lung cancer best timed pathway · @gmceducation i lung cancer challenges •poor outcomes compared...
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Lung Cancer Best Timed Pathway
Greater Manchester’s approach
Dr Seamus Grundy
Consultant Respiratory Physician
Salford Royal
© Copyright Greater Manchester Cancer. All rights reserved.
@GMCEducation I
Overview
• National and Regional ‘best timed pathways’
• GM Cancer Project
@GMCEducation I
Lung Cancer: The Facts
Greater Manchester Cancer
Current National Targets
https://www.nuffieldtrust.org.uk/news-item/cancer-waiting-times-how-has-nhs-performance-changed-over-time
Target: 85%
Target: 93% Target: 96%
@GMCEducation I
Lung Cancer Challenges
• Poor outcomes compared with European Countries
• Significant variation in practice/outcomes
• Failure to meet NHS England Cancer Targets
• RCT evidence that shorter diagnostic pathways associated with significantly improved long term outcomes
62 day performance Q1 19/20
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Bolton Pennine East Cheshire WWL Stockport Salford Tameside MFT GM
Greater Manchester Cancer
National ‘Optimal’ Pathway
Triaging Test
Greater Manchester Cancer
National ‘Optimal’ Pathway
Staging/Diagnostic tests
Clinical Triage/ Filter out non-cancer
MDT discussion
Greater Manchester Cancer
National ‘optimal’ pathway
Greater Manchester Cancer
National ‘optimal’ pathway
• 52 day pathway
• Taken a ‘pragmatic approach’ to timings
• Sets out clear principles with which to work
• But is 52 days really ‘optimal’?
(Optimal: adj. best or most favourable)
Greater Manchester Cancer
GM ‘Optimal’ Lung Pathway
Greater Manchester Cancer
GM Optimal Lung Pathway
@GMCEducation I
Standardised staging bundles
@GMCEducation I
GM Cancer Best timed Pathway Project
• Resource Gap Analysis
• Investment of £1.3M
• Clinical Leadership with Project Management Support
@GMCEducation I
GM Cancer Best timed Pathway Project
• Invested in all Secondary care trusts in GM & East Cheshire + specialist treatment centres
• Pathway Navigators (9 across GM)
• Specialist Nurses (11 across GM)
• Clinical Fellows (1 @ MFT)
• Point of care eGFR testing
@GMCEducation I
GM Cancer Best timed Pathway Project
Outcome measures:
• Complete achievement of 62 day standard
• 90% staging CT within 72 hrs of referral
• 80% discussed at MDT by day 21
• Reduced median time from referral to treatment
@GMCEducation I
Lessons Learnt
• Prompt access to initial ‘diagnostic test’ essential
• Immediate Specialist triaging • Job planned ‘virtual DCC’
• Thorough resource gap analysis
• Pathway Navigators are key to success
Q&A
© Copyright Greater Manchester Cancer. All rights reserved.