalCancerPatientExperienceSurvey.Thishashelpedidentifywhereimprovementeffortsshouldbefocusedwithinthesystem.Wehaveworkedwithtruststodevelopalearningcommunity,particularlyaroundusingreal-timefeedbackandqualityimprovementtoeffectchange,andsharingbestpracticeingoodpatientinformation.

Wehaveworkedwithcommunitygroupstodeliveraward-winningprojectsandprogrammesthat supportpatientslivingwithandbeyondcancer. Thisprogrammeofworkislargelycentredona‘recoverypackage’whichensuresthatallcancerpatientsreceivethebestpossiblesupportforimprovedoutcomesandqualityoflife.

Reducing variation and aiming for world-class careDuringthepastyear,wehaveworkedwithLondon’sspecialist commissioners to implement some of thekeyrecommendationsfromLondon’s Model of Care for Cancer Services.The12hospitaltrustshavemadesignificantprogressinworkinginpartnership


Welcome from the Chair and Chief Medical Officer of London Cancer

Every hour, three more Londoners are diagnosed with cancer. On average, one of them will die within 12 months, one will live with their cancer for the rest of their life, and only one will beat it.

toproposechangestofivespecialistcancerservices.Theseproposalswouldcreatehighervolumespecialistteams,whobyworkingtogetherinanewway,couldprovideaccesstothesamelevelofexpertisesevendaysaweekforallpatients.Bybringingalltheexpertstogetherintooneteam,wearealsoimprovingtrainingandacceleratingresearchandaccesstonewandcutting-edgetreatmentforpatients,nomatterwhereinthesystemtheyarefirstdiagnosed.

WehavealsocontributedtothecreationofLondon’sfiveyearcancercommissioningstrategythatembracesinnovationstodiagnosticandtreatmentpathwaysandservicesforpatients.

Improving access to researchAt London Cancer,wearecommittedtosupportingcancerresearchandimprovingpatients’accesstoclinicaltrials.Thisyearsawsuccessinimmunotherapytrials,withcliniciansintheregionenteringthefirstpatientinaglobalclinicaltrialofanewtypeoftreatmentthatisshowinggreatpromiseinpatientswithadvancedskinandlungcancer.Wehavealsoseentheimpactthatasystem-wideapproachcanhaveinaccesstoclinicaltrials,suchasthatdemonstratedbyourTeenagerandYoungAdultPathwayBoard.

Wehavesupportedwidercancerresearchincludingresearchfocusedonhealthylifestylesandpatient-ledresearch.ClinicianswerealsosuccessfulinwinningfundingfromCancerResearchUKforresearchintolowdoseCTscanscreeningofheavysmokersforearlierdetectionoflungcancer.

Focus for the futureWiththeblueprintforaworld-classcomprehensivecancersysteminplace,andtheproposalsforspecialisthubsdefined,wearenowputtingmostofoureffortintothecommoncancerpathways,tomakethebiggestdifferenceforthelargestnumberofpatients.WearebringingUCLPartners’expertiseinqualityimprovementacrosspathwaystosupportourpartnersinaco-ordinatedmanner,fromdiagnosis

throughinformedtreatmentoptionsandfollowup asclosetohomeaspossible.

Connectivityofhealthcareinformationiscriticaltoensurethatcancerpatients,andthestaffwhocareforthem,havetherightinformationintherightplaceattherighttime.Wewillthereforebeworkingtoimplementandjoinuphighquality,easytousedatasystemsthathelpnavigatecarealongthepatientjourneyandtounderstandthequalityandoutcomesofwholepathwaysofcare.

London Cancer’sworkisstartingtomakearealdifferenceforcancerpatientsinNorthandEastLondonandWestEssex.Withacontinuedfocusonincreasingearlydiagnosis,reducingvariationandworkinginpartnershipwithprimarycareandpatientsthemselves,wearedeterminedtosupportallthoseinvolvedinthedaytodaycareandtreatmentofcancerpatients.Together,wecanachievethestepchangethatisrequiredtomakesurethatLondonersandpatientsacrosstheentiresixmillionpopulationservedbyUCLPartners’sAcademicHealthScienceNetworkwillhaveoutcomesandcarethataretheverybestavailableinEnglandandcanmatchthebestinanypartoftheworld.


Tackling the reasons behind late diagnosis of cancer is key to making improvement, as well as addressing the unacceptable variations across the capital in screening rates and access to treatment.

Pelham Allen, Chair

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”Pelham Allen Professor Kathy Pritchard-Jones

Pelham Allen, Chair

Professor Kathy Pritchard-Jones, Chief Medical Officer

DespiteoverallimprovementsincancersurvivalintheUK,patientsinLondonstillhavepooreroutcomescomparedtotherestofthecountry.Itisestimatedthatanextra1,000livescouldbesavedinLondonaloneifinternationalbestpracticecouldbematched.Improvingearlydiagnosisofcancer,whentreatmentsaremoresuccessful,isthereforeakeyfocus of London Cancer.

Inthepastyear,London Cancerhasworkedwithawidevarietyoforganisationstoincreasetheearlierdiagnosisofcancer.FromupdatingtheprocessesGPsusetoreferpatientstohospitals,toimprovingtheassessmentofvagueabdominalsymptomstocatchcancerearlierandcreatingITsolutionstoincreasethespeedofdiagnosticservices,wearetirelesslyworkingtohelpourpartnersdiagnoseandtreatcancersooner.

Supporting professional development in primary careAsthemajorityofpatientcaretakesplacewithinprimarycare,werecognisethekeyrolethatGPsplayinpatientpathwaysandinincreasingratesofearlydetectionofcancer.WearecommittedtosupportingGPstoimprovehowtheyspottheearlysignsandsymptomsofvariouscancersandimprovingtheirknowledgeofreferralroutesanddiagnosticsthroughourGPEducationalSeries,inpartnershipwithMacmillanCancerSupport.

Wehaveco-creatededucationaleventswithlocalMacmillanGPcancerleadssinceNovember2012, toensurethecontentanddeliveryofeventsismatchedtotheidentifiedlearningneedsoflocalGPs.Throughinteractivecasestudydiscussionswiththelocalhospitalstaffwhocareforcancerpatients, wearestrengtheningrelationshipsthatarevital forimprovementworkindiagnosticandfollow uppathways.

“Co-producing educational events with London Cancer has allowed me as a local Macmillan GP Cancer Lead to bring clinical leaders to a local forum for innovative and system-changing dialogue. We have used innovative, inclusive approaches that reach out not only to GPs but also to their wider healthcare teams,”saidDrClareStephens,PrimaryCareCancerLead,BarnetCCG.

TheseeducationaleventshavebeenmadepossiblebygeneroussupportfromMacmillanCancerSupportandlocalCCGs.Atotalof279GPsand86practicestaffhaveattendedacrossthesystemwithverypositivefeedback.Asuiteofeducationalfilms areavailableontheLondon Cancerwebsite www.londoncancer.org/gps/educational-films/.

Whenaskedhowparticipationhaschangedtheirpractice,GPsindicatedseveralchanges.Attheevents,someGPswereopenabouttheirhesitationtoreferpatientsforcertaindiagnostictests.Examplesweregivenaroundsigmoidoscopyforsuspectedbowelcancerandtestsforovariancancerinpeopleintheir40sand50s.Howeverafterattendingtheeducationevents,andunderstandingtheimportanceofthetwo-weekreferralprocess,GPsreportedtheirwillingnesstoreferpatientsandtoprovidethesupportandinformationneededtoreassurepeopleduringtheprocess.


Objective 1:To increase one year survival for patients by improving earlier diagnosis of cancer.

Straight to test triage for colorectal cancerLondon Cancer isworkingcollaborativelytoshortenthepatientpathwaytodiagnosis.DrEdSewardatBartsHealthNHSTrusthasdevelopedanewserviceat Whipps Cross Hospital that opens up the referral pathwayforpatientswithlowergastrointestinalsymptomsbeyondthestrictcriteriaforurgentreferralofsuspectedcolorectalcancer.GPsandpatientsreceiveadefinitivediagnosismoreefficientlythrougha‘straighttotest’modelwherebyatrainedspecialistnurseassessespatientsbytelephone.Thisenablesmostpatientstogodirectlytotheappropriateendoscopicinvestigation,accordingtosymptomsandage,ratherthanattendingclinicfirst.

Clearbenefitsforpatientshavealreadybeenseenfromthefirst125cases,including:fasterdiagnosis, areductioninmissedappointmentsandunnecessaryclinicvisitsandcostsavingsacrossthewholepathway,whichcouldberedeployedformoreearlydiagnosis.Theprojectwasrecentlyshortlistedfor aBMJAwardin2014.

We are delighted with this innovation. For the first time, we are able to offer our patients a service that prioritises making a reliable diagnosis in days rather than weeks or months. The patient feedback is fantastic, it is truly patient-centred, and the service costs my commissioner colleagues less money. Everyone wins.

Dr Munesh MistryGP in Waltham Forest


Tackling health inequalities and early diagnosisLondon Cancer hasbeenworkingtoimproveearlydiagnosisforgroupsexperiencinghealthinequalities.InSeptember,weparticipatedinaneventtomarkthepublicationof‘HearMeNow’,areporthighlightingthehealthinequalitiesforblackAfrican/Caribbeanmenwithprostatecancer.Wearenowdevelopingthefirstprojecttolinkpromotionofprostatespecificantigen(PSA)testinginhigh-riskcommunitiestoacancerdiagnosticandtreatmentoptionsappraisalpathway.Thiswillmaximisechoiceoftreatmentandavoidovertreatmentforpatientswithlessaggressivedisease.Byimprovingearlierdiagnosisofprostatecancerinthesehardtoreachhigh-riskpatients,weaimtoincreasesurvivalandminimisetheriskofpermanentsideeffectsoftreatment.

InpartnershipwithMacmillanCancerSupportandCancerEquality,weheldaneventinHackneytoraiseawarenesswithlocalcouncillorsandCCGsaboutthehigherriskofprostatecancerandpooreroutcomesamongstblackandminorityethniccommunities.Throughlocalcommunityworkers,wehavehelpedsupportpeoplefromthesegroupstogetthemost outofGPappointments.

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Community engagement with Tottenham HotspurImprovingpublicunderstandingofcancersymptomsiscriticaltoearlydetection.London Cancer partneredwithTottenhamHotspurFootballClub,HaringeyCouncilandNHSEngland(London)tolaunchthefirst‘GetToKnowCancer’drop-inclinicclosetoWhiteHartLanefootballstadium.

Theclinic,staffedbynursespecialists,wasopentoanyonewhohadquestionsorconcernsaboutsymptomsandcrucially,noappointmentswerenecessary.ThegoalwastoreducethefearorembarrassmentassociatedwithcanceranditssymptomsthatcanstoppeoplegoingtotheGPwhensignsfirstappear.Thedrop-inclinicwasmainlyaimedatmenwhohaveatendencynotgotothedoctorasregularlyaswomen.

Theclinicwasopenforatrialperiodof21sessionsoversixweeks,predominatelyoutsideGPhours. Thelaunchreceivedfantastictractiononsocialmediahavingover300tweetsthatreachednearlysixmillionfollowers.

VisitorswerepredominantlymaleandfromtheTottenhamarea.Nursessaw325peopleinone-to-oneconsultations,discussingthemostcommonsymptomsoflumps,changeinbowelorbladderhabitsandunexplainedbleeding.JohnHines,urologicalcancersurgeonandPathwayDirectoratLondon Cancer,alsotooktothepitchduringhalf-timeagainstManchesterUnitedtoencouragethetensofthousandsoffanstovisittheirdoctorifworriedaboutsymptoms.

TheTottenhamHotspurFoundationwillcontinue tosupporttheGettoKnowCancercampaignduringthe2014/15PremierLeagueseason.

BELOW: Kyle Walker receiving a BMI check at Tottenham Community

Market, White Hart Lane

My wife nagged me for months to go to the doctor when I had symptoms. I was lucky they caught the cancer in time – she probably saved my life.

Steve Brown, cancer survivor, speaking at the launch of the cancer drop-in clinics in Tottenham.

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Get to Know Cancer clinic in numbers• 325visitorsduringthe21days• 21%werereferredtoafollowupservice

(e.g.GP,stopsmokingclinic)• 11%referredtoaGP• 4.6%referredtoaweightmanagementprogramme• 5.2%referredtostopsmokingservice• Over50%offanssaidtheknowledgegainedhad

changedhowlongtheywouldwaittogetadviceaboutunexplainedchangesintheirhealth

• Costpervisitwasnearlyhalfthatofawalk-in clinicorA&Eattendance

Earlier diagnosis of cancer in CamdenA new way of working in partnership

Cancer accounts for 35% of premature deaths in Camden and the toll is disproportionately high among women and lower socioeconomic communities

London Cancer and Camden CCG are collaborating with clinicians and partners to address the main causes of late diagnosis. The programme aims to increase population awareness of cancer, tackle health myths and misperceptions in specific community groups and encourage people to use the services of primary care.

Theworkisbeingdeliveredthroughapartnershipapproach,involvingMacmillanCancerSupport,CancerResearchUK,BMJLearning,localGPpractices,communitygroupsandNHSproviders.

Theoverarchingobjectivesoftheprojectareto: 1 Improveoneyearsurvivalrate 2 Increaseuptakeinscreeningprogrammes 3 Increasethenumberofcancerpatients

presentingatStage1and2 4 Increaseknowledgeandawarenessofsigns

andsymptomsofcancer.

• Over50%ofGPpracticesinCamdenhavebeeninvolved

• 60volunteershavebeentrainedtotalkabout cancer

• ThroughpartnershipwiththeBengaliWorkersAssociation,wecontacted7,000peoplefromtheBangladeshicommunity

• Weaimtoreachover10,000peopleagedover50toraiseawarenessofbowelcancerthroughpartnershipwithArsenalintheCommunityandtheTottenhamHotspurFoundation

GP education and professional development in CamdenAbespokeprimarycareeducationprogrammewasdevelopedtoimproveGPreferralofpatientsforinvestigationofcancersymptoms.Thiswasinresponsetopractitionerdelaysidentifiedinthe2012CamdenAnnualHealthReportasoneofthekeydriversoflatecancerdiagnosis.EngagementwithGPshasbeenverysuccessfulwithoverhalfofCamdenGPpracticeshavingreceivedavisitandtwowellattendededucationaleventshavebeenheld.

The small ‘c’ campaign The‘smallc’awarenesscampaignisbeingusedtosupporttheworkofcommunitygroupsfollowingitssuccessineastLondonin2009.Thefearsurroundingcancercanleadpeopletoignoreimportantsymptomsbecausetheyareafraidofcancer-the‘BigC’-,andthiscampaignwantstoovercomethestigmaandencouragepeopletoseekhelpearly.Theaimistohighlightthatinmostcases,byparticipatinginnationalscreeningprogrammesandrecognisingandactingontheearlywarningsignsofcancer,peoplecanturnthe‘BigC’intoa‘smallc’.

PeereducationworkinCamdenbeganinAprilwithvolunteerscompletingCancerResearchUK’s‘TalkCancer’programme,empoweringthemtobuildtheirknowledge,skillsandconfidencetotalkaboutcancer.

This is a truly exciting project that tackles one of our biggest health issues in Camden and typifies our CCG’s integrated approach. London Cancer has been instrumental in co-ordinating and leading this work to provide a focused approach to getting cancer diagnosed early whilst linking it in with other work streams across north and east London.

Caz Sayer, Chair Camden CCG and local GP.


Your GP wants to know. Chances are, it’s nothing serious,

but if it’s lung cancer, the time to know is now.

Why? You’re far more likely to survive early stage lung

cancer than late stage lung cancer. Seeing your GP

promptly could save your life.

Do you have these symptoms?

www.smallc.org.uk/lung

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”

It is well known that the late diagnosis of cancer leads to poorer outcomes for patients. The London Cancer region has a particularly high number of people diagnosed with cancer after attending A&E (also known as an emergency presentation), rather than through traditional routes. Nearly a quarter of patients in our region are diagnosed this way – totalling approximately 3,000 patients each year.

Theemergencypresentationofcancercanbeconsideredafailureofthehealthcaresystem.London Cancer madeitaprioritytounderstandhowandwhysomanypatientsarediagnosedviathisrouteandundertookasystem-wideevaluationacrossnortheastandcentralLondonandwestEssex.InpartnershipwithninehospitaltrustsandGPsacrosstheregion,weaimedtounderstandtheinfluencesanddriversofemergencypresentationthatmaybekeytoimprovingsurvivalratesfromcancer.

ByanalysingdatainGPandhospitalrecords,wewereabletoassessthewholediagnosticpathway.Theprojectidentified963patientsintotal.Thecommonesttypesofcancersidentifiedbytheemergencyroutewere:lung(32%),colorectal(18%),uppergastrointestinalandhepatobiliary(12%)andhaematology(8%).

Theevaluationshowedpoorearlyoutcomesas10%ofpatientsdiedwithinamonthofdiagnosis.Analysisoftheprimarycareresponsesidentifiedsomeemergingthemesandareasforimprovement,forexample:fasteraccesstodiagnostictestsforGPsandbetteraccessinhospitals.ThisworkalsoshowedthatA&Ecanbeseenasafast-tracktodefinitivetestsbybothGPsandpatients.

MostpatientsidentifiedintheevaluationwereknowntotheirGPandreportedagoodrelationshipwiththem,despiteso-called‘stoic’attitudestohelp-seeking.Peoplewereputoffseekinghelpforasecondorthirdtimeifamedicalpractitionerhadalreadygiventhematentativediagnosis.SomedidnothaveaGPorhadnotseentheirGPinthelasttwoyears.

London Cancerisnowactivelyworkingtoaddresstheconcernshighlightedinthestudy.

Wehavestandardisedameasuretosystematicallycollectanemergencypresentationsmetricacrosstrusts in London Cancer–approvedbytheHealth andSocialCareInformationCentre(HSCIC).

London Cancer’spathwayboardsareworkingtomaximiseunderstandingoftheroutetodiagnosisforeachtypeofcancerandtoidentifyandprioritisepossibleinterventionstodiagnosecancerssooner.

WeaimtodelivercontinuededucationtoraiseawarenesswithGPsandothersinprimarycareofthesignsandsymptomsofcancer;how‘redflag’symptomscanbemissedinpatientswithmultipleproblems;andtheneedforbetterpathwaysforpatientswhohave‘vague’symptoms.

Wearealsoworkingcloselywithprimaryandsecondarycarecolleaguestoredesignreferralpathwaysandsystemstoensurethatpatientswhoarediagnosedonanon-urgentroutearetransferredontoatime-dependentpathwayandnotdelayedinthesystem.


Understanding the reasons for late diagnosis of cancer

Follow-up with primary care and interviews provided the following insights:

• 64%ofpatientswenttoA&Ewithsymptomslastinglessthanamonth

• 63%ofpatientshadseentheirGPforthesameproblempriortoA&EandoverhalfofthesepatientswerewaitingfortestsorganisedbytheirGP

• Themostcommonreasonfordelaywasnotthinkingtheproblemwasserious(53%)

• 7%ofpeopledelayedbecausetheywereworriedaboutwhatwouldbefound.Thisgroupwaitedthelongestbeforeseekinghelp.


At London Cancer,webelievethatpatientexperienceandthepatientvoiceisanunderutilisedresourceforimprovingthehealthservice.Fromtheoutset,wehaveco-designedourworkinpartnershipwithpatientswhoareactiveparticipantsinourpathwayboardsandexpertreferencegroups.Thisyear,wehaveevenmorepatientandcarerinputintoallareasofourwork,with65peopleworkingdirectlywithourteamandclinicalleadersand16newlyjoinedinthepastyear.

Wehaveseenimprovementsinfiveofthetentopicsthatmattertomosttopatients,howeverthereismuchworktobedone.Weremaincommittedtogivingpatientsandcarersapowerfulvoiceandmoreactiveinvolvementintheircare.Thissectionprovidesanoverviewofouractivitiestoimprovepatientexperience.

WearegratefultoMacmillanCancerSupportfortheirpartnershipinfundingandmentoringourworkinthisimportantarea.

NikkiCannon,SeniorMacmillanDevelopmentManagercomments:“Every person diagnosed with cancer should be treated with dignity and respect throughout their cancer journey and we are delighted to be working with London Cancer to improve patient experience. Great progress has been made in North and East London over the past 12 months and we look forward to continuing to work together on further improvements in this crucial area.”

Listening to patients and acting on their comments Lastyear,withtheagreementofalltrustsinLondon,bothintegratedcancersystemsinLondonworkedtogethertoperformathematicanalysisofover15,600freetextcommentssubmittedbycancerpatientsintheNationalCancerPatientExperienceSurvey(NCPES).

Patientfeedbackwasmorepositivein2012/13thaninpreviousyears,withover65%ofthecommentssubmittedbeingpositiveaboutpatient’sexperienceandlessthan35%makingsuggestionsforimprovement,comparedto60%and40%respectivelyin2011/12.Positivecommentswere

generallyaboutthequalityofcare,specificservicesandteams,qualityofprofessionals,speedandefficiencyandsupportandattention.

Patientshighlightedtenmainareasofimprovement:qualityofcare,qualityofcommunication,waitingtimesinoutpatientclinics,information,staffinglevels,liaisonbetweendepartments,theenvironmentandhospitalsite,support,GPliaison,anddelays.ImprovementideashavebeensharedwithtrustsandwillbetakenforwardbythePatientExperienceLearningCommunity(seebelow).

Establishing a community to improve patient experience In March 2014, London CancerlaunchedthePatientExperienceLearningCommunitytohelpdriveimprovementinpatientexperience.Itspurposeistoenablesharingofbestpractice,reflectonlesshelpfulpracticeanddriveimprovementthroughcollaboration.

Thecommunitywillhavequarterlylearningsetsandanonlineplatformtoallowongoingdiscussionbetweenpatientexperienceimprovementmanagers,patients,andstafffromthethirdsector.Todate,fivelocalimprovementprojectshavebeenstartedasaresponsetoourLearningCommunitylaunch.Theworktoassessandunderstandreal-timefeedbackwillbesharedwiththelearningcommunityasinsightsemerge.

Using real-time patient feedback to improve careOverthepastyear,all12London Cancer trusts havedevelopedtheirreal-timepatientfeedbackmechanisms,includingelectronicsurveys,onlinefeedback,kiosks,patientexperiencetrackers,complimentandcommentcards,andpatientandstaffstories.Therearemanysimilaritiesbetweenthequestionsaskedacrossthetrusts,whichincludetheFriendsandFamilyTest,alongsidebespokesurveysdevelopedwithpatients,carersandexternalagenciestobetterunderstandandmeasureimprovementsmade.

Improving the information patients receive about their careLondon Cancerhasworkedwithtrustsandpeopletocreateaninformationstandardacrosstheintegrated

Objective 2:Improve patient experience by delivering 90% positive level of response on 10 areas most important to patients on the annual National Cancer Patient Experience Survey in 2015.

cancersystem.Thisinvolvedidentifyingtheprinciplesofgoodpatientinformationandagreeingasetofcoreinformationtrustsshouldbeprovidingtoallcancerpatients,drawingonthestrengthoforganisationsthatarealreadyshowingbestpracticeinthisarea.

Aworkshop,facilitatedbyMacmillanwasheldto:• Identifytheprinciplesofgoodinformation• Agreeasetofcoreinformation–keepingit

simpleacrosstumour-types• Getpatientperspectivesandadviceon

behaviouraroundprovisionandcommunication ofinformation.

London Cancer’spathwayboardshavealsodevelopedseveralprojectstoimprovethequalityofinformationthatpatientsreceiveabouttheircancerdiagnosis.

Forexample,theTeenagerandYoungAdultsPathwayBoarddevelopedanewpatientinformationpacktogiveyoungpeoplewithcancerandtheirfamiliesextraguidanceandsupport;highlightingstaffwhoareavailabletohelp,supportservicesavailableandpracticaltipsaboutfinances,educationandhowtostayactiveduringandaftertreatment.Thiswillbeissuedtoallyoungpeopleaged13-24yearsinNorthLondon,MountVernonandEssexwhoarenewlydiagnosedwithcancer.

Improving quality of life through community-based physical activityTheAquaterraCancerSurvivorshipExercisePilotsupportedbyLondon CancerwonanawardattheQualityinCareExcellenceAwards2013.

Thispilotprogrammeprovidesacommunity-basedphysicalactivityprogrammetopromotethephysicalandpsychologicalwellbeingofindividualslivingwithorbeyondcancer.Participantsareoffereda12-weekpersonalisedcoursetoincreasetheiractivitylevels,withastrongemphasisoninformedchoiceandempowerment.Thissupporttoadoptahealthierlifestylemayreducetheriskofcancerrecurrence.

Resultsshowedthatphysicalactivitylevelsincreasedby100%andparticipantsimprovedenergy(71%);well-being(75%);andgreaterconfidence(65%).85%intendedtocontinuewiththelifestylechanges,and91%tookadvantageofanActiveHealthdiscountedmembershiptocontinueusingleisurefacilitiesaftertheintervention.


“I am a senior citizen and was treated with the utmost care and respect. I received excellent service throughout. I would have liked sufficient opportunity to discuss options – not least the option to decline treatment and to understand the full consequences of that decision.”

If you are a patient or carer and would like to be involved in one of London Cancer’s groups or projects, please contact us at [email protected]

With generous support from Macmillan Cancer Support, we are continuing our work to implement the National Cancer Survivorship Initiative (NCSI) recovery package for all individuals diagnosed with cancer. This package combines several interventions which, when delivered together, aim to improve care co-ordination, experience and outcomes for individuals.

Theinterventionsare:holisticneedsassessment(HNA),treatmentsummaries,cancercarereviews(conductedbyGPs)andhealthandwellbeingevents.

Treatment summaries Wehavesuccessfullyagreedastandardisedtreatmentsummarytemplatewhichoutlinesthedetailsofthetreatmentreceived.Italsoincludespossible treatment toxicities and/or late effects, symptomsthatrequirereferralbacktoaspecialistteam,anongoingmanagementplan,contactdetailsforreferralbackintosecondarycare,andanyrecommendedGPactionstomonitorandsupporttheindividualoncetheyhavefinished theirtreatment.Thisdocumentissharedwith boththeindividualandtheGP.

Holistic needs assessment WehaveworkedjointlywiththeLondonCancerAlliancetoagreeastandardpan-LondonHNAtool,whichwaslaunchedinNovember2013.SeveraltrustsarealsoparticipatingintheMacmillanCancerSupporte-HNApilotproject,whichuses a touchscreen tablet for ease of completion of theholisticneedsassessmentandgenerates apersonalisedcareplan.

“Whenever possible, we give patients the HNA in advance so they can think about any issues they wish to discuss. HNAs often prompt discussions in difficult areas for the patient and they bring emotions to the fore which need careful managing. However, this means these problems can be addressed with a care plan early on in treatment.”JanetCopp,HaematologyClinicalNurseSpecialist(Barking,HaveringandRedbridgeUniversityNHSTrust).

Sincethebeginningoftheproject,ninetrustshaveintroducedholisticneedsassessments,fivehaveimplemented treatment summaries and six host healthandwellbeingevents.


Implementing the National Cancer Survivorship Initiative patient recovery package

Completing holistic needs assessments can highlight concerns for patients that don’t always come to light in consultation.

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Clinicians across London Cancer have been working closely with NHS England and local CCG partners to ensure that we can achieve the best possible outcomes for every patient requiring a complex procedure for one of five cancers.

Buildingoncommissioners’recommendationsin2010,clinicianscametogethertodevelopaCaseforChangetodriveimprovementsinthehealthoutcomesandexperienceforcancerpatientsinourarea.TheCaseforChangeoutlinesproposalstoconsolidatesomespecialistcancerservicesintoapartnershipofworld-classspecialistcentresinanewconnectedsystemofcare–includinglocalhospitals,primaryandcommunitycareservices–toprovideconsistentlyexcellentservices.

Cliniciansbelievetheproposalswouldallowmorerapidimprovementsincare,ensureeverypatienthasaccesstothefullrangeoftreatmentoptionsandresearchopportunitiesandprovideaconsistentlevelofcarenomatterwhereapatientlivesorfirstreceivescare.Ifagreed,thechanges,alongwithimprovementsacrossthewholecarepathway, couldsaveover200livesayear.

NHSEnglandhasledtheworktodeveloptheproposalsfollowingfeedbackandinputfrompatients,staffandstakeholdersduringanengagementexerciseattheendof2013.Theproposalshavereceivedstrongsupportfromclinicians,clinicalcommissioninggroups(CCGs)andthethreejointhealthscrutinycommitteesforthearea.Itisexpectedthatafinaldecisionwillbemadebycommissionersinsummer2014,followingasecondperiodofengagementon adetailedbusinesscase.

“Everyone who lives and works in our area deserves world-class care. Unfortunately the way that some specialist services are currently organised makes it impossible for our clinical teams to do their best for patients. This is frustrating for everyone; we are convinced by the evidence that consolidating complex and specialist cancer services into a small number of world-class specialist centres, where all the experts can work together in a new way around the patient pathway, is the best way to achieve this.”

Professor Kathy Pritchard-Jones, Chief Medical Officer of London Cancer.


Aiming for world-class standards of care

Researchstudiesandclinicaltrialsallowpatientstoaccessthelatestinterventionsnotyetavailableaspartofstandardcare,andhelpbuildtheevidencebaseforchangesinclinicalpracticethatwillimproveoutcomesforallpatients.OuraimacrossLondon Cancerisforresearchersatthecuttingedgeofdiscoveriestoworkwithpatientssothatwecanchangelives,atafasterpace.

Byworkingtogetherasaco-ordinatedsystemandlinkingupourclinicalpracticewithleadingmedicalresearchandinnovation,wehavearemarkableopportunitytogivepatientsimprovedaccesstoclinicaltrials.WeareworkingcloselywiththenewlyformedNIHRClinicalResearchNetworkNorthThamestoimproveinformationforstaffandpatientsandaccesstoafullportfolioofstudiesforourpopulation

Novel immunotherapy approaches – a London Cancer firstTrialsofanexcitingnewtherapythathasshowndramaticresponsesinsomepatientsintheadvancedstagesofskincancer(malignantmelanoma)andlungcancerhavebeensupportedbyLondon Cancer thisyear.InSeptember,apatientofDrDavidChao,London CancerskinPathwayDirector,becamethefirstintheworldtobeenrolledinaglobalphaseIIIskincancertrial.Withmanylungcancersandmalignantmelanomasdiagnosedatalatestage,thisbreakthroughcouldofferhopetopatientsinLondonandfurtherafield.

DrChaoleadstwoofthethreetrialstakingplaceintheregionandallstudiesareopentopatientsfromanyhospitalacrossouracademichealthsciencepartnership.“We want to ensure that as many patients as possible have access to these potentially curative or life-extending therapies,” saysDrChao.“The idea is that UCLPartners functions as one virtual hospital for this and other leading clinical trials.”

Aswellasconductingtheclinicaltrials,DrChaoandhisteamacrossUCLPartnerswillalsohelpenhancetheunderstandingoftheimmunesystembyworkingwithUCLInstituteofImmunologyandTransplantationbasedattheRoyalFreeHospital.“We have world-class research laboratories focusing on the immune system and we are aiming to work collaboratively with pharmaceutical companies to develop better therapies for our patients.”

Currently,thecancersinwhichimmunotherapiesareshowingthemostpromisearemalignantmelanoma,lungcancer,andkidneycancer.“Itishopedthatthesebreakthroughscaneventuallybeextendedtoothertypesofcancers.”concludesDrChao.

Engaging with kidney cancer patientsTheRoyalFreeHospitalandLondon Cancer hosted a renalcancerresearchday,animportantpartoftheeducationandtrainingplanfortheplannedRenalCancercentre.Theeventfocusedonfuturetreatmentofrenalcancer,particularlytheresearchandclinicaltrialstakingplace.Themeetingwasattendedby120delegateswithinternationalspeakersfromtheNetherlandsCancerInstitute,HarvardMedicalSchoolandtheClevelandClinicandparticipationfromclinicians,academics,thirdsectorandpatients.

Research into living with and beyond cancerLondon CancerispleasedtobeworkingincollaborationwithProfessorJaneWardle,DirectoroftheCancerResearchUKHealthBehaviourResearchCentreatUniversityCollegeLondon(UCL).Theaimistoexploretheimpactofhealthylifestylesonshortandlong-termoutcomesinpeoplelivingwithandbeyondcancer–focussingonbreast,colorectalandprostatecancers.

National funding to support CT screening research for lung cancerLungcancerkillsmorepeoplethananyothercancer,largelybecauseitisdiagnosedlateandstandardchemotherapyisnotveryeffective.Inpatientswithearlystagetumours,thediseaseisoftenfoundbyaccident.However,screeninghigh-riskpeople(thosewhohavesmokedapackofcigaretteseverydayformorethan30years)usinglow-dosecomputedtomography(CT)hasshownimpressiveresultsinearlydetectiontrials.


Objective 3:To give patients access to innovation by increasing participation in clinical trials to over one-third of patients within three years.

We want to ensure that as many patients as possible have access to these potentially curative or life-extending therapies.

DrSamJanes,lungcancerPathwayDirector,inconjunctionwithProfessorJaneWardle,hasbeensuccessfulinabidtotheNationalAwarenessandEarlyDiagnosisInitiative(NAEDI) – fundedbyCancerResearchUK–toresearchthedevelopmentandtestingoftargetedinvitationmaterialsforapilottrialoflungcancerscreening.TheprojectwilltestthebestwaytoinvitepeopleathighriskoflungcancertohaveascreeningCTscan.Thosewiththehighestriskoflungcanceroftencomefromthemostdeprivedcommunities,whichalsohavethelowestratesofuptakeofothercancerscreeningprogammes(breast,bowelandcervicalcancers).Thisprojectwillmakeanimportantcontributiontoaddressingthisinequality.


London Cancer publications and presentations

The primacy of early stage cancer survival statistics in reducing emotional barriers to help-seeking behaviour in lower socioeconomic status populationsSCunnington-King,London Cancer, oralpresentation,NCINconference,2014

Paediatric clinical outcomes research – UK policy and the role of the European Network for Cancer research in Children and AdolescentsKPritchard-Jones,oralpresentation,NCINconference 2014

Emergency presentation of cancer: patients’ journeys before arriving at A&EVSpencer-Hughes,MRidge,LGrun,KPritchard-Jones,posterpresentation,NCINconference2014

London CancerChiefMedicalOfficer,ProfKPritchard-Jonesgaveaplenarylecture:“What can we learn from abroad?” attheWorldCancerDaycongress:Togetheragainstcancer–takingthenextsteps.RadboudUniversityMedicalCentre,Nijmegen,TheNetherlands,February2014

Straight to test colonoscopy – a viable means of shortening time to a definitive diagnosisPAndrews,HWatson,MMistry,MMachesney, ESeward,posterpresentation,BritishSocietyofGastroenterology2014 Straight to test colonoscopy – a viable means of shortening time to a definitive diagnosisLSteward,PAndrews,HWatson,MMistry,MMachesney,ESeward,posterpresentation,EuropeanSocietyofColoproctology2014 Pragmatic approach to quality metrics development in cancerDChung,ADwarakanath,CWilliams,KPritchard-Jones,JMountford,AMayer,posterpresentation,ASCOQualityCareSymposium2013


ChrisDevereux,apatientrepresentativeontheLondon CancerSkinPathwayBoard,isundertakingapieceofpatient-ledresearchthatcomplementstheskinresearchportfolio.Anavidcyclist,Chriswasdiagnosedinearly2012withabasalcellcarcinomawhichwassuccessfullyremovedbyMohsmicrographicsurgery;asurgicaltechniquethatisappropriateforsometypesofskincancer.Heisnowconductingastudyofpatients’perceptionsoftheirownMohssurgerywiththeintentionthatthiswillenableimprovementsincarethroughreciprocalunderstanding. Drawingfrombehaviouralsciencesandlearningtheory,thequalitativestudyinvolvesin-depthconversationswithpatients,discussingwiththemhowtheyfeltabouttheprocesstheywentthroughfromstarttofinish–whattheyappreciatedaboutitandwhatcouldbeimproved.Thegoalistoimproveunderstandingbetweenpatientsandthosewhoworkwiththem.

Researchfindingswillbeusedtooffersuggestionsfortangibleactionsforimprovement.Keythemesemergingfromhisresearchshowthatpatients’experienceshavebeenmostinfluencedbytheiranxietyabouttheprocedureandpooradministrativeprocedureswhilsttheyhavebeenimpressedbythetechnicalexpertiseofthesurgeonandtheoutcomeofthesurgeryitself.

London Cancer is committed to engaging with patients in the development of our research strategy. Patients are at the heart of both study design and the oversight of clinical trials and recently we have introduced innovative models of patient-oriented research.

Supporting patient-led research in skin cancer

Working with patients like me on their experiences of Mohs surgery has enabled conversations that may not happen when talking to professionals. This study has given me the chance, through talking to fellow patients, to suggest low-cost ways in which some aspects of the patient experience could be made better.

Chris Devereux, Patient representative on the London Cancer Skin Pathway Board

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The NIHR Clinical Research Network North Thames

• ThenewlyformedNIHRClinicalResearchNetworkNorthThamesisastreamlinedorganisationwhosegeographicalboundariescorrelatewiththeUCLPartnersAcademicHealthScienceNetwork.

• ItisthesecondlargestClinicalResearchNetworkbypopulation;servingaroundsixmillionpeople.

• TrustsinLondon Cancerareparticularlystronginrecruitingtointerventionaltrials(studiesthattestaparticulartreatment),contributing11.3%ofthetotalcancerpatientsrecruitednationally,withparticularstrengthingynaecologicaloncology,melanomaanduppergastro-intestinalcancers.

• London Cancer’strustshaverecruited20%ofthecountry’sChildren’sCancer&Leukaemiaportfolio.

• Todate,70PrincipalInvestigatorsfromLondon Cancer trusts haveparticipatedin14disease/cross-cuttingareas.

Aparticularsuccesshasbeen London Cancer’sworkwithacutelymphoblasticleukaemiaTYApatients.Previously,thesepatientshavehadpoorersurvivalcomparedtochildren,likelyduetoacombinationoffactorsincludingmoreaggressivebiologyofdisease,increasedtoxicity,poorerrecruitmenttoclinicaltrials,poorercomplianceandlackofunifiedprotocol,withpatientstreatedoneitherapaediatricoradultprotocolbasedpurelyonlocalreferralpatterns.

TheTYAPathwayDirector,DrRachaelHough,wasinvolvedinanationalworkinggroupwhichbroughttogetherpaediatricandadultphysicianstoagreewhichprotocolsofferyoungerpatientsthebest

chanceofsurvival.Thesewerethenrolledoutacrossthesystem.Nowpatientsupto24yearsofagearetreatedonthepaediatricprotocolsandhaveasubstantialimprovementinevent-freesurvival.Thishasalsodoubledrecruitmenttoclinicaltrialsascliniciansnowknowwhichtrialisbestfortheirpatientsandaremorewillingtorefer.

Inaddition,thisagegrouppreviouslyhadpoorclinicaltrialsrecruitmentcirca40%.Thishasdramaticallyimprovedascliniciansnowknowwhichtrialisbestfortheirpatientsandaremorewillingtorefer.Thishasdoubledenrolmentinclinicaltrials.

Following the establishment of the Teenager and Young Adult Cancer Network (TYA) in November 2012, we have seen a dramatic improvement in participation in research.

Increasing participation by teenagers and young adults (TYA) in clinical trials


London Cancer currently hosts 11 cancer pathway boards, five specialist boards and six expert reference groups (ERGs). Last year, we hosted 15 educational events within these groups, bringing together multi-professional groups to better understand and treat cancer, leading to several joint initiatives, co-developed across the partnership.

Implementation of sub-cutaneous trastuzumabTheChemotherapyERGworkedwiththeLondonCancerAllianceandNHSEnglandintheimplementationofsubcutaneoustrastuzumab(Herceptin)acrossLondon.Sub-cutaneousinjectionsare made just under the skin as opposed to the traditionalintravenous(IV)routeofadministrationwhichtakesalongtimetoadminister.

Thesub-cutaneoustrastuzumabhasbenefitsincost,efficiencyandimprovedpatientexperiencecomparedtoIVtherapy.London Cancer,inconjunctionwithLondonCancerAlliance,developedacomprehensivepackageforhospitalstoallowtheeasyadoptionofthistreatmentwiththeaimofreducingthetimerequiredforimplementation.Thispackageincludesriskassessments,guidelines,apatientinformationleaflet,e-prescribingadvice,andanursingadministrationprocedure.

Todate,fourtrustshaveimplementedsub-cutaneousHerceptinandtheChemotherapyERGisworkingwiththeremainingtruststodriveadoptionacrossthesystem.

Single integrated radiotherapy serviceTheLondon CancerRadiotherapyExpertReferenceGroup(ERG)hasbeenconductinganoptionsappraisalintothefeasibilityofasingleintegratedradiotherapyserviceworkingacrosstheintegratedcancersystem.ThevisionistoprovideahighqualityradiotherapyservicetoanypatientwithinLondon Cancerasclosetohomeasispossible;facilitatingswiftaccesstospecialistandinnovativetreatments,poolingexpertiseandsharingtheresourcerequiredtolead,manageandmaintainahighqualityservice.ThereportwillbecompletedbyAugust2014.

Online integrated renal pathwayWeweresuccessfulinsecuringfundsfromtheNHSEnglandSaferHospitals,SaferWardsTechnologyFundtointegratedatawithinexistinghealthcareITsystemsinordertoprovidearenalcancerpathwayoverview.Thiswillshowthenumberofpatientsatdifferentstagesofthepathwaywiththeabilitytodrilldowntoanindividualpatientlevel.ThisisaninnovativeprojectwithanindustrypartnerbasedinScotland,andhostedattheRoyalFreeLondonNHSFoundationTrust.

Using information to improve the patient pathwayThispastyearLondon Cancersignedaninformationsharingagreementwithtrustsinourareatosetouthowwewillshareinformation.Wehavestartedmodellinganddevelopingscorecardsforeachofthepathways.FormoreinformationonLondon Cancerscorecardsgotohttp://meetinglibrary.asco.org/content/120394-140.Wewillcontinuetodevelopourscorecardsin2014/15,withthesupportofourpartnertrusts,topresentdatathatdrivesimprovementsacrossthepatientpathway.

Pan-London five year strategy plan to transform cancer servicesLondon Cancer,inconjunctionwithLondonCancerAlliance,participatedinthedevelopmentofNHSEngland’s(London)fiveyearplantotransformcancerservices,leadingonthereducingvariationandpatientexperienceworkstreams.Thestrategysetsoutkeyrecommendationsforhealthservices.Wecontinuetoworkcloselywithcommissioners,NHSEngland,PublicHealthEnglandandcharitypartnerstoensuretheimplementationofthiswork.

Directory of servicesInordertoassistourclinicalstafftosignpostindividualstorelevantservicesduringoraftertreatment, London Cancercarriedoutasystem-widescopingexercisetoidentifylocalresourcestosupportindividualsclosetohome.Adirectoryoftheseserviceshasbeencreatedandwillbeuploaded to the London Cancerwebsite.


Transforming pathways of care


London Cancer BoardLondon Cancer is led by an independent, skills-based and clinically-led board that sets the overall strategy, considers recommendations from cancer pathway directors and makes specific recommendations to commissioners on potential changes to cancer services and pathways.

London Cancer Board and Clinical Leadership

The London Cancer board is made up of the following members:Chair - Pelham AllenChief Medical Officer - ProfessorKathyPritchard-JonesExecutive Director – MairéadLyonsNon-Executive Directors: ElizabethBenns,DrTonyBrzezicki,DrDavidColin-Thomé, DrNigelMarchbank,ProfessorEmmaReam,DrTimothyWalls Clinical Leadership of London Cancer London Cancer pathway directors provide clinical expertise and leadership to cancer pathway boards and expert reference groups helping to drive excellence in care and research and inspire improvement.

Acute Oncology Expert Reference Group – DrIanGrantandDrEkateriaBoletiBrain and Spine Pathway Board –DrJeremyReesandMrAndrewElsmoreBreast Pathway Board – DrRebeccaRoylanceChemotherapy Expert Reference Group – DrChrisGallagherColorectal Pathway Board – MrMichaelMachesneyGynaecology Pathway Board – MrTimMouldHaematology Pathway Board – ProfessorRonjonChakravertyHead and Neck Pathway Board – MrSimonWhitleyLiving with and Beyond Cancer Board – SharonCavanaghLondon and South East Sarcoma Network Sarcoma Advisory Group – ProfessorJeremyWhelanandMrAndrewHayesLung Pathway Board – ProfessorSamJanesNorth Thames Children’s Cancer Network Coordinating Group – DrDarrenHargraveNorth Thames Teenager and Young Adult’s Cancer Network Coordinating Group – DrRachaelHoughNursing Expert Reference Group – AlisonHill(interim)Palliative care (PallE8) – DrAdrianTookmanandClarePhilipsPsychosocial Support Expert Reference Group – DrMarkBarringtonRadiotherapy Expert Reference Group – DrKatharinePigottandDrSeeniNaiduRehabilitation Expert Reference Group – SharonCavanaghSkin Pathway Board – DrDavidChaoUpper GI (Oesopho-gastric) Pathway Board – ProfessorMuntzerMughalUpper GI (Hepatic Pancreatic and Biliary) Pathway Board – DrAndrewMillarUrology Pathway Board – MrJohnHines

Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT)

KingGeorgeHospitalQueen’sHospital

Barts Health NHS Trust (Barts Health)NewhamUniversityHospitalTheRoyalLondonHospitalStBartholomew’sHospitalWhippsCrossUniverityHospital

Great Ormond Street Hospital for Children NHS Foundation Trust

Homerton University Hospital NHS Foundation Trust

Moorfields Eye Hospital NHS Foundation Trust

North Middlesex University Hospital NHS Trust

Princess Alexandra Hospital NHS Trust

Royal Free London NHS Foundation Trust Barnet Hospital ChaseFarmHospitalRoyalFreeHospital

Royal National Orthopaedic Hospital NHS Trust University College London Hospitals NHS Foundation Trust (UCLH)

Whittington Hospital NHS Trust

London Cancer 170TOTTENHAMCOURTROAD,LONDONW1T7HA

Web:www.londoncancer.org|Email:[email protected]|Twitter:#londoncancer@uclpartners

London CancerispartofUCLPartners,anAcademicHealthSciencePartnership.

Findoutmoreatwww.uclpartners.com

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London Cancer Annual Revie · 2016. 7. 6. · Contents 03 London Cancer: A partnership in pursuit...

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