CA News: June 2019

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Edition 4

June 2019 Welcome to the SYBND Cancer Alliance’s newsletter Our monthly focus on the people who make the Cancer Alliance

Sue Yates, a lay representative at our Recognition and Celebration Conference, find out more on page 2


Lesley Smith, CEO of NHS Barnsley CCG, Deputy System Lead for the South Yorkshire and Bassetlaw Integrated Care System and Chair of the SYBND Cancer Alliance. Lesley’s accent tells you that she’s not native to the patch but originally from Glasgow. She’s lived in Yorkshire since 2000 and has enjoyed a varied career with over 12 year as an NHS Chief Executive across both commissioning and provider trusts in Scotland and Yorkshire. Lesley has worked as a senior policy advisor at the Department of Health, as a managing consultant at KPMG and spent seven years as a leadership development consultant and executive coach. Lesley said: “Welcome to this, the fourth edition, of CA News, our monthly newsletter, which we’re hoping to highlight and showcase the people that are the ‘Cancer Alliance’. The Cancer Alliance, for me, is more than the sum of its parts: We are a partnership of all the cancer care and services from our

Lesley Smith voluntary partners to amongst the largest acute and tertiary centre in the country. Our vision is to work together to develop services based around the whole person, not just

their cancer, for every stage of support they may need to: Be healthy; be in treatment; recover; stay healthy; be pain free; die with dignity. We are collaborators working to develop and implement a different model of cancer care for South Yorkshire, Bassetlaw and North Derbyshire. “We want to deliver this vision by planning ‘without walls’, managing our resources as ‘one budget’, working collaboratively and challenging the status quo. Your commitment and passion to work in this way was reinforced to me when I met so many of you at our SYBND Cancer Alliance Recognition and Celebration conference in Doncaster. You were clear and unanimous in your view that working together across the network, without organisational boundaries means that we will deliver the best we can for our patients

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and local populations, whilst at the same time harnessing the skills, talent and potential of all of our staff. I was so proud to hear of some of the great work you are doing across the network and I know that our guests from the National Cancer Team were equally impressed! So thank you all. “As part of this, this edition of CA News will hopefully continue this theme and give you the human side to what’s underway to make this happen, from the work in the Pathology Programme to Ian Scott’s role in Sheffield Cancer Services, to a week in the life of Jayne Galloway from Barnsley Hospitals. We are continually looking for positive stories, news and views from across the Alliance, so do send us what you’d like to feature and any feedback. We hope you enjoy the read.”

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FREE HEAD AND NECK CANCER STUDY EVENT – 22 JUNE We’re hosting a free event for primary care across South Yorkshire, Bassetlaw and North Derbyshire focusing on head and neck cancer pathways and care. Sessions include diagnosis, referrals and top tips for primary care from Mr Nigel Beasley, ENT Surgeon and Mr Muzzammil Nusrath, Oral & Maxillofacial Surgeon. Other sessions across the study morning will include: • Using cancer case reviews to improve Early Diagnosis and reduce emergency presentations • Learning points from the Vague Symptoms pathways during the first year • Patient stories, case studies, stalls, refreshments & much more.

To see the full agenda and to register your place, please visit the following link


RECOGNITION AND CELEBRATION CONFERENCE: THANK YOU! The first annual Recognition and Celebration Conference was held on 17 May 2019 at the Keepmoat Stadium, Doncaster. We wanted to recognise and formally acknowledge everybody who attended and spoke at the event. We’ve received lots of positive feedback and will be using this to build on the next steps in our journey to deliver those incredible ‘postcards from the future’. Over the coming weeks we will be analysing the feedback and developing a film, gallery of images taken on the day and visual minutes. Look out for a full review in the next edition of CA News out at the end of June.


YOUR ROLE IN THE CANCER ALLIANCE Ian Scott, Programme Director, Specialised Cancer Services Transformation Programme I’ve worked in the NHS since way back in 1989, graduating in Sheffield as a registered nurse in 1992. During my nursing career I worked in a range of clinical specialties, from acute medicine to diabetes and endocrinology to stroke rehabilitation to name just a few, ending up a Ward Manager in cardiology at the Royal Hallamshire Hospital, a role which I continued in until 2001. Ready for something new, I studied for my BA in Business and Marketing before securing a place on the national NHS Management Training Scheme, graduating in 2006 with an MSc in Healthcare Leadership. During the scheme I was really fortunate to spend time working in New Zealand to commission and help set up services for the Maori and Polynesian communities, working closely with their wider community and leadership groups. The time there was invaluable in shaping my understanding of how to set up and transform services which truly respond to the needs of their users. Returning home, I managed Specialised Rehabilitation Services, based at the Northern General before later taking a secondment to Sheffield Children’s Hospital, managing and leading over 20 paediatric specialties alongside my clinical colleagues. I returned to Sheffield Teaching Hospitals and for the next seven years worked as Operations Director leading Specialised Cancer provision and a wide variety of other specialities which included Haematology, Sexual Health & HIV and Spinal Injuries. Working alongside Patricia Fisher and Martin Salt, we oversaw the development and approval of the Weston Park Transformation Strategy, which I now lead as Programme Director. Back In 2016, Weston Park published the People Centred

Ian Scott Cancer Care strategy – an ambitious five-year strategic framework to transform how we work, develop and improve. It sets out overarching four themes: Transforming Our Hospital; Investing in Our People; Delivering the Best for Our patients and Delivering World Class Innovation.

For more information, you can email at or ring on 0114 22 (65011)

Working with clinical, managerial and academic colleagues in Sheffield, and with partners across the Network, my role is to lead and deliver the overall Weston Park Transformation Programme. We work closely with teams across the Network, and have already joined up our SACT, Acute Oncology and Radiotherapy transformation plans with the Alliance’s High Quality workstream. One of our key aims is to bring chemotherapy assessment and delivery closer to where patients live across the region, rather than need people to travel to Weston Park. It’s still early days but non-medical Advanced Practitioner pilots that we’re currently running in Barnsley and Chesterfield are proving really positive and we’re working with other providers across the region to see how we can use what we’re learning there. Back at Weston Park, we’re part way through transforming the estate. Two new modern inpatient wards, a custom built assessment unit and a second outpatient department are now fully open. And feedback so far has been great. This year we’ll complete a walkway to acute services at the Royal Hallamshire Hospital, and we’ll finish building our larger modern chemotherapy production unit and modernising the rooms for our brachytherapy service. The changes we’re making will benefit patients from across the region who need to have treatment at Weston Park and will make a real difference to working environments for patients, visitors and our staff. I’m really excited about the future, and how we can all work together to truly transform how we support people with cancer in our region.



MORE CONVENIENT CANCER SCREENING SERVICES MUST BE ROLLED OUT TO BOOST UPTAKE, SAYS PROFESSOR SIR MIKE RICHARDS The NHS should roll out online booking, out of hours appointments and text reminders to boost the uptake of breast, cervical and other screening services, leading expert Professor Sir Mike Richards has said. Sir Mike, who was the first NHS Cancer Director and is a former CQC chief inspector of hospitals, is leading a major overhaul of national cancer screening programmes as part of a renewed drive to improve care and save lives. Increasing early detection of cancers when they are easier to treat is at the heart of the NHS’s Long Term Plan to upgrade services and make sure patients benefit from new technologies and treatments. Sir Mike’s interim report, published on 24 May, calls for practical measures to be used across the NHS to make screening more convenient and reverse the long-standing decline in the proportion of people being tested. Professor Sir Mike Richards said: “Our screening programmes have led the world and save around 9,000 lives every year. “However, people live increasingly busy lives and we need to make having a screening appointment as simple and convenient as

Professor Sir Mike Richards booking a plane ticket online.” Screening can help spot problems early before a person has any symptoms, when cancer is often easier to treat. In some cases, it can even prevent cancers from developing in the first place, by spotting people at risk. The NHS sent people

over 11 million invitations for screening last year but the proportion of women participating in cervical screening is at the lowest for a decade. He will deliver his final report later in the summer with further recommendations on:

• Future management, delivery and oversight of screening programmes • The use of Artificial Intelligence to free up workforce pressure • Increasing uptake of screening and making it more targeted in high risk communities Professor Sir Mike Richards added: “The next stage of the review will focus on solutions to make screening services as effective as possible, looking at recent advances in technology, future management of the programmes and innovative approaches to selecting people for screening.” There are three national cancer screening programmes in England. • Cervical screening – offered to women aged 25 to 64, with screening offered every three years for women aged up to 49 and every five years from 50 to 64. • Breast screening – offered to women aged 50 to 70, with women over 70 able to self-refer for screening. • Bowel screening – offered to men and women aged 60 to 74, and another bowel screening test offered to men and women at the age of 55 in some parts of England.

STAFF AND PATIENTS CREATING CHANGE Ever wondered why a survey is still on the shelf or improvements for patients get stuck in the pipeline? One tip is to engage with staff and colleagues earlier. colleague’s knowledge of gaps in service can be identified early and addressed alongside patients. The approach is not only empowering but brings new ideas and approaches to the table.

So What Is Experience Based Co-design? It is a set of tools and approaches that can be used flexibly in quality improvement projects, bringing together ideas and energy, of staff and patients.


Key Features: Patient touchpoints and stories • Staff and patients identify touchpoints that matter for patients • Triggers from patients stories, frame patient and staff workshops • Issues for change are prioritised together • Joint task and finish action groups work on practical solutions Please contact the Communications and Engagement Team to find out more. You can email us.




Macmillan Chemotherapy Clinical Nurse Specialist Tell us about your background I began my nurse training in Barnsley as a student nurse in 1989 (along with Florence Nightingale!) and I qualified in 1992. Fast forward seven years and I accepted for a job at Weston Park Hospital’s chemotherapy suite. The suite was considerably smaller and only had nine treatment chairs in comparison to the 30+ it has today. I loved working there, I learnt such a lot in a short space of time and I eventually stayed there for around nine months until Barnsley Hospital opened their own new chemotherapy unit where I got a job as a staff nurse. The chemotherapy unit opened in 2000 with six treatment chairs and around 20-30 patients a week: At present we can expect to treat that many patients in a single day. Since the unit opened, I have worked in a number of roles including staff nurse, chemotherapy sister and I have been in my current role of Macmillan Chemotherapy Clinical Nurse Specialist since 2008. Do you have a typical week? I ensure that we have robust policies and procedures to ensure safe administration of chemotherapy to our patients. I investigate incidents and look at how we can learn from them and avoid these incidents reoccurring. Here at Barnsley, we provide an outreach chemotherapy service for Weston Park Hospital where I act as the facilitating link between both Trusts. This allows us to keep up-to-date with current practice across the network, but by working together we can plan for the future. What are your high points and challenges? A definite high point has been successfully introducing new treatments, as a team, for our patients. These treatments have only previously been given at Weston Park Hospital, resulting in those patients no longer having to travel to WPH.

Jayne (second from the right) with other Macmillan nurses before they ran the Great North Run

Jayne running the London Marathon I have successfully set up a number of nurse-led clinics and roles that have previously been undertaken only by a doctor. These include bone marrow biopsy, venesections and pre chemotherapy assessments. A large part of my role is assessing patient’s fitness prior to proceeding with their next cycle of chemotherapy; it is perhaps one part of my role I enjoy the most as I enjoy that patient contact. The least favourite part of my role is the admin and updating polices and procedures, all essential however this can prove a little dry sometimes. I feel this is one area where the Cancer Alliance are instrumental in ensuring a network and team approach to working together, sharing best practice and different ideas and visions. Sometimes communication can be challenging as our IT

Some of the chemotherapy team from Barnsley Hospital systems don’t always ‘talk’ to one another. We are a small unit and still only have six treatment chairs and with numbers of patients increasing, space can be limited, leading us to be inventive when scheduling patients in for their treatment. What do you enjoy out of work? I had my only child at the grand age of 42, I knew I couldn’t change how old I was, but I was very keen to not be an old, fat mum, so I decided to get fit. I used a couch to 5K app, and took up running on my own. Over the years I have participated in a number of races and this year I ran my first marathon, the London marathon. I ran for the charity Muscular Dystrophy as my youngest cousin died from this cruel condition just last year. I managed to raise over £2,200

for MDUK. Myself and four other Macmillan Clinical Nurse Specialists ran the Great North Run, raising money both for MacMillan and a local cancer charity ‘Little Foxes’. If I had 3 wishes what would they be? Number 1 would be to have a new motorhome and take off in it with my family and go exploring the whole of the British Isles. Number 2 would be a lovely yacht to then set sail around the med, exploring the many islands especially in the Adriatic Sea. My third wish would to be the Euro Lottery. I would ensure all my family and friends are well taken care of, but I would also love to pay for our Trust to have a new cancer building with a least double the treatment chairs we have now.



A FOCUS ON… THE SOUTH YORKSHIRE AND BASSETLAW (SYB) PATHOLOGY TRANSFORMATION PROGRAMME Here Sarah Bayliss, Programme Manager for the Pathology Transformation Programme, is giving us an insight into the work going on in the South Yorkshire and Bassetlaw Pathology transformation programme. What exactly is pathology? It is the study of disease and can be considered the bridge between science and medicine. It underpins every aspect of patient care, from diagnostic testing, treatment advice, using cutting-edge genetic technologies and preventing disease. Pathology: • Predicts susceptibility to disease • Prevents disease by identifying risk factors in patients that can be modified • Diagnoses many conditions including cancer • Informs prognosis • Shows the presence or absence of infection • Monitors disease • Personalises treatment to achieve the best possible outcomes.


Around 70% of medical treatment decisions rely on pathology but national reviews into pathology services found that: • 97% of departments across the country do not have enough staff for the amount of work. • There is a 25-28% consultant-level vacancy rate with many posts vacant for over six months. • We need more trainee posts but we can only fill 73% of current trainee posts. • We are expecting significant workload increases in some areas of the service. For example there may be a 150% increase in samples from the bowel cancer screening programme due to the screening age lowering from age 60 to 50. In 2017, NHS Improvement (NHSI) published requirements to change pathology services across the country so that we can all better manage the work, better plan for the future and make the service as high quality and responsive as possible.

With this in mind, as Programme Manager for the SYB Pathology Transformation Programme, I’m working with Pathology staff from the current services in Barnsley, Bassetlaw, Doncaster, Rotherham and Sheffield to look at how we can make pathology services more sustainable, continue to develop best practice and provide equal services for all. This also includes patients and clinicians in Chesterfield and North Derbyshire as we work together to deliver SYB &ND Cancer Alliance objectives.

Options We’re considering a number of options, including one put forward by NHS Improvement that brings the analysis of many samples onto one site. We’re also reviewing the potential of ‘doing nothing’ before making recommendations for what we think will work best for pathology services across patch. Our staff are the key to improving our services

with personnel from all partners leading the review and redesign of the service.

Impact and involvement We’re not looking at making any changes to how or where patients access blood testing or collection of other sample types, only where these samples are sent to be analysed. This is so we can make sure that they are analysed in the right place, at the right time, by people with the skills needed. This will allow us to make better use of our highly skilled workforce and their ability to deliver improved, clinicallyappropriate, diagnostic services. We want to improve overall care, diagnosis and treatment planning. This also means that we may be better able to invest in the latest technologies available to support this. The samples may travel and some Pathology staff may need to work differently to make this happen, but patients and clinicians shouldn’t need to do anything differently to what they do now.

Sarah Bayliss Progress FIT Development and implementation of Faecal Immunochemical Testing (FIT) for primary care patients across South Yorkshire, Bassetlaw and North Derbyshire to improve patient experience by early diagnosis of colonic cancer in low risk patients, and ruling out cancer so patients avoid further invasive diagnostic procedures. Patient feedback was used to design the process, so that following a GP request, patients across SYBND produce their sample and then pop it in the post using the kit provided.


Digital Pathology A survey of the current cohort of consultants and trainees in SYBND CA shows that there is a positive attitude towards using digital pathology, and their feedback will be used to shape its implementation. The technology for acquiring digital images of microscope slides (whole slide images) has matured

and become more affordable, enabling provision of a diagnostic histopathology service using on-screen viewing rather than viewing physical slides with a microscope. The benefits for histopathology include case and workflow management, the ability to work remotely, to work in sub-specialist teams, to quickly share images with

colleagues at MDTs and to reduce double reporting. All of which should help close the gap between demand and capacity. Funding is required for procurement and implementation and a business case and bid for funding is being prepared. Lynch Lynch syndrome (LS) is

a genetic condition which predisposes those affected to develop cancers such as colorectal, endometrial, ovarian, gastric, skin and brain cancers, often at a relatively young age. NICE have recommended that all patients with colorectal cancer should be tested to assess whether the tumour may have arisen because of LS. This identifies individuals at risk of having LS, for whom further testing and assessment at a Clinical Genetics clinic can confirm (or exclude) the diagnosis. If confirmed, risk-reducing strategies can be offered to allow early diagnosis of further cancers, both for the patient and for relatives. Sheffield Teaching Hospitals (STH) have been working with a company and have validated the ‘Idylla’ testing system, which enables testing to be performed reliably and means that tests are complete within three hours. This is highly attractive since, in principle, it will enable a result to be given at the same time as the initial biopsy is reported in around 75% of cases. Installing the Idylla platform in each unit in the region will have the significant added benefit of the platform then being available for testing in lung cancer, melanoma and bowel cancer, as is already established at STH, in order to enable personalised treatment. Managed Service Contract We have informed the market of our intention to procure a single pan-Pathology Managed Service Contract for SYB and have commenced supplier engagement. This will enable implementation of standardised analytical and processing equipment across SYB, thereby reducing training requirements, supporting movement of staff between sites, improving service resilience and delivering efficiency savings. Next steps An outline business case for Pathology Transformation is being developed for Autumn 2019, which will propose some possible next steps. For more information please see www. healthandcaretogethersyb. Or get in touch at



Prof Jon Wadsley, Consultant Clinical Oncologist, Weston Park Hospital, Cancer Specialty Lead NIHR Y&H CRN



Allowing patients access to clinical trials is increasingly seen as an important quality marker for cancer services, and should be seen as a routine part of the cancer care pathway. Not only are they the mechanism for testing and proving the worth of new treatments, but increasing evidence is accumulating to show that outcomes are better for all patients treated within a research-active environment, not just for those actually taking part in clinical trials. Our patients are increasingly aware of this. I have noticed a significant increase in recent years in patients actively asking if there are clinical trials that they can take part in. Cancer research is not just about testing new drugs, but covers every aspect of the cancer care pathway, from trying to achieve earlier diagnosis, right through to aspects of living with and beyond cancer, or providing the very best end of life care. We are fortunate to have access to a broad portfolio of cancer trials in the SYBND region with over 200 cancer trials open at any one time,

covering the full range of different cancers, treatments and stages of the disease. The NIHR Yorkshire and Humber Clinical Research Network (Y&H CRN) provides the local infrastructure to deliver clinical trials across all disease areas, including cancer. This includes distributing the funding to support the research workforce in healthcare settings across our region. In 2018/19 the network supported the recruitment of 7,042 patients to trials aiming to improve cancer care across the region. This represents over 10% of all patients taking part in cancer clinical trials across England. The CRN are committed to collaboration with the Cancer Alliance to ensure that as many patients as possible are able to access research opportunities. We want to ensure that as cancer service delivery evolves, the impact on clinical trial delivery is always considered and new

opportunities for research are actively pursued. A prime example of this is engagement with the current review of MDT working practices. With streamlining of MDT working we hope that teams will have more time to actively consider clinical trial opportunities for their patients. We are also committed to providing every MDT with an up-to-date list of clinical trials open in the region relevant to their disease site so that patients who are interested can be referred across sites to access trials. Another current key priority within the CRN is encouraging and developing early career researchersthe research workforce of the future. Very successful trainee collaboratives have been established in surgery and oncology across the region. It is great to see a new generation becoming enthused by what can be achieved through research projects. This applies not

just to medical staff, but to any professional group and it is great to see talented researchers emerging from amongst our nurses, radiographers and other allied health professions. It goes without saying that patient engagement is absolutely critical to all that we do. We are fortunate to benefit from very strong public and patient involvement (PPI) panels in the region who advise on what the priority areas for further research should be. They assist with the development of new clinical trial protocols to ensure that they are acceptable to patients, and promote research opportunities to fellow patients. I firmly believe that clinical research is a core part of our business as professionals providing cancer care and that it is the responsibility of everyone involved in cancer care to create opportunities for our patients to take part. Prof Jon Wadsley Consultant Clinical Oncologist, Weston Park Hospital, Cancer Specialty Lead NIHR Y&H CRN

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