Find out about our plans for cancer services in our area and how well we are doing on our plans.
More than one in three people will develop some form of cancer during their lifetime. In the UK, the four most common types of cancer are:
There are more than 200 different types of cancer, and each is diagnosed and treated in a particular way.
Over the last few years, our CCG has been working with our partners to improve cancer outcomes for patients in Bradford.
We welcome this increased focus. Cancer survival rates in Bradford have been increasing year on year, however, we recognise that there is still work to be done to make sure our local rates are better than national survival rates.
Our work addresses specific areas cited in the NHS England Five Year Forward View - prevention, early diagnosis, research and innovation. We are looking at these areas to achieve better outcomes for our local population.
We are working with providers of cancer services that we commission to assess current provision. We are also working closely with the public health team at Bradford Council to make sure that our local population are cancer aware, especially around how the disease can be prevented. Our work does not cover the commissioning of specialised cancer services which are managed through NHS England.
Diagnosing cancer at an early stage (known as stage one or stage two) is associated with higher rates of survival than cancer diagnosed at a later stage of development.
There are a number of measures in place to improve the rates of early cancer diagnosis, including:
Improving cancer survival is one of the three ambitions of the Achieving world-class cancer outcomes: a strategy for England 2015-20, which was published by the Independent Cancer Taskforce in July 2015.
We aim to deliver a year-on-year improvement in the proportion of cancers diagnosed at stage one and stage two; reducing the proportion of cancers diagnosed following an emergency admission.
The national average for the proportion of tumours diagnosed at Stages 1 and 2 is 49.8%.
What we are doing to improve early diagnosis of cancer (at stage 1 or 2)
To support earlier diagnosis of cancer at stage 1 and 2 we aim to improve uptake of screening programmes locally and the CCG will continue to engage with GP practices to support best practice. This includes work with GP practice nurse forums which has been supported by visits from Cancer Research UK. In addition to work with primary care, the CCG will engage with local third sector organisations to access local faith and community groups. By reaching out to people and increasing awareness of the early symptoms of cancer we aim to reduce the proportion of cancers diagnosed following an emergency hospital admission.
This standard measures the proportion of people with an urgent GP referral for suspected cancer who began their first definitive treatment within 62 days of the urgent referral. We are just below the 62 day cancer standard of 85% with a year to date result of 84.5%
The CCG aims to continue to adhere to this standard ensuring both performance monitoring and the necessary governance arrangements are in place to ensure exceptions are investigated and reported. Shorter waiting times for cancer patients can:
The cancer 62 day standard is one of the NHS Constitutional standards for waiting times. It aims to span the whole patient pathway, from referral to first treatment. The 62 days covers the time from urgent GP referral, to the first outpatient appointment, decision to treat and finally the first definitive treatment.
GP engagement and training events are being run to disseminate best practice and strengthen links between primary and secondary care. There will be an increase in direct access diagnostic testing to increase the speed and efficiency with which patients move along their treatment pathway.
The Healthy Futures cancer work programme is developing a system wide model of care for cancer across West Yorkshire. The West Yorkshire and Harrogate Cancer Alliance Board will work to implement a single delivery plan for cancer. This aims to ensure patients have access to some of the best diagnostic services for cancer which enables earlier diagnosis and treatment. The system wide model will also form part of our sustainability and transformation plan (STP) which looks at how we can provide sustainable, joined up care, which puts patients at the centre.
This measure looks at the one year survival rate of all adults between the ages of 15 and 99 who have been diagnosed with a first primary, invasive malignancy.
If comparing the rates of cancer survival with other countries, there have been improvements in all countries for breast, colorectal, lung and ovarian cancer patients. However, the gap in survival between the highest performing countries (which includes Australia, Canada and Sweden) and the lowest performing countries (which includes England) has remained largely unchanged (with the exception of breast cancer where we England are narrowing the gap).
Improving cancer survival is one of the ambitions of Achieving world-class cancer outcomes: a strategy for England 2015-20, published by the Independent Cancer Taskforce in July 2015.
65.8% patients survived at one year, demonstrating improvement on previous years. However, this is still the seventh lowest survival rate in England. When compared to the England and West Yorkshire rate our result was slower and shows the CCG has the greatest need for improvement.
Working closely with our Public Health colleagues at Bradford Metropolitan District Council we aim to raise awareness amongst local people around the risks of cancer and how to improve prevention. This will include more public engagement through the Council Smoking Cessation and Obesity services and helping the public understand how they can reduce the risk of cancer. We will aim to diagnose cancer at an early stage and treat quicker, thereby improving the patient outcomes.
Improving patient experience of cancer care and treatment (and quality of life) is one the of the three key ambitions in the report Achieving world-class cancer outcomes: a strategy for England 2015-20, published by the Independent Cancer Taskforce in July 2015. The taskforce has set an ambition for the continuous improvement in patient experience and have given this an equal priority with improving clinical outcomes.
The patient experience rating in our CCG was 8.5 / 10 (1 being the lowest and 10 the highest) in 2015, with 8.5 /10 being the national average.
What we are doing to improve the patient experience for people with cancer:
We will make further progress in improving how we perform against national cancer standards so that patients and their families get the best possible experience. We will be concentrating on the following standards, to make sure patients are:
We will make further progress to improve survival rates after one year of diagnosis, by delivering a year on year improvement in the proportion of cancers diagnosed at stage one and stage two and thereby reduce the proportion of cancers diagnosed following an emergency admission. Generally the cancer survival rate is increased the earlier a cancer is diagnosed.
You can read more about what we are doing to improve patient experience of cancer care in the 'what we are doing over the next five years' section below.
We make sure that we are listening, engaging and involving patients in the planning and design of their local NHS.
To do this, each programme of work has the infrastructure to engage and collect information from people through:
The insight and feedback ensures that we not only collect information but have the means and ability to use it to inform how we commission activity and improve quality. We pull together insight and feedback into what we call Grass Roots. This uses data from our services, individual and public activity to provide us with an understanding of what local patients, carers and stakeholders say about their experience of local NHS services.
For each programme of work, in addition to the above, we tailor engagement to ensure we are reaching people who use the services.
Grass roots pulls together information reported through NHS Choices, Patient Opinion, Healthwatch, complaints, local groups and direct patient, family and community feedback so that we can understand experiences of local NHS services. This information helps us inform our CCG planning and decision making.
Over the past year, we have been promotiing the importance of cancer screening to our local population. We want more of our population to attend cancer screenings and highlight any unusual signs and symptoms to their GP. To raise awareness we held a successful open event in August 2015, in partnership with Bradford Districts CCG.
There are three main types of cancer screening;
Bowel cancer is the second most common cause of cancer death in the UK. Having a bowel cancer screening test reduces your chances of dying from bowel cancer as it can spot the signs early.
The NHS offers screening every two years to all men and women aged 60 to 69. This age range is currently being extended to 60 to 74. People within the age range are automatically sent an invitation and a screening kit to enable them to do the test at home. Although there is the option to opt-out of this service by contacting the NHS bowel cancer screening programme directly.
Breast cancer screening saves lives by finding breast cancers at an early stage when they are too small to see or feel. Screening is offered every three years to all women aged 50 to 70. Some older and yonger women are also being invited as part of a study on screening in different age groups. People over the age of 70 are still at risk of breast cancer and can choose to continue to have breast screening every three years.
Cervical screening is not a specific test just for cancer, it also spots any abnormalities. All women aged 25 to 49 are invited for screening every three years and women aged 50 to 64 are invited every five years. There have been nationally-led screening campaigns which we have heavily publicised in Bradford. We also work with our local GP practices to encourage engagement with relevant screening programmes.
The National Institute for Health and Care Excellence (NICE) issued new best practice guidance on patient referrals for care. The guidelines make recommendations on how to manage the referral process for patients with potential cancer symptoms who present to primary care services.
We have an established cancer local area network (CLAN) who meet on a regular basis. These meetings ensure good communication and relationship building between local providers, charities and other organisations to ensure the best possible care is available to those who need it.
We have developed a cancer recovery package in conjunction with Bradford Teaching Hospitals NHS Foundation Trust (BTHFT). This aim of the package is to help patients live well with, and beyond cancer.
Currently, this package is available for patients who have been diagnosed with colorectal cancer and are now in the recovery phase. The relative risks of these patients are identified and those who are suitable have a programme of education and, based on the clinical evidence, reduced interventions - access to medical support is still provided. The patients who are not suitable, continue with the same level of clinical input.
We are also developing recovery packages for other types of cancers.
Over the next year, we will be continuing to build on the positive work that we did in 2015/16.
We are focusing specifically on the areas highlighted in the Achieving world class cancer outcomes strategy, 2015-2020, published by the Independent Cancer Taskforce - around catching cancer early and therefore improving survival rates.
You, the public, are a key part of making sure that cancer can be caught early and that the survival rate is improved. There are three main things that you can do:
Attending screening tests - there are three main types of screening tests; cervical screening, breast screening and bowel screening. You are called for these tests at different stages of life, but it is important that you attend when called. Screening tests are vital in helping to spot the signs of cancer early and usually take no longer than 5 minutes.
Living a healthy lifestyle - 40% of cancers could be prevented by making healthy lifestyle choices. Making changes to your lifestyle such as stopping smoking and reducing the amount of alcohol you drink, can make a significant difference to your chances of being diagnosed with cancer.
Giving us your opinion - your opinions and experiences matter. By feeding back to us, you can help us make decisions about the services you receive. We can also make sure that we are designing and buying services that are centered around your needs.
Our challenge is to improve screening rates and increase the life expectancy following a cancer diagnosis. There are a number of areas that, combined with support from patients and the public, we are working on to help achieve this goal:
Engagement workshop - this year we held an engagement workshop with NHS stakeholders, charity partners, the local council, patient representatives and members of the public. Our aim was to discover the barriers that our population face around cancer screening and learn how we can improve by listening to examples of best practice in other areas of the country.
We have gathered all the feedback from the workshop and are now putting together a plan which will address how to overcome the barriers to cancer screening, improve uptake and increase the proportion of cancers diagnosed at stages one and two (earlier diagnosis). By doing this, we can make a positive difference to survival rates - enabling people with cancer to live longer, and in better health.
Closer working with our local GP practices - we have a dedicated primary care team which works closely with local GP practices. Our primary care team will be encouraging our member practices to adopt best practice around screening and cancer care. This will include the use of practice nurse forums and practice visits from colleagues at Cancer Research UK.
Improving your experience by focusing on standards
We want to make further progress in improving how we perform against national cancer standards so that you get the best possible experience. We will be concentrating on the following standards:
Over the next five years we want to improve your care and the quality of services you recieve - we plan to achieve this by developing a system wide model for the delivery of planned care.
The system wide model will be developed through Healthy Futures - a collaboration between CCGs across West Yorkshire. Healthy Futures is aimed at making sure that you have access to some of the best diagnostic services for cancer which enables earlier diagnosis and treatment.
The system wide model will also form part of our sustainability and transformation plan (STP) which looks at how we can provide sustainable, joined up care, which puts you at the centre.
Our sustainability and transformation plan will focus on;
Addressing the whole patient pathway - we are expanding our approach to cancer to include the whole patient pathway. This includes raising awareness, screening, early diagnosis, treatment and recovery. This feeds into our sustainability and transformation plan to deliver patient interventions which go beyond care that is based within a hospital.
Working more closely with our local partners - our local partners will cover all aspects of cancer care - including, hospital trusts, community trusts, voluntary and charitable sectors. This close working relationship will mean that we can develop joined-up services.
Raising awareness around cancer prevention - we will be working closely with our public health colleagues at Bradford Metropolitan District Council to raise awareness amongst local people around cancer prevention. This will include encouraging more public engagement with the council-run stop smoking and obesity services and helping you understand how you can reduce your cancer risk.