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Resources

This section contains information about resources available to Primary Care, including detail of the Macmillan Facilitators and also information for the Public.

Resources for the Public can be accessed here
Resources for Primary Care can be accessed here

TVSCN Cancer Diagnostic Demand & Capacity Project – May 2016

Message from Bernadette Lavery & Monique Audifferen

Following participation in the Thames Valley Cancer SCN Demand and Capacity Project, we are very pleased to enclose the links to the reports from this important piece of work;

SPH Workshop icon

Initial Capacity Workshop – March 2016

National Trends in Cancer data

National Trends in Cancer data

Modelling future demand in cancer diagnostics

Modelling future demand in cancer diagnostics

Guidance Summary

Guidance Summary

Summary of Findings

Summary of Findings

Cancer diagnostic modelling demand tool - Excel

Cancer diagnostic modelling demand tool – Excel 

This was a major project commissioned by the Cancer SCN and delivered by Solutions for Public Health, in which they undertook analysis of current demand for diagnostics within confirmed and suspected cancer pathways. Part of the analysis included projecting anticipated future demand based on demographic changes up to 2021 and the new NICE Urgent Referral for Suspected Cancer Guidance (2015).

You will be able to review all the data, and add additional information about your own pathways to the modelling demand tool to update your projections.

Key Findings:

In the Thames Valley between now and 2021 there will be substantial increases in suspected cancer referrals:

Gynaecology 10%
Colorectal 17 – 31%
Upper GI 10% (via 2ww or direct access to test)
Lung 7 – 22%
Urology 16 – 26%

1. The number of diagnostic tests will obviously increase at least in line with the increase in referrals. It is likely, given the rapid development of new tests used for both diagnostic and treatment purposes, that test requests will increase more steeply than referrals but the size of this increase is unclear: e.g. between 2014 and 2015 immunocytochemistry test requests increased by 60% in one trust.

2. There is variation in the number of tests typically used to diagnose cancer per head of population across the Thames Valley CCGs. There may be value in looking into the reason for this variation.

3. At the front end of the pathway, variation in primary care includes:

  • the direct access tests used prior to referral
  • the information given on the referral form
  • the preparation of the patient for receiving an early appointment for an uncomfortable test to rule out cancer.

4. Late presentation, co-morbidities and involvement of a tertiary centre all typically lead to a complex pathway with numerous tests and potential CWT breaches. Some Trusts are already re-configuring pathways to be parallel with pre-booking diagnostics rather than the traditional sequential route.

5. Radiology services are typically made up of a patchwork of Trust, independent providers, agency staff and overtime to keep up with increasing demand.

This is unsustainable due to:

  • Year on year budget cuts;
  • Imaging services not being included in new service developments;
  • Staff leaving to go to independent providers;
  • Difficulty attracting staff in a high cost of living area;
  • Increase in requests due to application of new technologies in diagnostics and treatments that require radiology
  • NHSI capping use and funding of agency staff

6. Pathology services suffer from similar issues to radiology:

  • Year on year budget cuts;
  • Pathology services not being included in new service developments;
  • Staff leaving to go to independent providers;
  • Difficulty attracting staff in a high cost of living area;
  • Increase in requests due to application of new technologies in diagnostics and treatments that require pathology services

This project has clearly quantified the severe challenge for diagnostic services with current levels of demand. We encourage each commissioner to work with their diagnostic services providers to review their data as more detailed analysis may be required to ensure each health economy is working at optimal sustainable productivity.

It is clear however that to meet the future challenges identified a network wide collaborative approach will be necessary; the SCN is developing an approach to facilitate this necessary action.


Commissioning Guidance 2015/16

We are more than happy to discuss how this guidance could be utilized locally. (Contact details at the back of the guidance).


Head & Neck Cancer Scoping Report and Presentations – February 2016

On 24th February, TVSCN and Macmillan hosted an event to fully understand rehabilitation services for those patients with Head & Neck Cancer (HNC) in the Thames Valley.

The event, chaired by our Cancer Clinical Director – Bernadette Lavery  gave our stakeholders the opportunity to hear more on the emergent National Cancer Strategy with further information and examples of best practice in Head & Neck cancer rehabilitation services across England. Thames Valley SCN Macmillan Head Neck Scoping Project Report – web published in collaboration with the Thames Valley Cancer Strategic Clinical Network and Macmillan Cancer Research  defining the scope of rehabilitation support available to patients diagnosed with head and neck cancer in long term survivorship. The presentations and report can be accessed here;