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Introduction
This document summarises the actions required as part of WHHT’s cancer improvement programme. It builds on
previous work so that there is a single action plan showing what is needed in response to external recommendations, to
ensure achievement of national cancer standards and to promote continuous improvement of cancer services.
The following sections are included in this updated document:
1 Current Performance
2 Cancer Programme Governance Structure
3 Latest Cancer Action Plan
4 Current Management Structure for Cancer Services
5 Key Risks
The cancer action plan is expected to continuously evolve, particularly given that a new improvement and new service
manager are both shortly to take up post. It will be used by the Cancer Improvement Group to assess progress and will
also be regularly discussed with the CCG. Please note that this is a draft version and so is not yet for further circulation.
Document Authors:
S Davey, D Foster & E Moors
Notes: Some completed actions are included in this version so that the broad direction of travel can be seen. Also, the
master plan from which these snapshots have been taken can be easily organised so that progress against the external
recommendations made by S Ramsden et al can be seen.
2
2. Cancer Improvement Programme Governance
Executive Steering
Committee
Project 5:
Divisional
Cancer Action
Plans
Project 3:
Information
Quality
Project 4:
Infrastructure
& Admin
Project 2:
Cancer Care
Pathways
2.1 Cancer Governance Structure & Existing Operational Governance Structure
Transformation CommitteeSubcommittee of WHHT Trust Board
TLEC
Divisional Management Committees
Trust Access Meeting
Weekly Divisional Access Meetings
Cancer Improvement
Group
Programme Structure, in Place for Duration of RTT Programme Operational Structure, Remains after Cancer Programme Closes
Project 1:
Peer Review
CCG Cancer
Action Group
4
Executive Steering CommitteeMeeting Frequency: Fortnightly
Chair: Chief Executive
Remit: To provide overall strategic direction for the Trust’s Transformation Programme; to receive updates from each
programme, to consider links and wider implications to remove any obstacles that are impeding progress.
Membership: All Executive Team
2.2 Cancer Programme Meetings & Membership
Cancer Improvement GroupMeeting Frequency: Weekly
Chair: Cancer Programme Senior Responsible Owner ie Deputy CEO
Remit: To deliver the cancer improvement programme according to plan, identify dependencies between projects and ensure coherent
approach.
Membership: Clinical Lead for Cancer, Medicine Divisional Manager, All Project Leads, Women & Children’s Divisional Managers, Surgery
Divisional Manager, Clinical Support Divisional Manager, Associate Director for Performance & Information.
Transformation Committee
(as Sub-Committee of WHHT Trust Board )
Project team meetings for each individual project as required.
A dedicated weekly meeting is already in place for the cancer information & quality project.
2. Cancer Improvement Programme Governance
5
Please note that this is a programme management structure, not a line management structure.
Lead Executive: Senior Responsible OfficerL Hill
(Chief Operating Officer)
Cancer Improvement Lead
[Oversees Overall Cancer Action Plan]
Project 1:
Peer Review
Scope:
Ensuring that peer
review process is robust
and any
recommendations made
are delivered.
Management Lead:
M Sorley
Clinical LeadDr A Barlow
(Cancer Clinical Director)
Project 3:
Information
Quality
Scope:
Delivery of robust
governance structure
for managing cancer
waiting lists and care
pathways, with reliable
underlying information.
Management Lead:
Information lead tbc
Project 2:
Cancer Care
Pathways
Scope:
Ensure the care
pathway for each
tumour site is reviewed
and streamlined, eg with
1-stop clinics or direct
access diagnostics.
Management Lead:
Cancer Improvement
Manager
Project 4:
Infrastructure &
Administration
Scope:
Ensuring that booking
pathways are robust,
communication with
patients and GPs is
effective, the access
policy is adhered to
and standard operating
pathways in place.
Management Lead:
Cancer Service
Manager
2.3 Cancer Improvement Programme Leadership Structure
Project 5:
Divisional Cancer
Action Plans
Scope:
Ensuring that each
division delivers the
national cancer waiting
time standards and that
there are action plans in
place for specialties for
which there are
concerns.
Management Lead:
Cancer Improvement
Manager
2. Cancer Improvement Programme Governance
6
3 Cancer Action Plan
3.1 Peer Review
Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
• Review current peer review process & capacity needed. Michelle Sorley WHHT -
Medicine
01-Mar-15 Green
• Generate timetable for peer review and reporting arrangements, so progess
is routinely fedback within WHHT appropriately.
Michelle Sorley WHHT -
Medicine
01-Mar-15 Green
Peer review needs to embedded, so that
action plans are adequately tracked and
recommendations delivered.
Further actions continued overleaf . . .
7
3.2 Care Pathways
Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
Progress the recently initiated Beds and
Herts Cancer Forum review of all cancer
pathways between primary, secondary and
tertiary care providers using the National
Cancer Action Team Toolkit and
Commissioning Cancer Services Report
2011
• Map care pathways to policies on what should be happening and compare
with ECRIC data to see what is actually happening. Further update will be
provided at the CCG Cancer Action Group with representation from Beds and
Herts Cancer Forum who are a core member, as a precursor to further
review with MDTs.
Tonia
Dawson/Healt
h Awylward
CCG 01-Feb-15 Green
• Full-time cancer improvement manager in post D Foster WHHT -
Medicine
01-Feb-15 Offer made on
24/12/14 awaiiting conf
start date.
Green
• Confirm priorities and tumours sites to be completed in phases, linking with
work completed on capacity and demand. Plan is for capacity & demand work
to inform pathway development.
Cancer
Programme
Lead
WHHT &
CCG
01-Feb-15 Green
• Complete review of phase 1 tumour sites and confirm changes/actions
needed as result of phase 1.
Phase 1: Lung, head & neck and urology
Cancer
Programme
Lead
WHHT &
CCG
01-May-15 Need to confirm if this
is realistic timescale
Amber
• Complete review of phase 2 tumour sites and confirm changes/actions
needed as result of phase 2.
Cancer
Programme
Lead
WHHT &
CCG
31-Aug-15 Need to confirm if this
is realistic timescale
Amber
• Complete review of phase 3 tumour sites and confirm changes/actions
needed as result of phase 3.
Cancer
Programme
Lead
WHHT &
CCG
30-Nov-15 Need to confirm if this
is realistic timescale
Amber
• Confirm where straight to test pathways can be implemented. Cancer
Programme
Lead
WHHT &
CCG
01-May-15 Green
• Confirm where further one-stop clinics can be established Cancer
Programme
Lead
WHHT &
CCG
31-May-15 Green
Implementation of newly agreed pathways • Implement direct to test pathway for lung patients - will provide GPs direct
access to diagnostics for CT scan which would be available to the consultant
at 2ww appointment.
A Barlow / P
Sawyer
WHHT &
CCG
31 Nov 14 Done
Methodical care pathway review is required,
led by clinical teams and in liason with CCG.
8
3 Cancer Action Plan
3.3 Information Quality (1 of 2)Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
• The PAS supplier has confirmed that the system cannot be engineered in
the way described. The 2ww timeline is triggered by the referral data itself.
Femi
Odewale/ Sam
Ingram
WHHT -
Medicine
01-Dec-14 Red?
• Where referrals are made through Choose and Book, published slots are
controlled to prevent this happening.
Femi
Odewale/ Sam
Ingram
WHHT -
Medicine
01-Dec-14 Done
• An audit report detailing PAS clinic edit permissions has been produced for
review by divisions. Relevant actions will then be taken regarding and further
controls required – ongoing as part of out-patient transformation.
Femi
Odewale/ Sam
Ingram
WHHT -
Medicine
01-Dec-14 Ned to confirm that
clinic edit permissions
have been updated.
Green
• Change appointment slot type on the new outcome form with this will be
“2WW” instead of “VU” when the new PAS upgrade takes place next month.
Femi
Odewale/ Sam
Ingram
WHHT -
Medicine
01-Dec-14 Need to confirm
completion
Green
• 2ww, 31 and 62 day Cancer PTLs have been developed and are in use . Sandra Davey WHHT -
Medicine
In place Done
• Ensure newly agreed validation timetable is implemented & embedded Femi Odewale WHHT -
Medicine
01-Feb-15 Green
• Data quality reports have been developed and are available for use. These
compare Infoflex and PAS data for reconciliation purposes. Currently
undergoing validation prior to being fully utilised.
Sandra Davey WHHT -
Medicine
In place Done
• An Information Team resource attends the weekly Cancer access meetings to
provide support but this is variable and needs to be embedded.
Sandra Davey WHHT -
Medicine
01-Nov-14 Done
• Appoint a second Cancer Information Analyst post Debbie
Foster/Mark
Currie
WHHT -
Medicine/Infor
mation
01-Nov-14 6 month extension to
second analsyt post
agreed
Amber
• The Trust is currently transitioning to a new infrastructure managed service
which will include provision of secure email (nhs.net and Trust email within
single mailbox).
Mark Currie WHHT -
Information
01-Jun-15 Green
• As part of the infrastructure service transformation, fax is being phased out
and replaced by scan to email.
Mark Currie WHHT -
Information
01-Jun-15 Green
• Similarly all primary care are moving from practice specific email addresses
to nHS.net account and hence will complement this work.
Mark Currie WHHT -
Information
01-Jun-15 Green
Booking Safeguards:
Although patients referred as 2WW on the
PAS system have a code that distinguishes
them with “C”, the system will not prevent
these referrals from being booked into
routine, urgent or follow-up slots. It would
seem sensible to engineer the PAS system
(if possible) to prevent this, and/or to add a
flag or warning to the system to alert the
user when this operation is being performed.
In addition to this, there should be better
controls over who has permission and who
has training to perform the relevant
conversion of appointment slots on the PAS,
to ensure that this is fit for purpose.
Data quality:
A suite of reports to test compliance with
booking policies and recording outcomes
should be created and used regularly by
senior managers, identifying barriers to
compliance and regularly monitoring metrics
in these areas, building on the recent work of
the Intensive Support Team. The Board/sub-
committees should request assurance on
data quality regularly.
The Trust and local partners should move
over to secure NHS email accounts to
improve communication and information
governance, eliminating the need to use
facsimile communication.
9
3 Cancer Action Plan
3.3 Information Quality (2 of 2)
Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
• The Trust IM&T Strategy is being refreshed to make recommendations
regarding future IT system requirements- cancer service requirements need
to be reflected in this.
S Gilchrist WHHT -
Information
On going Green
• As part of the infrastructure managed service, the supplier will be delivering
an integration engine and clinical data repository which will provide a single
portal view into the Trust’s clinical systems including Infoflex and PAS.
S Gilchrist WHHT -
Information
Late 2015 Green
• Data quality reports have been produced to assist with reconciliation
between PAS and Infoflex.
Lisa Emery WHHT -
Information
01-Oct-14 Done
• Monthly validation of breaches is in place for all cancer which supports
accurate data uploading.
Sandra Davey WHHT -
Medicine
01-Oct-14 Done
• However the progress on the visibility of service outcome and performance
data has been slow. There is patient level data but the MDTs are not aware of
the performance of their services as data collection remains fragmented. We
have requested a suite of reports for individual tumour sites but these are not
available.
Mark Currie WHHT -
Information
December
2014 to
February
2015
The cancer team have
escalated the on-going
concerns with data and
data collection.
Red
• The plan is for the new Data Manager to meet with all MDT Leads and MDT
Co-ordinators so that there is a greater understanding of what information by
tumour site is required.
Femi Odewale WHHT -
Medicine
December
2014 to
February
2015
Dependent on staff
time being available.
Amber
• Complete specification outlining what is needed from the cancer information
system.
Mark
Currie/Elizabet
h White
WHHT -
Medicine
01-Nov-14 Expected to complete
by end Dec 14.
Delayed exp mid Jan
Amber
• Reach a decision regarding immediate and longer-term strategy for cancer
information system.
Lisa Emery WHHT -
Information
tbc Amber
• Ensure routine validation of long-waiters is in place. Femi
Odewale/ADM
WHHT - Div
Teams
31-Jan-15 Amber
• Ensure sufficient dedicated information analyst support for cancer team. D Foster/Mark
Currie
WHHT -
Information
01-Dec-14 6 month extension to
second analsyt post
agreed
Amber
Visibility of service outcome and
performance data:
the accountability of all staff for providing
high quality services needs to be increased
by making staff across MDTs aware of the
performance of their services. Involve staff in
the design of performance reports and
provide regular opportunities to review these
and act on them.
The current cancer database (an addition to
infoflex) is not fit for purpose and future
plans need to be finalised.
IT systems: the use of parallel systems and
lack of information sharing between Infoflex
and PAS is a risk that should be addressed.
Infoflex is slow, unreliable and should be re-
examined in light of these issues above and
the external and internal reviews. This is part
of the Trust’s IT business case.
10
3 Cancer Action Plan
3.4 Infrastructure & Admin (1 of 2)
Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
• This is included in the two week wait project group work stream. This is a
sub group of the cancer committee. The group consisting of senior managers
are implementing all the recommendations which have been made on 2 week
wait referrals, reducing paper and fax usage and ensuring that patients are
offered appointments in chronological order.
Sandra Davey WHHT -
Medicine
Complete Done
• Proposals are being agreed for the 2ww central booking team to be providing
the service between 8am to 7pm from the current provision of 9-5pm which
will enhance patient’s access outside the normal working hours.
Sam
Ingram/Femi
Odewale
WHHT -
Medicine
31-Jan-15 Proposals agreed,
need to be
implemented
Amber
• However other improvements include having generic emails addresses
particularly for straight to test patients internally so that diagnostics results are
available at the 2ww appointment
Sandra Davey WHHT -
Medicine
31-Oct-14 Done
• Standard Operating Procedures have been developed awaiting approval. Femi
Odewale/Sam
Ingram
WHHT -
Medicine
31-Dec-14 Not yet all completed. Amber
• All relevant staff have received cancer waiting times training including all
MDTs. A training lead has been allocated for outpatient training and
competency frameworks are being developed to provide assurance that these
processes are being followed.
Sandra Davey WHHT -
Medicine
31-Oct-14 Will need repeated in 1
year's time, at the
maximum.
Done
• All MDT teams and OPD administrative staff have received cancer waiting
times training.
Sandra
Davey/Sam
Ingram
WHHT -
Medicine
30-Sep-14 Done
• Upper GI team scheduled to receive training. Sandra
Davey/Sam
Ingram
WHHT -
Medicine
01-Dec-14 Awating conf. That
training hastaken place
Done?
• Pilot proposed for a cancer admin support to be based with the central
booking team in order to commence tracking of patients on infoflex at source.
Femi
Odewale/Sam
Ingram
WHHT -
Medicine
31-Jan-15 Not yet happened, but
imminent.
Amber
• Email accounts being created to allow email of referrals, to reduce the
reliance on paper and faxes for internal direct to test.
Sandra
Davey/Sam
Ingram
WHHT -
Medicine
31-Oct-14 Done
• Increase the use of choose & book for cancer referrals Femi
Odewale/Sam
Ingram
CCG 01-Feb-15 Need to confirm plans
with CCG.
Amber
Appointments processes need to be
improved, with a more patient focussed
approach, so that cancer 2WW referrals are
scheduled into appropriate appointment
slots and arranged to suit the patient’s
needs, encouraging attendance as a result.
Processes for developing, implementing and
assuring adherence to policy: future policies
will require better consultation and
engagement to reinforce best practice.
Standard operating procedures/individual
action cards should be co-developed to
support this.
Skills: training in systems and processes
relating to cancer patients, including national
guidance and local Trust policy, needs
addressing. All administrative staff in OPD
need to be trained in all aspects of the
booking pathway to increase flexibility,
continuity and understanding. Continue the
training started by the Intensive Support
Team and ensure this is sustained and
refreshed regularly.
Handling referrals:
review and improve the process within the
Trust for noting receipt and tracking
incoming 2WW cancer referrals. The
continuing reliance on a paper-based log
and email list is not sustainable. The Trust
should also review with the CCG the
potential for Choose & Book to be used
widely in managing 2WW
11
3 Cancer Action Plan
3.4 Infrastructure & Admin (2 of 2)
Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
Changes to Choose and Book: enable direct
access for GPs to make referrals to
diagnostics on the 2WW pathways. The
paperwork should include advice to keep
people updated of decision changes and the
value of these appointments.
• Some diagnostic services have this facility enabled through Choose and
Book. Further diagnostic services will be reviewed as part of the two week
wait project group work stream. This will also be included in work undertaken
as part of upcoming Choose and Book system upgrades.
Femi Odewale WHHT -
Medicine
01-Mar-15 Dependent on Choose
& Book system
upgrade and on
diagnostic capacity.
Amber
Urgent non-cancer referrals and the
management of DNAs in this context need to
be considered too e.g. when patients are
referred to the Rapid Access Chest Pain
Clinic. Give the same attention to reviewing
non-cancer urgent referral DNAs as cancer
2WW DNAs.
• The 2WW DNA report currently only covers 2WWs – Urgent referrals could
easily be added into the same report/a separate one, however the trust is
currently exploring this further
Femi
Odewale/Mark
Currie
WHHT -
Medicine/Infor
mation
Complete
for 2ww
October
2014
Plan for review of rapid
access patients tbc
Red
• Priority is given to all 2ww outcomes following consultation with letters sent
to referrer within 48 ours following appointment.
Sandra Davey WHHT -
Medicine
Complete
October
2014
Done
• Further discussion underway to email the outcome letters via nhs.net and
confirm this is acceptable.
Sandra Davey WHHT -
Medicine
Discussion
25
November
2014
Done
• Implementation of emailing outcome letters is in the outpatient
transformation plan, but cancer improvement group need to be assured of
progress.
Femi
Odewale/Sam
Ingram/Mark
Currie
WHHT -
Medicine/Infor
mation
01-Mar-15 Plans need to be
confirmed.
Red
• CCG as part of the development of CCG GP IT strategy/Framework will be
implementing the E-Referral come April 2015. In the mean time as part of
good practice, we are developing standards for the use of choose and book
and regular audits around 2ww at General Practice
Avni
Shah/Shane
Scott
CCG 01-Feb-15 Amber
• Liaising with NHSE regarding agreeing standards for 2ww from Dental
Practices
Avni
Shah/NHSE
CCG 01-Jan-15 Amber
• New cancer services manager in post. D Foster WHHT -
Medicine
01-Feb-15 NB: There is an interim
gap.
Green
• Review Cancer Specialist Nurse stucture and confirm and actions needed Michelle Sorley WHHT -
Medicine
01-Feb-15 Green
• Review office arrangements for cancer service team - present
accommodation is inadequate.
Femi
Odewale/Debb
ie Foster
WHHT -
Medicine
01-Jun-15 Amber
Ensure adequate operational leadership &
support for cancer services
To review the governance of the two week
cancer pathway in primary care, including
dental practices, and agree standards for all
referring clinicians, including the use of “
Choose and Book”.
A standard response form at the hospital
would improve consistency of information
regarding the outcome of the referral. Faster
responses would also be beneficial, as
would clear guidance on response times to
achieve.
12
3 Cancer Action Plan
3.5 Divisional Action Plans
Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
Establish a patient and public participation
forum for cancer services to help educate
the public and specifically focus on reducing
DNAs on the 2WW pathway
• Patient and Public Participation Forum is already set up across Bed and
Herts Cancer Forum. Work needed to ensure there are representatives from
Herts Valleys at this forum and how we engage with the forum on the various
aspects of work including work from Herts Valleys under Primary care
Transformation around Prostate cancer etc.
Tonia
Dawson/Healt
h Awylward
CCG 01-Dec-14 Needs ongoing review
to embed
Green
• Focus initially on lung, head & neck and urology, and complete capacity &
demand review.
Femi
Odewale/ADM
tbc 31-Jan-15 Approach to be
confirmed
Amber
• Review capacity & demand for all other tumour sites. Femi
Odewale/ADM
tbc 31-Mar-15 Approach to be
confirmed
Amber
Robust achievement of 2-week wait
standard
ie standard has been achieved for 6
consecutive months.
• Agree plan to ensure that 2-week wait is sustainable for the breast service. E Odlum WHHT -
Surgery
31-Jan-15 Green
Robust achievement of 31-day standard
ie standard has been achieved for 6
consecutive months.
• Agree plans to ensure that 31-day standard is sustainable for all specialties D Foster(until
Prgramme
Lead in post)
WHHT -
Medicine
31-Jan-15 Green
• Agree plans to ensure that 62-day standard is sustainable for colorectal E Odlum WHHT -
Surgery
31-Jan-15 Green
• Agree plans to ensure that 62-day standard is sustainable for urology E Odlum WHHT -
Surgery
31-Jan-15 Green
• Agree plans to ensure that 62-day standard is sustainable for lung D Foster WHHT -
Medicine
31-Jan-15 Green
Robust achievement of 62-day standard
ie standard has been achieved for 6
consecutive months.
Capacity & demand for cancer services
needs to be understood.
13
3 Cancer Action Plan
3.6 Governance
Issue / Recommendation Actions Needed Action Owner Lead
Service /
Organisatio
n
Target
Finish date
Comment RAG Rating
for
Completion
on Time
• Review all actions taken to ensure appropriate escalation of concerns and
sharing of good practice are embedded & reinforce messages made during
Oct 14.
Femi Odewale WHHT -
Medicine
28-Feb-15 Green
• WHHT Cancer strategy away day planned for February 2015. Cancer
Programme
Lead
WHHT -
Medicine
28-Feb-15 Will take place once
new improvement lead
in post
Red
The NHS Trust Development Authority,
Monitor and NHS England should require
Boards to assure themselves of the quality
of data used to measure compliance with
national targets in cancer and other NHS
Standards.
• Any actions required of WHHT need to be confirmed. D Foster/Lisa
Emery
WHHT -
Medicine
01-Oct-14 D Foster to confirm
with L Hill if further
action is required.
N/A
• With the formation of the Herts Valleys Cancer Action Group, focus on
Cancer has been raised across the organisation and a development of work
plan around Cancer is currently being developed which will include the
proposed work on:
Avni Shah/Phil
Sawyer
CCG 01-Jan-15 Green
a.Early diagnosis Avni Shah/Phil
Sawyer
CCG 01-Jan-15 Green
b.Education and training for primary care on Cancer Avni Shah/Phil
Sawyer
CCG 01-Jan-15 Green
c.Regular audits in general practice around cancer Avni Shah/Phil
Sawyer
CCG 01-Jan-15 Green
d.Development of local pathways with providers to support direct access
to diagnostics such as lung cancer
Avni Shah/Phil
Sawyer
CCG 01-Jan-15 Green
e.Wider system end to end pathways in collaboration with Beds and Herts
Cancer Forum
Avni Shah/Phil
Sawyer
CCG 01-Jan-15 Green
Ensure governance changes made as a
result of external review are embedded.
Leadership capacity and continuity to
transform
14
3 Cancer Action Plan
Acute Oncology
Service –
note that this doesn’t come
under WHHT line management arrangements
Michelle Sorley
Lead Nurse for Cancer & Palliative
Care
Cancer & Palliative Care
Clinical Specialist Staff
Cancer Programme
Lead
Cancer Service Manager
Breast MDT Facilitator
Breast MDT Assistant
Colorectal & Data
MDT Facilitator
Colorectal/Urology MDT Assistant
Urology MDT Facilitator
Dermatology and Upper GI /CUP MDT Facilitator
Dermatology/Lung MDT Assistant
Lung and CNS MDT Facilitator
Gynae Paeds and Colp MDT
Facilitator
Gynae, Haem and H&N MDT Assistant
Haematology & Head and Neck
Pathway Facilitator
Band 4
Admin MDT Manager
Audit & Data Manager
Audit & Data Assistant
Medicine Divisional Director
Medicine Divisional Manager Cancer Clinical Director
4. Operational Cancer Service Management Structure
Please note that this is a newly established structure – vacant posts are shown in italics and interim cover arrangements have been put into place.
until substantive staff are in post.15
5. Key Cancer Improvement Programme Risks
• Breast clinic capacity increased, backlog cleared, patient choice is key risk to
compliance going forwards. Identifying best practice to implement locally, to reduce
this risk to a minimum, with HV CCG.
• Tumour site capacity issues being addressed and recovery plans are being
developed with support from IST. Current focus are urology and colorectal, work will
shortly begin on lung.
• Data input and clinical systems issues identified in internal and IST reviews,
impacting on accuracy of reporting of cancer performance. Cancer Informatics
Group in place to address immediate issues and deliver data quality improvement
plans. The option appraisal is due for completion in December.
• Increase in validation capacity and capability until software solutions in place.
• Due to staff turnover within the Cancer Management team interim support has been
appointed.
16