Project Title

South Eastern Health and Social Care Trust Renal Cell Carcinoma Pathway Development Project (PDP)

Organisations involved

MSD

South Eastern Health and Social Care Trust

Summary

An optimal Renal Cell Carcinoma pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all Renal Cell Carcinoma patients receive optimal cancer care. There is an opportunity in South Eastern Health and Social Care Trust to optimise the Renal Cell Carcinoma pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved Renal Cell Carcinoma pathway and achievement of the 31 and 62 day Cancer Waiting Time Targets. The project intends to run for approximately 12 months

Project Objectives

The primary objective of this project is the optimisation of Renal Cell Carcinoma pathways across South Eastern Health and Social Care Trust. Specifically contributing towards; –

• Achievement of the Renal Cell Carcinoma 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets
• Measurement of the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the Renal Cell Carcinoma pathway in South Eastern Health and Social Care Trust
• Quicker diagnosis and treatment of Renal Cell Carcinoma and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in Renal Cell Carcinoma across South Eastern Health and Social Care hospital sites resulting in

• Achievement of the Renal Cell Carcinoma 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of patients
• Increase in treatment rates for Renal Cell Carcinoma
• Optimisation of service delivery

MSD Benefits

• Better understanding of Renal Cell Carcinoma patient needs
• Enhanced reputation of MSD through partnership work

• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

No funding is associated with this project. The project is a shared contribution of time from both the NHS organisation and MSD

Job Code GB-NON-07411 | Date of Preparation – May 2023

Project Title

Western Health and Social Care Trust Pathway Development Project (PDP)

Organisations involved

MSD

Western Health and Social Care Trust

Summary

A Renal Cell Carcinoma pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all renal cell carcinoma patients receive optimal cancer care.  There is an opportunity in Western Health and Social Care Trust to optimise the renal cell carcinoma pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved renal cell carcinoma pathway and achievement of the 31 and 62 day Cancer Waiting Time Targets. The project intends to run for approximately 11 months

Project Objectives

The primary objective of this project is the optimisation of renal cell carcinoma pathways across Western Health and Social Care Trust. Specifically contributing towards; –

• An optimised renal cell carcinoma pathway
• Achievement of the 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Measurement of the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the renal cell carcinoma pathway in Western Health and Social Care Trust.
• Quicker diagnosis and treatment of renal cell carcinoma and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway renal cell carcinoma across Western Health and Social Care Trust hospital sites resulting in

• Achievement of the renal cell carcinoma 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of renal cell carcinoma patients
• Increase in treatment rates for renal cell carcinoma cell patients
• Optimisation of service delivery

MSD Benefits

• Better understanding of renal cell carcinoma patient needs
• Enhanced reputation of MSD through partnership work

As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

No funding is associated with this project. The project is a shared contribution of time from both the NHS organisation and MSD

Job Code GB-NON-07059 | Date of Preparation – February 2023

Project Title

Renal Cell Carcinoma Southern Health and Social Care Trust Pathway Development Project (PDP)

Organisations involved

MSD

Southern Health and Social Care Trust

Summary

A Renal Cell Carcinoma pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all renal cell carcinoma patients receive optimal cancer care. There is an opportunity in Southern Health and Social Care Trust to optimise the renal cell carcinoma pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved renal cell carcinoma pathway and achievement of the renal cell carcinoma 31-day and 62-day Cancer Waiting Time Targets. The project intends to begin on 01/07/22 and anticipates a finish date on 31/12/23.

Project Objectives

The primary objective of this project is the optimisation of renal cell carcinoma pathways across Southern Health and Social Care Trust. Specifically contributing towards; –

• An optimised renal cell carcinoma pathway
• Achievement of the renal cell carcinoma 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each renal cell carcinoma service in Southern Health and Social Care Trust and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing renal cell carcinoma patients in Southern Health and Social Care Trust
• Implementation of an optimised pathway for each site managing renal cell carcinoma patients across Southern Health and Social Care Trust
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the renal cell carcinoma pathway in Southern Health and Social Care Trust.
• Quicker diagnosis and treatment of renal cell carcinoma and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in renal cell carcinoma across Southern Health and Social Care Trust hospital sites resulting in:

• Achievement of the Renal Cell Carcinoma 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of renal cell carcinoma patients
• Increase in treatment rates for renal cell carcinoma
• Optimisation of service delivery

MSD Benefits

• Better understanding of renal cell carcinoma patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £6020.48; MSD contribution = £3100; NHS Contribution = £2920.48

Job Code GB-NON-06937 | Date of Preparation – January 2023

Project Title

Renal Cell Carcinoma Belfast Health and Social Care Trust Pathway Development Project (PDP)

Organisations involved

MSD

Belfast Health and Social Care Trust

Summary

A Renal Cell Carcinoma pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all renal cell carcinoma patients receive optimal cancer care. There is an opportunity in Belfast Health and Social Care Trust to optimise the renal cell carcinoma pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved renal cell carcinoma pathway and achievement of the renal cell carcinoma 31-day and 62-day Cancer Waiting Time Targets. The project intends to begin on 01/07/22 and anticipates a finish date on 31/12/23.

Project Objectives

The primary objective of this project is the optimisation of renal cell carcinoma pathways across Belfast Health and Social Care Trust. Specifically contributing towards;

• An optimised renal cell carcinoma pathway
• Achievement of the renal cell carcinoma 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each renal cell carcinoma service in Belfast Health and Social Care Trust and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing renal cell carcinoma patients in Belfast Health and Social Care Trust
• Implementation of an optimised pathway for each site managing renal cell carcinoma patients across Belfast Health and Social Care Trust
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the renal cell carcinoma pathway in Belfast Health and Social Care Trust
• Quicker diagnosis and treatment of renal cell carcinoma and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in renal cell carcinoma across Belfast Health and Social Care Trust hospital sites resulting in:

• Achievement of the Renal Cell Carcinoma 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of renal cell carcinoma patients
• Increase in treatment rates for renal cell carcinoma
• Optimisation of service delivery

MSD Benefits

• Better understanding of renal cell carcinoma patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £8099.42; MSD contribution = £4300; NHS Contribution = £3799.42

Job Code GB-NON-06899. Date of Preparation – January 2023

Project Title

Northern Cancer Alliance lung cancer Getting It Right First Time (GIRFT) implementation Project

Organisations involved

Northern Cancer Alliance + MSD UK Ltd

Summary

This is a collaborative working project between MSD UK and The Northern Cancer Alliance (NCA). NCA is responsible for overseeing the implementation of 3 selected treatment recommendations from the national lung Getting It Right First Time (GIRFT) report. The Northern Cancer Alliance has also identified improvement of Systemic Anti-Cancer Treatment (SACT) rates, introducing a Stage 2 Multi-Disciplinary Team (MDT) meeting and Inter-Patient Transfer (IPT) rules as priorities.

This project intends to work with the NHS Foundation Hospital Trusts (FTs) in the Northern Cancer Alliance (North Cumbria NHS FT, Northumbria Healthcare NHS FT, Newcastle upon Tyne Hospital FT, Gateshead NHS FT, South Tyneside and Sunderland NHS FT, North Tees and Hartlepool NHS FT, Country Durham and Darlington NHS FT and South Tees NHS FT) to implement the 4 GIRFT recommendations and to implement a new Stage 2 MDT meeting for lung cancer and create and implement new Inter-Patient Transfer (IPT) rules across the region. The project aims to run for approximately 12 months.

Background

The Northern Cancer Alliance has some of the highest incidence of lung cancer in the UK, with lung cancer being the 2^nd most common cancer in the region. In the Northern Cancer Alliance, lung cancer accounts for 24.8% of cancer deaths¹.

Project Objectives

The Project intends to achieve the following:

• Implementation of 4 GIRFT recommendations (and achievement of the targets involved with each priority):
  • >85% radical treatment rate in all FTs for NCSLC stage I-II and PS 0-2
  • All FTs to ensure Multimodality treatment recording for Stage IIIA and radical treatment for fit patients
  • Radical treatment to start by day 49; Surgery, Thermoablation, Radiotherapy to start by day 16 after decision to treat (DTT)
  • All trusts should improve their treatment rates with SACT to achieve greater than 70% treatment for fit patients with advanced NSCLC

• Implementation of Stage 2 MDTs in all FTs across the region
• Agreement and implementation of region wide IPT rules for lung cancer

Benefits

Benefits Realisation

Benefits/ Impact to patients

• More options for treatment for lung cancer patients
• More rapid access to treatment for lung cancer patients
• Better experience of the healthcare system

Benefits to the NHS partner

• Implementing GIRFT and implementing new ways of working with Stage 2 MDT and IPT ‘rules’
• Cancer Waiting Time performance improvement (28-day, 62 day & 31 day).

Benefits to MSD

• The intended benefits of implementing GIRFT recommendations across NCA, may mean that more patients have access to treatment options in line with NICE guidance, which may or may not include MSD medicines
• Better understanding of the challenges faced by the NHS in delivering high-quality patient services and care
• Reputational benefits of MSD collaborating with the NHS to support patient care

Resources

This project is a shared contribution of time between Northern Cancer Alliance and MSD UK

Ref 1: NHS Digital, Cancer registration statistic’s 2019 (published 2021) North East had the highest rate of cancer incidence for males and females – NDRS (digital.nhs.uk) last accessed 31^st May 2023

GB-NON-07314 |  Date of Prep May 2023

Project Title

Manchester Royal Infirmary Pathway Development Project (PDP)

Organisations involved

MSD

Manchester Royal Infirmary

Summary

A national optimal Lung cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all Lung cancer patients receive optimal cancer care. There is an opportunity in Greater Manchester to optimise the Lung cancer pathway  in line with the national optimal Lung cancer pathway  to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  Lung cancer pathway aligned with the national optimal pathway  and achievement of the Lung cancer  28 day Faster Diagnostic Standard and the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 1-10-22 and anticipates a finish date on 31-3-23

Project Objectives

The primary objective of this project is the optimisation of Lung cancer pathways across Greater Manchester. Specifically contributing towards; –

• An optimised Lung cancer pathway aligned to the national optimal timed Lung cancer pathway
• Achievement of the Lung cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets

Project Approach

•  Pathway mapping of each Lung cancer service in Greater Manchester and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing Lung cancer patients in Greater Manchester
• Implementation of an optimised pathway for each site managing Lung cancer patients across Greater Manchester
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the Lung cancer pathway in Greater Manchester.
• Quicker diagnosis and treatment of Lung cancer and hence improving the chance of successful treatment

NHS Benefits

• An optimised pathway in Lung cancer across Greater Manchester hospital sites resulting in
• Achievement of the Lung cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of Lung cancer patients
• Increase in treatment rates for Lung cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of Lung cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £6227.50 MSD contribution = £3700 NHS Contribution = £2527.50

Job Code GB-NON-06440 | Date of Preparation – September 2022

Project Title

Glasgow Royal Infirmary Pathway Development Project (PDP)

Organisations involved

MSD

Glasgow Royal Infirmary

Summary

There is an opportunity in the North Sector of NHS Greater Glasgow to optimise the lung cancer pathway   to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  lung cancer pathway and achievement of the lung cancer  31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 01/06/2022 and anticipates a finish date on 30/11/2022

Project Objectives

The primary objective of this project is the optimisation of lung cancer pathways across North Sector of Glasgow. Specifically contributing towards; –

• An optimised lung cancer pathway
• Achievement of the 31-day treatment target and 62-day referral to treatment lung Cancer Waiting Time targets

Project Approach

• Pathway mapping of each lung cancer service in North Sector of Greater Glasgow and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing lung cancer patients in North Sector of Greater Glasgow
• Implementation of an optimised pathway for each site managing lung cancer patients across North Sector of Greater Glasgow
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the lung cancer pathway in North Sector of Greater Glasgow
• Quicker diagnosis and treatment of lung cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in lung cancer across North Sector of Greater Glasgow hospital sites resulting in:

• Achievement of the lung cancer 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of lung cancer patients
• Increase in treatment rates for lung cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of lung cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £3,700.00; MSD contribution = £3,688.32; NHS Contribution = £7,388.32

Job Code GB-NON-05960 | Date of Preparation – May 2022

Project Title

Hywel Dda University Health Board lung Pathway Development Project (PDP)

Organisations involved

MSD

Hywel Dda University Health Board

Summary

A national optimal lung cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all lung cancer patients receive optimal cancer care. There is an opportunity in Hywel Dda University Health Board to optimise the lung cancer pathway  in line with the national optimal lung cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved lung cancer pathway aligned with the national optimal pathway and achievement of the lung cancer 62 day Cancer Waiting Time Targets. The project intends to begin on 1^st April 2022 and anticipates a finish date on 30^th September 2022

Project Objectives

The primary objective of this project is the optimisation of lung cancer pathways across Hywel Dda University Health Board. Specifically contributing towards; –

• An optimised lung cancer pathway aligned to the national optimal timed lung cancer
• Achievement of the lung cancer 62 day Cancer Waiting Time targets

Project Approach

• Pathway mapping of each lung cancer service in Hywel Dda University Health Board and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing lung cancer patients in Hywel Dda University Health Board.
• Implementation of an optimised pathway for each site managing lung cancer patients across Hywel Dda University Health Board.
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the lung cancer pathway in Hywel Dda University Health Board.
• Quicker diagnosis and treatment of lung cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in lung cancer across Hywel Dda University Health Board  hospital sites resulting in

• Achievement of the lung cancer (62 day) Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of lung cancer patients
• Increase in treatment rates for lung cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of lung cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £4,477.25.10; MSD contribution = £3,100; NHS Contribution = £ 1377.25

Job Code GB-NON-05710 | Date of Preparation – March 2022

Project Title

Belfast Health and Social Care Trust Pathway Development Project (PDP)

Organisations involved

MSD

Belfast Health and Social Care Trust

Summary

A national optimal lung cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all lung cancer patients receive optimal cancer care. There is an opportunity in Belfast Health and Social Care Trust to optimise the lung cancer pathway   to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  lung cancer pathway  and achievement of the Lung Cancer   the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 14/03/22 and anticipates a finish date on 01/12/22.

Project Objectives

The primary objective of this project is the optimisation of lung cancer pathways across Belfast Health and Social Care Trust. Specifically contributing towards; –

• An optimised lung cancer pathway
• Achievement of the Lung Cancer 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each lung cancer service in Belfast Health and Social Care Trust and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing lung cancer patients in Belfast Health and Social Care Trust
• Implementation of an optimised pathway for each site managing lung cancer patients across Belfast Health and Social Care Trust
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the lung cancer pathway in Belfast Health and Social Care Trust
• Quicker diagnosis and treatment of lung cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in lung cancer across Belfast Health and Social Care Trust  hospital sites resulting in:

• Achievement of the lung cancer 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of lung cancer patients
• Increase in treatment rates for lung cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of lung cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £7076.67; MSD contribution = £3700; NHS Contribution = £ 3376.67

Job Code GB-NON-05650 | Date of Preparation – March 2022

Project Title

University Hospitals of Birmingham (UHB) Lung Cancer Pathway Development Project (PDP)

Organisations involved

MSD

University Hospitals Birmingham Foundation Trust (UHB), West Birmingham & Sandwell Foundation Trust, Walsall Foundation Trust, Birmingham & Solihull Integrated Care System (BSOL ICS), Birmingham Health Partners (BHP), Black Country & West Birmingham Strategic Transformational Partnership (BC & WB STP) & West Midlands Cancer Alliance

Summary

A national optimal lung pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all lung cancer patients receive optimal cancer care.  There is an opportunity in Birmingham and the referring trusts of the West Midlands to optimise the lung cancer pathway in line with the national optimal lung cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  lung cancer pathway aligned with the national optimal lung cancer pathway and achievement of the lung cancer  28 day Faster Diagnostic Standard, the 31,  62  and 104 day Cancer Waiting Time Targets. The project intends to begin on 1^st January 2022 and anticipates a finish date on 30^th April 2022.

Project Objectives

The primary objective of this project is the optimisation of lung cancer pathways across Birmingham and referring centres across the West Midlands. Specifically contributing towards; –

• An optimised lung cancer pathway aligned to the national optimal lung cancer pathway
• Achievement of the lung cancer 28 day Faster Diagnostic Standard, 31-day treatment target, 62-day referral to treatment and 104-day Cancer Waiting Time targets

Project Approach

• Pathway mapping of each point of entry to the lung cancer service in Birmingham as well as referring centres from across the West Midlands and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing lung cancer patients in UHB
• Implementation of an optimised pathway for each site managing lung cancer patients across Birmingham as well as those referred into UHB from across the West Midlands
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the lung cancer pathway in Birmingham and referring centres across the West Midlands.
• Quicker diagnosis and treatment of lung cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in lung cancer across UHB hospital sites resulting in

• Achievement of the 28 day Faster Diagnostic Standard, 31-day treatment target, 62-day referral to treatment and 104 day Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of lung cancer patients
• Increase in treatment rates for lung cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of lung cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £16,471.31; MSD contribution = £9,700.00; NHS Contribution = £ 6,771.31

Job Code GB-NON-05402 | Date of Preparation – December 2021

Project Title

University Hospitals Dorset NHS FT Poole General Hospital Lung Pathway Development Project (PDP)

Organisations involved

MSD

University Hospitals Dorset NHS FT Poole General Hospital

Summary

A national optimal lung cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all lung cancer patients receive optimal cancer care. There is an opportunity in and across Dorset to optimise the lung cancer pathway in line with the national optimal lung cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved lung cancer pathway aligned with the national optimal pathway and achievement of the lung cancer 28 day Faster Diagnostic Standard and the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 1st June 2021 and anticipates a finish date on 30th April 2022

Project Objectives

The primary objective of this project is the optimisation of lung cancer pathways across Dorset. Specifically contributing towards; –

• An optimised lung cancer pathway aligned to the national optimal timed lung cancer pathway
• Achievement of the lung cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each lung cancer service in Dorset and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing lung cancer patients in Dorset
• Implementation of an optimised pathway for each site managing lung cancer patients across Dorset
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the lung cancer pathway in
• Quicker diagnosis and treatment of lung cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in lung cancer across Dorset hospital sites resulting in

• Achievement of the lung cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of lung cancer patients
• Increase in treatment rates for lung cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of lung cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £14,190 MSD contribution = £7,300 NHS Contribution = £ 6,890

Job Code GB-NON-05406 | Date of Preparation – December 2021

Project Title

Peninsula Cancer Alliance Lung Cancer Pathway Development Project  (PDP)

Organisations involved

MSD
Peninsula Cancer Alliance; Royal Devon & Exeter Hospital; University Hospital Plymouth; North Devon Hospital; Royal Cornwall Hospital and Torbay & South Devon Hospital

Summary

A national optimal lung cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all lung cancer patients receive optimal cancer care. There is an opportunity in Devon and Cornwall to optimise the lung cancer pathway in line with the national optimal lung cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved lung cancer pathway aligned with the national optimal pathway and achievement of the lung cancer 28 day Faster Diagnostic Standard and the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 3rd January 2022 and anticipates a finish date on 30th November 2022

Project Objectives

The primary objective of this project is the optimisation of lung cancer pathways across Devon and Cornwall. Specifically contributing towards; –

• An optimised lung cancer pathway, aligned to the national optimal timed lung cancer pathway
• Achievement of the lung cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment Cancer Waiting Time target

Project Approach

• Pathway mapping of each lung cancer service in Devon and Cornwall and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing lung cancer patients in Devon and Cornwall
• Implementation of an optimised pathway for each site managing lung cancer patients across Devon and Cornwall
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the lung cancer pathway in Devon and Cornwall.
• Quicker diagnosis and treatment of lung cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in lung cancer across Devon and Cornwall hospital sites resulting in

• Achievement of the lung cancer 28 day Faster Diagnostic Standard, 31 day treatment target and 62 day referral to treatment target
• Earlier referral, diagnosis and treatment of lung cancer patients
• Increase in treatment rates for lung cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of lung cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £16,457; MSD contribution = £10,300; NHS Contribution = £6,157

Job Code GB-NON-06229. Date of Preparation – July 2022

Project Title

Manchester University NHS Foundation Trust Patient Experience App

Organisations involved

Manchester University NHS Foundation Trust

Summary

Wythenshawe Hospital (Manchester University NHS Foundation Trust) have initiated a RAPID (rapid access to pulmonary intervention and diagnosis) pathway for all lung cancer patients. It aims to reduce the time from GP referral to first treatment to 28 days, less than half the current NHS target. While the pathway has demonstrated advantages in time to diagnosis, further evidence is needed to understand the impact of such a fast-track diagnosis on the patient experience. The aim of the project is to work with Manchester University NHS Foundation Trust to develop a patient experience survey. The purpose of the survey is to build an evidence base of what the experience of the patient is within this accelerated pathway, and to facilitate continuous improvement to the pathway through real time analysis.

Background

Wythenshawe hospital have introduced the RAPID program for lung cancer patients, with the aim of 28 day pathway from referral to treatment decision.

While the pathway has demonstrated advantages in time to diagnosis, further evidence is needed to understand the impact of such a fast-track diagnosis on the patient experience.

Currently, patient experience surveys have focused on patients who have been given a cancer diagnosis, this project will address this by gaining insights into all patients going through RAPID- regardless of the diagnosis

Project Approach

• To develop a patient experience app to capture patient satisfaction with the optimal lung cancer pathway within Wythenshawe hospital
• The tool will be co-produced with GM focus group
• The survey will be offered to approximately 500 patients going through the optimal lung cancer pathway at Wythenshawe hospital during a twelve-month period
• Data will be captured and collated, and results reviewed
• Evaluation- App will be built to deliver reports providing data analysis at 3/6/9/12 months. Report will be owned by the NHS and they will give license to MSD to use it. Any publication of data will be approved by both parties

Project Objectives

To work with Wythenshawe hospital to evidence the patient experience whilst in the RAPID (Rapid access to pulmonary assessment and diagnosis) lung cancer pathway.

To share and disseminate that data with the wider lung cancer community, to support the implementation of the NOLCP (or other service improvements) in other Trusts.

Benefits

Benefits to patients:

• For patients currently in RAPID pathway, their patient experience concerns will be identified and addressed
• Addressing patient concerns will continuously improve and develop the service for subsequent patients
• Adding patient experience data to outcome data may prove sufficiently compelling to lead to wider adoption of the pathway in other Trusts, in turn speeding up the pathway there and reducing variation across the NHS
• More rapid diagnoses may improve treatment rates and outcomes for patients

Benefits to NHS:

• Capturing this patient experience data will enable generation of data to demonstrate performance and delivery of the pathway (by monitoring dates of interventions etc.) by the Trust, which may be used for reporting and publication. This will enable them to assess the value of extending the RAPID pathway across wider GM
• Continuously improve the service (e.g. highlighting areas of need or dissatisfaction)
• Provide other hospitals and services evidence to form business cases to adopt the RADID pathway
• Development of a patient experience survey that can be used to support future pathways and projects within the wider NHS, in multiple cancers

Benefits to MSD:

Data generated on the patient pathway and experience prior to treatment decision could be used by MSD for:

• Policy and advocacy activities
• Development of patient support materials
• Advocacy for the RAPID pathway model

• Reputational benefit from partnering on this high profile, innovative project
• All benefits are non-financial and can potentially be realised from the first data read out from the survey
• An opportunity to measure patient experience in other projects in GM and the wider NHS

Funding

People:

From MSD:

• Project manager to attend monthly meetings with steering group, to support and review progress throughout 12-month pilot
• Oncology franchise and medical to advise on the methodology and design of the survey and analytical methods

From the NHS partner:

• Development of App with 3^rd party provider
• Identification of suitable patients to take part in the survey, and encouraging usage of survey in 500 plus patients
• Attendance at monthly meetings with steering group

Funds

Total MSD £41,650

Total NHS £37,500

Total project=£79,150

Date of Preparation: August 2020 Re-approval August 2022 | GB-NON-03087

Project Title

EPIC: Early Prehabilitation In Lung Cancer

Organisations involved

Edinburgh Cancer Centre, NHS Lothian and MSD

Summary

The Edinburgh Cancer Centre, NHS Lothian is working with MSD to understand the feasibility of utilising prehabilitation techniques in patients with advanced metastatic lung cancer with the overall aim of reducing symptom burden, improving patient fitness and increasing treatment rates for lung cancer.

Background

Lung cancer is the most common cancer in Scotland with more than 5,300 registrations in 2018 and it accounted for over 25% of all cancer deaths. Five year survival rates remain below 10% with almost 50% of patients being identified at stage 4 meaning that access to treatment can be limited and this is compounded by the fact that many patients have comorbidities and are frail which adds to the symptom burden.

An option to help support patients with advanced lung cancer is the use of prehabilitation which is the practice of enhancing a patient’s functional and psychological capacity before treatment commences. It focuses on three areas –

• Nutrition
• Physical activity
• Psychological support

Several studies indicate that prehabilitation is safe, feasible and can be delivered alongside complex treatment pathways in different cancer sites including lung cancer. A growing number of national and international reports now recommend prehabilitation as part of cancer pathways but little work has been carried out looking at the impact of prehabilitation in patients with advanced lung cancer.

Project Objectives

The project will be based at St John’s Hospital, Livingston and will aim to include all appropriate patients with advanced lung cancer.

The principle objectives will be to –

• Maximise patient fitness as they are investigated and start treatment for lung cancer
• Reduce symptom burden
• Improve nutrition and stop weight loss
• Maintain or improve performance scores
• Sign posting to psychological support and smoking cessation
• Increase treatment rates for lung cancer

The project is a pilot that now will run for 30 months after a decision by both the Edinburgh Cancer Centre, NHS Lothian and MSD to extend the project to phase 2 after initial learnings from the project signalled that it may be beneficial for patient care. At the end of the project the model will be evaluated and may well be of interest to other health economies across Scotland and the UK.

Benefits

Benefit to Patients

• Improved access to healthcare provision
• Enhanced disease management
• Potential improvement patient’s fitness and wellbeing which may allow access to therapeutic options
• Reduction in health inequalities

Benefits to the NHS

• Potentially scalable prehabilitation service for patients with advanced lung cancer that could be scaled to other cancer centres across Scotland/UK
• Aligns with national and local cancer policy – Scottish Government, SCAN, NHS Lothian
• Priority of national third sector organisations
• Potential opportunity to offer more therapeutic options to previously untreatable patients
• Reduction in health equalities
• Potential cost savings and improved capacity

Benefits to MSD

• Opportunity to engage as a partner with NHS Lothian/SCAN rather than just a supplier of medicines
• Potentially scalable project that could be shared with other cancer centres across the UK
• Priority of national third sector organisations

Funding

The project is being funded with equal allocation of resources to the project from Edinburgh Cancer Centre, NHS Lothian and MSD

Date of Preparation: November 2021 | GB-NON-05303

Project Title

Gloucestershire AHP Prehabilitation Service (GAPS) for Lung Cancer Patients

Organisations involved

Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) and MSD

Summary

We supported Gloucestershire Hospitals NHS Foundation Trust to set up and run a lung cancer prehabilitation service pilot over a 6-month period. We set out to determine the extent to which prehabilitation support for lung cancer patients can either maintain or improve their fitness levels and suitability for systemic anti-cancer therapy (SACT). Secondarily, we intended to measure the effect of prehabilitation on supporting a patient’s physical function and mental resilience. Patients were referred by a lung physician or lung cancer clinical nurse specialist at the diagnostic clinic stage as soon as a lung cancer is highly suspected. They were then assessed for the level of prehabilitation support that would best suit their individual needs and circumstance. We intended to use the evaluation to inform a business case that will seek to ensure recurrent funding and sustainability of this service. MSD provided funding, project management and evaluation support for this initiative. The project began on the 2^nd May 2022 and finished on the 30^th November 2022.

Benefits Realised

Benefits to the Patient

• As a result of engaging with GHNHSFT ‘s prehabilitation service, 80% of patients either maintained (41 patients or 68%), or improved (7 patients or 12%) their fitness from the time they were referred, through to the time that their treatment started:
  • Of the 25 patients measured as PS1 on referral, 16 (64%) maintained their PS1 and 3 (12%) had improved to PS0 by the time of decision to treat
  • Of the 27 patients measured as PS2 on referral, although 21 (78%) patients maintained their PS2, 5 (19%) had improved to PS1 by the time of decision to treat
• Patient experience and outcomes of receiving the service were measured:
  • 90% of patients stated they were satisfied with the information and advice provided (59% ‘very satisfied’ and 31% ‘satisfied’). This number increased to 97% among those who attended face to face prehabilitation
  • 79% of patients reported prehabilitation as improving their overall health and wellbeing either ‘a great deal’ (39%), or ‘a fair amount’ (40%). This number increased to 85% among those attending face to face
  • Of the patients that were able to use the psychological skills training, 82% stated that it helped reduce their worry/anxiety either ‘a great deal’ 31% or a fair amount 51%
• Patient’s lifestyle factors were seen to improve as a result of receiving prehabilitation support
  • 69% of patients reported that prehabilitation has helped them increased their physical activity
  • 57 % reported that prehabilitation has supported a positive change in their diet and nutrition
  • 61% of patients stated that prehabilitation supported their emotional well-being during a traumatic time in their lives

Benefits to GHNHSFT

• The development of a prehabilitation service in Gloucestershire dedicated to the needs of lung cancer patients
• Redesign and expansion of the lung cancer patient pathway to incorporate prehabilitation services
• Achievement of recommendations to provide prehabilitation within NHSE Diagnostic Standards of Care for suspected lung cancer
• A service evaluation has been produced highlighting the benefits of a prehabilitation service for lung cancer patients, which can serve as supporting business justification for longer term funding of the service
• The data available through the service evaluation is not sufficient enough to conclude that introducing prehabilitation results in an improvement of treatment rates

Benefits to MSD

• Enhanced reputation of MSD through partnership work
• A better understanding of how prehabilitation services support the needs of lung cancer patients
• An opportunity for MSD to support a service evaluation to help establish the benefits of prehabilitation for lung cancer patients
• An opportunity to engage as a partner with NHS Gloucestershire rather than just being seen as a supplier of medicines to the healthcare system
• Involvement in a potentially scalable service that could be shared with other cancer centres across the UK

Funding & Resources

This project was a shared funding commitment from GHNHSFT and MSD. The total project cost was £28,119

Lessons learnt:

• This project benefitted from having a data lead who can dedicate time to supporting the project through capturing service level data and synthesising the data to produce relevant insights.
• Outlier events such as global pandemics can’t be predicted, but where there is solid justification for setting up a new service, the strength of the case to do so will outlast external challenging forces
• Our forecast of patient numbers referred to the service over the 6-month pilot were affected by several factors (150 forecasted, 76 actual). These were, relying on an average number of patients flowing through the service, not factoring in patients declining the service, clinicians not referring patients who are PS3 and above to the service (due to the likely rapid deterioration and subsequent palliation), as well as perhaps more broadly communicating the service prior to it starting.
• Aligning all constituent elements of a prehabilitation service can be challenging and subject to change. For example, the local smoking cessation service initially agreed to attend prehabilitation sessions, but sadly did not engage when it was up and running.

Publications

Gloucestershire Hospitals NHS Foundation Trust intend to publish the results in a Professional Journal

GB-NON-07465  | Date of Prep May 2023

Project Title

Nottingham University Hospital NHS Trust Lung Cancer Pathway Development Project (PDP)

Organisations involved

Nottingham University Hospital (NUH) NHS Trust and MSD-UK 

Summary

The objective of this project was to improve Nottingham University Hospitals lung cancer service efficiency, service quality, productivity, and patient experience.  The desired outcome was an improved lung cancer pathway aligned with the national optimal lung cancer pathway and achievement of the lung cancer 28 day Faster Diagnostic Standard, the 31-day treatment target and 62-day referral to treatment Cancer Waiting Time (CWT) Targets.  The project began on 25th July 2022 and finished on 30th November 2022. 

Benefits Realised

Through implementation of MSD’s Pathway Development Programme with the Nottingham University Hospitals team, MSD provided project management support to assess the current state of the lung cancer pathway and provide a gap analysis contrasting the pathway with the National Optimal Lung Cancer Pathway. MSD then supported the implementation of improvement initiatives to close these gaps and assisted with the measurement of their impact. As a result of the project, the following benefits were realised: 

Patient Benefits

• Quicker diagnosis and time to treatment of lung cancer has been reported, as demonstrated below, through this project potentially leading to improved patient outcomes 
• All patients now have access to the Nottingham Education Materials for smoking cessation, diet, activity/exercise, and psychological support which was not previously available. It is envisaged this will support an improved patient experience 

NHS Benefits

An initial analysis taken from NUH CWT data Jul 2022-Feb 2023 reported an improvement of the lung cancer pathway targets (Percentage absolute change): 

• 28-day Faster Diagnostic Standard improvement of 6.9%
• 2WW improvement of 4.7% (with the 2WW percentage at 100% in Feb 2023)
• 31-day treatment target improvement of 1.5%  
• The 62-day referral CWT target is an ongoing measurement as only data to Feb 2023 was available at the time of the outcome summary publication. NUH are continuing to monitor the impact of the project and CWT data 

MSD Benefits

• Better understanding of lung cancer patient needs 
• Enhanced reputation of MSD through partnership work. NHS stakeholder commented their experience of working in collaboration with MSD was very insightful and helpful to have an objective review   

Funding & Resources

This was a project with shared time commitment from Nottingham University Hospital NHS Trust & MSD

Lessons learnt

Development of a strong engagement plan with the pathway manager and regular communication is needed to maintain the project momentum and drive the pathway work within the NHS. 

Strong leadership with a clear vision and appetite for change is necessary to effect a change in clinical services. 

A communication plan for disseminating the success of the service is essential to gain support to make service development changes sustainable and permanent. 

Publications

There are currently no plans to publish the outcomes of this project by the hospital trust as per the date of this summary

Job Code: GB-NON-07433 |  Date of Prep: May 2023

Project Title

Salisbury Lung Cancer Prehabilitation Pathway Development Project (PDP)

Organisations involved

Salisbury NHS Foundation Trust and MSD

Summary

A national optimal lung cancer pathway has been created with the intention of improving patient experience and outcomes. In association to an optimised clinical pathway, a prehabilitation service for cancer patients is seen as an effective support intervention to prepare a cancer patient for treatment by maintaining or improving their fitness levels, nutrition, and mental wellbeing. There is an opportunity in Wiltshire to optimise the lung cancer pathway and prehabilitation service to improve service quality and patient experience. The primary objective and desired outcome of this project is an improved lungcancerpathway and prehabilitation service.

Benefits Realised

Patient Benefits

• An improved experience of the lung cancer pathway and prehabilitation services in Wiltshire
• Prehabilitation support to maintain fitness levels, nutrition and mental wellbeing to be best prepared for treatment
• Patient benefits were not fully realised as this project was not completed.

NHS Benefits

• An optimised pathway in lung cancer and prehabilitation service across Wiltshire
• Service map developed of the current prehabilitation service.
• Insights and recommendations report provided to inform future service development initiatives
• Potential for a less fragmented prehabilitation service
• NHS benefits were not fully realised as this project was not completed

MSD Benefits

• Better understanding of how prehabilitation service support the needs of lung cancer patients
• Enhanced reputation of MSD through partnership work
• MSD benefits were not fully realised as this project was not completed

Funding & Resources

This was a project with shared time commitment from Salisbury NHS Foundation Trust and MSD

Lessons learnt

Creation of a formal contingency plan should any of the key stakeholders leave their post or their organisation during the implementation of the project

Publications

No publications are planned

Job Code: GB-NON-07332 |  Date of Prep: April 2023

Project Title

Oxford Respiratory Early Diagnosis Service (REDS) Lung Cancer Pathway Development Project (PDP)

Organisations involved

Oxford University NHS Hospitals Trust and MSD-UK

Summary

The objective of this project was the optimisation of lung cancer pathways across Oxfordshire through service redesign with the Oxford REDS team and focussing on early diagnosis through the provision of next day CT scans, outpatient appointments and implementation of diagnostic bundles for patients found to have abnormal chest X-rays. Specifically contributing towards achievement of the lung cancer 28-day Faster Diagnostic Standard, 31-day treatment target and 62-day referral to treatment Cancer Waiting Time target. MSD helped to project manage the implementation of this initiative through MSD’s Pathway Development Programme. The project began on the 6^th of October 2020 and finished on the 4^th of July 2022

Benefits Realised

Through implementation of MSD’s Pathway Development Programme with the Oxford REDS team, MSD provided project management support to assess the current state of the Oxford early diagnosis service and provide a gap analysis contrasting the current state assessment with the desired ‘to be’ state of next day CT clinics. MSD then supported the implementation of improvement initiatives to close these gaps and assisted with the measurement of their impact. The project achieved the development of next day CT clinics for patients with abnormal chest x-ray alongside hot reporting of the CT scan, a same day outpatient appointment and diagnostic bundling of test ordering on the same day to speed up diagnosis and time to treatment. As a result, the project delivered an improvement in the lung cancer pathway aligned with the NOLCP and achievement of the lung cancer 28-day Faster Diagnostic Standard, as well as the 31 and 62-day Cancer Waiting Time targets.

Benefits Realised

• Patient Benefits

  • Patients experienced an overall average reduction of 16 days in the time taken to move from Chest X-ray to receiving treatment
  • Patients expressed an overall satisfaction of the new REDS lung cancer pathway (77% very satisfied and 23% satisfied)

• NHS Benefits

  • An optimised pathway in lung cancer across Oxfordshire hospital sites aligned to the National Optimal Lung Cancer Pathway
  • The pathway time from urgent 2ww referral to patients being diagnosed has been reduced on average by 15 days
  • 16-day efficiency saving in the average time from Chest X-ray reported to the patient receiving treatment
  • We did not measure the direct impact on treatment rates as a result of this project

• MSD Benefits

  • Better understanding of lung cancer patient needs
  • Enhanced reputation of MSD through partnership work

Funding & Resources

This was a project with shared time commitment from both the NHS & MSD

Lessons learnt

Strong clinical leadership with a clear vision for change is necessary to effect a change in clinical services

A communication plan for disseminating the success of the service is essential to gain support to make service development changes sustainable and permanent

Publications

There is a tentative plan to publish the outcomes of this project but as of the date of this summary, this has yet to be confirmed.

Job Code: GB-NON-06512.  Date of Prep – January 2023

Project Title

Northern Cancer Alliance Lung Pathway Board Project

Organisations involved

Northern Cancer Alliance & MSD UK Ltd

Summary

The Northern Cancer Alliance want to establish a Lung Cancer Pathway Board. The aim of the Lung Cancer Pathway Board is to improve lung cancer care for patients in the North East and North Cumbria, delivering an integrated care pathway from presentation and diagnosis through to personalised and palliative care for lung cancer thus reducing inequalities and delivering improved outcomes.

Background

The Northern Cancer Alliance population is about 5.9% of the England population but has 6.5% of all malignancies and 8.2% of total lung cancers.¹
For both males and females, lung cancer is the second most common cancer in the geographies across the Northern Cancer Alliance.¹
Lung cancer is the most common cause of cancer death in England, accounting for almost 21% cancer deaths (2017).¹
In the Northern Cancer Alliance, lung cancer deaths equate to 24.8% of cancer deaths.¹

Project Approach

The role of MSD UK in this project will be to provide a project manager who will provide project management support to the Northern Cancer Alliance Lung Pathway board. The resource required and commitment to complete this project is a project manager for 2 days per week for 12 months.
The Northern Cancer Alliance will provide a clinical chair for the Lung Pathway Board, administrative support and clinical and management supervision for the duration of the project.

Project Objectives

The primary objective of the Lung Cancer Pathway Board is to ensure that every lung cancer patient has access to an equitable, effective and responsive service compliant with National and Local standards, including specific lung cancer waiting times, with the aim of improving outcomes to be in line with world class services. This will include:

• Implementation of the National Optimal Lung Cancer Pathway (NOLCP)
• Implementation of the 28-day Faster Diagnostic Standard (FDS) Timed Lung cancer pathway, addressing local variation and inequality
• Dissemination and adoption of the North East Lung Case Finding Pilots (COPD annual review)
• Streamlining of MDT meetings and developing standards of care for lung cancer pathway

Benefits

Patients

• Earlier detection, diagnosis and treatment of lung cancer patients
• Patients detected, diagnosed and treated at an earlier stage of lung cancer have a greater chance of successful treatment, greater survival rates and clinical outcomes
• Improved patient experience of lung cancer pathway

NHS

• Implementation of the National Optimal Lung Cancer Pathway
• Achievement of lung cancer treatment targets (28-day target, 62 day target)
• Increased percentage of lung cancer patients being diagnosed at stage 1+2 as per the NHS target of 75% by 2028
• Earlier detection, diagnosis and treatment of lung cancer patients leads to more cost-effective use of healthcare resources and increased patient survival and patient experience

MSD

• Increased understanding of the lung cancer pathway and the challenges and solutions to its successful implementation and improvement which can be shared both internally within MSD UK and externally with NHS stakeholders outside of the North East and North Cumbria
• As a pharmaceutical manufacturer of oncology medicines, MSD may see an increase in usage of its NICE approved lung cancer medications as a result of this projects implementation of the National Optimal Lung Cancer Pathway
• Enhanced reputation of MSD UK and the wish to work in partnership further
• MSD UK gains a better understanding of customer and patient needs in lung cancer

Funding

This project involves a pooling of skills and resources between the Northern Cancer Alliance and MSD UK over 12 months.

MSD Contribution = £28,000

NHS Contribution = £36,000

Total Project = £64,000

Update September 2020: The project was put on hold for 3 months in 2020 due to delays caused by COVID-19. It has been agreed to extend the project to March 2021. There will be no further costs or resources required, other than those previously agreed in the initial PID for this project.

References –

1. Data supplied by Northern Cancer Alliance

Date of Preparation: October 2022 | GB-NON-03702

Project Title

CP/GP Head and Neck Cancer Pathway Project

Organisations involved

NHS Tayside

Summary

NHS Tayside, through the North Cancer Alliance, are working in collaboration with MSD to develop a communication pathway between community pharmacies in the Dundee city area and their local primary care practices for patients with suspected head and neck cancers (HNC).

The project will evaluate the effectiveness of a communication pathway between community pharmacy and primary care to determine whether it help to facilitate earlier patient review.

Background

The project is required because as there has been an increase in the incidence of HNC in Scotland over the last three decades making it the sixth most common cancer in Scotland and survival rates have shown little improvement since the 1980’s. The incidence of HNC is more prevalent in more deprived areas where there are sometimes issues accessing primary care however there is often a community pharmacy nearby which may be able to help identify any HNC symptoms and refer suspected cases directly to their local GP practice for follow up. 1,2,3,4

Project Approach

The project will be aiming to –

• Demonstrate that community pharmacy staff can accurately and reproducibly utilise communication pathways to encourage patient presentation to primary care for further assessment
• Track patients through their journey from point of contact with community pharmacy, where symptoms are first recognised, to GP consultation and any onwards referrals which will demonstrate the utility of a community pharmacy pathway
• Align with Scottish Government’s Recovery and Redesign Cancer action plan to potentially create a scalable model that can be reproduced across Scotland and potentially adopted for other tumour types
• Expand upon and help realise the full potential of the Pharmacy First Scotland policy and contribute to the Scottish Government’s vision for smoother patient pathways

Project Objectives

The project would aim to deliver –

• A communication pathway between around 20 community pharmacies and primary care services in the Dundee city area aimed at identifying HNC’s
• A written evaluation of the feasibility of engaging community pharmacies to identify potential cases of HNC’s and the effectiveness of the communication pathway
• A road map for other Health Boards and/or Scottish Government to emulate/scale the project

Benefits

Benefits/ Impact to patients

• Potential improved health outcomes
• Increased potential to receive treatment
• Reduced health burden for NHS Tayside citizens
• Reduction in health inequalities

Benefits to the NHS partner

• Potentially scalable Communication pathway that could be adopted by other Healthboards/Scottish Government
• Potentially reduced health costs in medications and follow up appointments
• Improved patient experience of a service run by NHS Tayside
• Expansion of existing skill base in Community Pharmacy

Benefits to MSD

• Potential increase in the number of patients eligible for therapeutic intervention by identifying HNC patients earlier
• Opportunity for MSD to help support the development of evidence to establish the benefit of utilising community pharmacy to identify HNC patients
• Opportunity to engage as a partner with NHS Tayside rather than just being seen as supplier of medicines to the healthcare system

Funding

This project involves a pooling of skills and resources between the NHS Tayside and MSD UK over 12 months.
MSD Contribution = £45,322; NHS Tayside Contribution = £37,622; Total Project = £82,944

November 2022

1. https://publichealthscotland.scot/publications/cancer-incidence-in-scotland/cancer-incidence-in-scotland-cancer-incidence-andprevalence-
in-scotland-to-december-2019/cancer-incidence-dashboard/ (Assessed September 2022)
2. http://eprints.gla.ac.uk/177913/ (Assessed September 2022)
3. Todd A, et al. BMJ Open 2014;4:e005764. doi:10.1136/bmjopen-2014-005764 (Assessed September 2022)
4. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/head-and-neck-cancers (Assessed September 2022)

Job Code GB-NON-06659 – Date of preparation November 2022

Project Title

Royal Liverpool University Hospital NHS Foundation Trust Pathway Development Project (PDP)

Organisations involved

MSD

Royal Liverpool University Hospital NHS Foundation Trust

Summary

A head and neck Best Practice Timed Pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all head and neck patients receive optimal cancer care. There is an opportunity in the Merseyside area to optimise the head and neck pathway in line with the head and neck Best Practice Timed Pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved head and neck pathway aligned with the Best Practice Timed Pathway and achievement of the head and neck 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 27th of September 2022 and anticipates a finish date on 26th March 2023

Project Objectives

The primary objective of this project is the optimisation of head and neck pathways across Merseyside. Specifically contributing towards; –

• An optimised head and neck pathway aligned to the head and neck Best Practice Timed Pathway
• Achievement of the head and neck Best Practice Timed Pathway, through improved biomarker request turnaround time, the 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each head and neck service in Merseyside and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing head and neck patients in Merseyside
• Implementation of an optimised pathway for each site managing head and neck patients across Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the head and neck pathway in
• Quicker diagnosis and treatment of head and neck and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in head and neck across Merseyside hospital sites resulting in

• Achievement of the head and neck 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of head and neck patients
• Increase in treatment rates for head and neck
• Optimisation of service delivery

MSD Benefits

• Better understanding of head and neck patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £3731.30; MSD contribution = £1540; NHS Contribution = £ 2191.30

Job Code: GB-NON-06319 Date of Prep: August 2022

Project Title

Swansea Bay University Health Board Head & Neck cancer Pathway Development Project (PDP)

Organisations involved

MSD

Swansea Bay University Health Board

Summary

A national optimal head and neck cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all head and neck cancer patients receive optimal cancer care. There is an opportunity in Swansea Bay University Health Board to optimise the head and neck cancer pathway  in line with the national optimal head and neck cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  head and neck cancer pathway aligned with the national optimal pathway and achievement of the head and neck cancer  62 day Cancer Waiting Time Targets. The project intends to begin on 15^th May 2022 and anticipates a finish date on 31st March 2023

Project Objectives

The primary objective of this project is the optimisation of head and neck cancer pathways across Swansea Bay University Health Board. Specifically contributing towards; –

• An optimised head and neck cancer pathway aligned to the national optimal timed head and neck cancer
• Achievement of the head and neck cancer 62 day Cancer Waiting Time targets

Project Approach

• Pathway mapping of each head and neck cancer service in Swansea Bay University Health Board and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing head and neck cancer patients in Swansea Bay University Health Board.
• Implementation of an optimised pathway for each site managing head and neck cancer patients across Swansea Bay University Health Board.
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the head and neck cancer pathway in Swansea Bay University Health Board.
• Quicker diagnosis and treatment of head and neck cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in head and neck cancer across Swansea Bay University Health Board  hospital sites resulting in

• Achievement of the head and neck cancer 62 day) Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of head and neck cancer patients
• Increase in treatment rates for head and neck cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of head and neck cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £4,944.10; MSD contribution = £3,100.00; NHS Contribution = £ 1844.10

Job Code GB-NON-06865. Date of Preparation – Dec 2022

Project Title

Aneurin Bevan University Health Board head and neck Pathway Development Project (PDP)

Organisations involved

MSD

Aneurin Bevan University Health Board

Summary

A national optimal head and neck Cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all head and neck cancer patients receive optimal cancer care. There is an opportunity in Aneurin Bevan University Health Board to optimise the head and neck cancer pathway  in line with the National Optimal Pathway for head and neck cancer to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  head and neck cancer pathway aligned with the national optimal pathway and achievement of the head and neck cancer  62 day Cancer Waiting Time Targets. The project intends to begin on  1^st February 2022 and anticipates a finish date on 1^st February 2023.

Project Objectives

The primary objective of this project is the optimisation of head and neck cancer pathways across Aneurin Bevan University Health Board. Specifically contributing towards; –

• An optimised head and neck cancer pathway aligned to the national optimal timed head and neck cancer
• Achievement of the head and neck cancer 62 day Cancer Waiting Time targets

Project Approach

• Pathway mapping of each head and neck cancer service in Aneurin Bevan University Health Board and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing head and neck cancer patients in Aneurin Bevan University Health Board
• Implementation of an optimised pathway for each site managing head and neck cancer patients across Aneurin Bevan University Health Board
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the head and neck cancer pathway in Aneurin Bevan University Health Board
• Quicker diagnosis and treatment of head and neck cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in head and neck cancer across Aneurin Bevan University Health Board  hospital sites resulting in

• Achievement of the head and neck canceri 62 day) Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of head and neck cancer patients
• Increase in treatment rates for head and neck cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of head and neck cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £4344.10; MSD contribution = £2500; NHS Contribution = £ 1844.10

Job Code GB-NON-06772. Date of Preparation– November 2022

Project Title

South Yorkshire and Bassetlaw Cancer Alliance Head and Neck Pathway Development Project (PDP)

Organisations involved

MSD

South Yorkshire and Bassetlaw Cancer Alliance:

• Sheffield Teaching NHS Foundation Trust
• Barnsley Hospital NHS Foundation Trust
• The Rotherham NHS Foundation Trust
• Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
• Chesterfield Royal Hospital NHS Foundation Trust

Summary

A national optimal Head and Neck Cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all Head and Neck cancer patients receive optimal cancer care. There is an opportunity in South Yorkshire to optimise the Head and Neck cancer pathways in line with the national optimal Head and Neck cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved Head and Neck cancer pathway aligned with the national optimal pathway and achievement of the Head and Neck cancer 28 day Faster Diagnostic Standard and the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 1^st January 2022 and anticipates a finish date on 31^st December 2022

Project Objectives

The primary objective of this project is the optimisation of Head and Neck cancer pathways across South Yorkshire. Specifically contributing towards; –

• An optimised Head and Neck pathway, aligned to the National Optimal Timed Head and Neck cancer pathway
• Achievement of the Head and Neck 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment Cancer Waiting Time target

Project Approach

• Pathway mapping of each Head and Neck cancer service in South Yorkshire and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing Head and Neck cancer patients in the South Yorkshire
• Implementation of an optimised pathway for each site managing Head and Neck cancer patients across the South Yorkshire
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the Head and Neck cancer pathway in South Yorkshire
• Quicker diagnosis and treatment of Head and Neck cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in Head and Neck cancer across South Yorkshire hospital sites resulting in

• Achievement of the Head and Neck cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment target
• Earlier referral, diagnosis and treatment of Head and Neck Cancer patients
• Increase in treatment rates for Head and Neck cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of Head and Neck cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE approved medicines

Funding

Total Project = £22,295.35           MSD contribution = £18,100  NHS Contribution =£4,195.35

Job Code GB-NON-05364. Date of Preparation – December 2021

Project Title

Northern Cancer Alliance Head and Neck Pathway Development Project (PDP)

Organisations Involved

MSD
Northern Cancer Alliance:
North Cumbria Integrated Care NHS Trust
Newcastle upon Tyne NHS Foundation Trust
County Durham and Darlington NHS Foundation Trust
South Tyneside and Sunderland NHS Foundation Trust
South Tees NHS Foundation Trust

Summary

A national optimal Head and Neck Cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all Head and Neck cancer patients receive optimal cancer care. There is an opportunity in the North East and North Cumbria to optimise the Head and Neck cancer pathways in line with the national optimal Head and Neck cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved Head and Neck cancer pathway aligned with the national optimal pathway and achievement of the Head and Neck cancer 28 day Faster Diagnostic Standard and the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 1st January 2022 and anticipates a finish date on 31st December 2022

Project Objectives

The primary objective of this project is the optimisation of Head and Neck cancer pathways across North East and North Cumbria.
Specifically contributing towards; –
• An optimised Head and Neck pathway, aligned to the National Optimal Timed Head and Neck cancer pathway
• Achievement of the Head and Neck 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment Cancer Waiting Time target

Project Approach

• Pathway mapping of each Head and Neck cancer service in North East and North Cumbria and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing Head and Neck cancer patients in the North East and North Cumbria
• Implementation of an optimised pathway for each site managing Head and Neck cancer patients across the North East and North Cumbria
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the Head and Neck cancer pathway in the North East and North Cumbria.
• Quicker diagnosis and treatment of Head and Neck cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in Head and Neck cancer across the North East and North Cumbria hospital sites resulting in
• Achievement of the Head and Neck cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment target
• Earlier referral, diagnosis and treatment of Head and Neck Cancer patients
• Increase in treatment rates for Head and Neck cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of Head and Neck cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE approved medicines

Funding

Total Project = £28,505.80 MSD contribution = £18,100 NHS Contribution =£10,405.80

Job Code GB-NON-05360. Date of Preparation – December 2021

Collaborative Working Outcome Summary

This project was cancelled due to significant and unanticipated capacity issues within the Dorset system which needed to take priority

Project Title

Dorset County Hospital NHS FT Head & Neck Pathway Development Project (PDP)

Organisations involved

• Dorset County Hospital NHS FT
• MSD

Summary

The primary objective of this project was the optimisation of head & neck cancer pathways across Dorset. Specifically contributing towards: –

• An optimised head & neck cancer pathway aligned to the national optimal time head & neck pathway.
• Achievement of the head & neck cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets.

Benefits Realised

Due to significant and unanticipated capacity issues within the Dorset system which needed to take priority, the Trust made the decision to cancel the project’s planned Head and Neck Cancer Service pathway development workshops, the mainstay of the project plan

Funding & Resources

This was a project with a shared time commitment from University Hospitals Dorset NHS FT & MSD. No resources were committed from either side as project work had not commenced prior to the program’s cancellation.

Lessons learnt

• The importance of a strong sequential stakeholder engagement & communication plan to support time management
• The need to gain agreement from service management to clinical & administrative stakeholders for protected time to prioritise improvement project vs day to day clinical work during a pandemic

Publications

No publications had been planned

Job code: GB-NON-07310  | Date of prep: April 2023

Collaborative Working Outcome Summary

This project was cancelled due to significant and unanticipated capacity issues within the Dorset system which needed to take priority

Project Title

University Hospitals Dorset NHS FT Head & Neck Pathway Development Project (PDP)

Organisations involved

• University Hospitals Dorset NHS FT
• MSD

Summary

The primary objective of this project was the optimisation of head & neck cancer pathways across Dorset. Specifically contributing towards: –

• An optimised head & neck cancer pathway aligned to the national optimal time head & neck pathway.
• Achievement of the head & neck cancer 28 day Faster Diagnostic Standard, 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets.

Benefits Realised

Due to significant and unanticipated capacity issues within the Dorset system which needed to take priority, the Trust made the decision to cancel the project’s planned Head and Neck Cancer Service pathway development workshops, the mainstay of the project plan

Funding & Resources

This was a project with a shared time commitment from University Hospitals Dorset NHS FT & MSD. No resources were committed from either side as project work had not commenced prior to the program’s cancellation.

Lessons learnt

• The importance of a strong sequential stakeholder engagement & communication plan to support time management
• The need to gain agreement from service management to clinical & administrative stakeholders for protected time to prioritise improvement project vs day to day clinical work during a pandemic

Publications

No publications had been planned

Job code: GB-NON-07265 |  Date of prep: April 2023

Project Title

Northern Health and Social Care Trust Pathway Development Project (PDP)

Organisations involved

MSD

Northern Health and Social Care Trust

Summary

A national optimal oesophageal cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all oesophageal cancer patients receive optimal cancer care. There is an opportunity in Northern Health and Social Care Trust to optimise the oesophageal cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved oesophageal cancer pathway  and achievement of the oesophageal cancer  31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 20/04/22 and anticipates a finish date on 30/06/23

Project Objectives

The primary objective of this project is the optimisation of oesophageal cancer pathways across Northern Health and Social Care Trust. Specifically contributing towards; –

• An optimised oesophageal cancer pathway
• Achievement of the oesophageal cancer 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each oesophageal cancer service in Northern Health and Social Care Trust and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing oesophageal cancer patients in Northern Health and Social Care Trust
• Implementation of an optimised pathway for each site managing oesophageal cancer patients across Northern Health and Social Care Trust
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the oesophageal cancer pathway in Northern Health and Social Care Trust.
• Quicker diagnosis and treatment of oesophageal cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in oesophageal cancer across Northern Health and Social Care Trust  hospital sites resulting in

• Achievement of the oesophageal cancer 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of oesophageal cancer patients
• Increase in treatment rates for oesophageal cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of oesophageal cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £5758.26 MSD contribution = £3700.00 NHS Contribution = £2058.26

Job Code GB-NON-06655. Date of Preparation – November 2022

Project Title

Belfast Health and Social Care Trust Pathway Development Project (PDP)

Organisations involved

MSD

Belfast Health and Social Care Trust

Summary

A national optimal Oesophageal Cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all Oesophageal Cancer patients receive optimal cancer care. There is an opportunity in Belfast Health and Social Care Trust to optimise the oesophageal cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved oesophageal cancer pathway and achievement of the Oesophageal Cancer the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 20/04/22 and anticipates a finish date on 30/06/23

Project Objectives

The primary objective of this project is the optimisation of oesophageal cancer pathways across Belfast Health and Social Care Trust. Specifically contributing towards; –

• An optimised oesophageal cancer pathway
• Achievement of the Oesophageal Cancer 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each oesophageal cancer service in Belfast Health and Social Care Trust and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing oesophageal cancer patients in Belfast Health and Social Care Trust
• Implementation of an optimised pathway for each site managing oesophageal cancer patients across Belfast Health and Social Care Trust
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the oesophageal cancer pathway in Belfast Health and Social Care Trust.
• Quicker diagnosis and treatment of oesophageal cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in oesophageal cancer across Belfast Health and Social Care Trust hospital sites resulting in:

• Achievement of the Oesophageal Cancer 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of oesophageal cancer patients
• Increase in treatment rates for oesophageal cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of oesophageal cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £6620.48; MSD contribution = £3700.00; NHS Contribution = £ 2920.48

Job Code GB-NON-06771. Date of Preparation – November 2022

Project Title

Southern Health and Social Care Trust Oesophageal Pathway Development Project (PDP)

Organisations involved

MSD

Southern Health and Social Care Trust

Summary

A national optimal oesophageal cancer pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all oesophageal cancer patients receive optimal cancer care. There is an opportunity in Southern Health and Social Care Trust to optimise the oesophageal cancer pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  oesophageal cancer pathway  and achievement of the Oesophageal Cancer  31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 20/04/22 and anticipates a finish date on 30/06/23.

Project Objectives 

The primary objective of this project is the optimisation of oesophageal cancer pathways across Southern Health and Social Care Trust. Specifically contributing towards; –

• An optimised oesophageal cancer pathway
• Achievement of the Oesophageal Cancer 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets

Project Approach

• Pathway mapping of each oesophageal cancer service in Southern Health and Social Care Trust and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing oesophageal cancer patients in Southern Health and Social Care Trust
• Implementation of an optimised pathway for each site managing oesophageal cancer patients across Southern Health and Social Care Trust
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the oesophageal cancer pathway in Southern Health and Social Care Trust
• Quicker diagnosis and treatment of oesophageal cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in oesophageal cancer across Southern Health and Social Care Trust hospital sites resulting in:

• Achievement of the Oesophageal Cancer 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of oesophageal cancer patients
• Increase in treatment rates for oesophageal cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of oesophageal cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £6620.48; MSD contribution = £3700; NHS Contribution = £2920.48

Job Code GB-NON-06654. Date of Preparation – November 2022

Project Title

Blackpool Teaching Hospitals NHS Foundation Trust Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology Pathway Development Project (PDP)

Organisations involved

MSD
Blackpool Teaching Hospitals NHS Foundation Trust

Summary

A national optimal Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all (Pan Tumour (Breast, Gynaecology, Upper GI) patients receive optimal cancer care. There is an opportunity in Blackpool to optimise the Pan Tumour (Breast, Gynaecology, Upper GI) Pathology pathway in line with the national optimal Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway aligned with the national optimal pathway and achievement of the Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway turnaround times reduction and 28 day Faster Diagnostic Standard Cancer Waiting Time Targets. The project intends to run for approximately 6 months

Project Objectives

The primary objective of this project is the optimisation of Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathways across Blackpool. Specifically contributing towards; –

• An optimised Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway aligned to the national optimal timed Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway
• Achievement of reducing Pan Tumour (Breast, Gynaecology, Upper GI) Pathology pathway turnaround times and 28 day Faster Diagnostic Standard Cancer Waiting Time targets
• Measurement of the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway in Lancashire.
• Quicker diagnosis and treatment of Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology performance through optimisation of the histopathology turnaround times and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology across Lancashire hospital sites resulting in

• Achievement of the reduction in Pan Tumour (Breast, Gynaecology, Upper GI) Diagnostic Pathology pathway turnaround times and 28 day Faster Diagnostic Standard Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of Pan Tumour (Breast, Gynaecology, Upper GI) patients
• Increase in treatment rates for Pan Tumour (Breast, Gynaecology, Upper GI)
• Optimisation of service delivery

MSD Benefits

• Better understanding of Pan Tumour (Breast, Gynaecology, Upper GI) patient needs
• Enhanced reputation of MSD through partnership work

As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

No funding is associated with this project. The project is a shared contribution of time from both the NHS organisation and MSD

Job Code GB-NON-07221 | Date of Preparation March 2023

Project Title

East Lancashire Hospitals NHS Trust Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology Pathway Development Project (PDP)

Organisations involved

MSD

East Lancashire Hospitals NHS Trust

Summary

A national optimal Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway has been created with the intention of improving patient experience through promoting quality cancer care and ensuring all Pan Tumour (Breast, Lung, Skin, Upper GI) patients receive optimal cancer care. There is an opportunity in East Lancashire to optimise the Pan Tumour (Breast, Lung, Skin, Upper GI) Pathology pathway in line with the national optimal Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway aligned with the national optimal pathway and achievement of the Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway turnaround times reduction, 28 day Faster Diagnostic Standard and the 31 and 62 day Cancer Waiting Time Targets. The project intends to run for approximately 6 months

Project Objectives

The primary objective of this project is the optimisation of Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathways across East Lancashire. Specifically contributing towards; –

• An optimised Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway aligned to the national optimal timed Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway.
• Achievement of reducing Pan Tumour (Breast, Lung, Skin, Upper GI) Pathology pathway turnaround times, 28 day Faster Diagnostic Standard, 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Measurement of the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway in Lancashire.
• Quicker diagnosis and treatment of Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology performance through optimisation of the histopathology turnaround times and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology across Lancashire hospital sites resulting in

• Achievement of the reduction in Pan Tumour (Breast, Lung, Skin, Upper GI) Diagnostic Pathology pathway turnaround times, 28-day Faster Diagnostic Standard, 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of Pan Tumour (Breast, Lung, Skin, Upper GI) patients
• Increase in treatment rates for Pan Tumour (Breast, Lung, Skin, Upper GI)
• Optimisation of service delivery

MSD Benefits

• Better understanding of Pan Tumour (Breast, Lung, Skin, Upper GI) patient needs
• Enhanced reputation of MSD through partnership work

• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

No funding is associated with this project. The project is a shared contribution of time from both the NHS organisation and MSD

Job Code GB-NON-07056 | Date of Preparation – February 2023

Project Title

Somerset Wiltshire Avon and Gloucestershire (SWAG) Cancer Alliance Prehabilitation Patient Information Platform

Organisations involved

Somerset Wiltshire Avon and Gloucestershire (SWAG) Cancer Alliance and MSD Ltd

Summary

Provision of project management support to engage and facilitate stakeholder healthcare professionals (HCPs) around regional prehabilitation services and their input in to a prehabilitation platform. HCP alignment and input will be facilitated through the creation of a steering group, where project management will be used to ensure all HCP stakeholders are engaged and informed on what the platform should contain. Local knowledge and expertise will be shared, and resources pooled to benefit all prehabilitation services within the region. Once SWAG Cancer Alliance have created the prehabilitation information platform, the project manager will drive adoption and usage across the respective Trusts within the region.

This is planned to take 9 months and will provide a digital platform to enable patient activation and improved health literacy, as well as ensuring a consistent set of prehabilitation resources for any Trust organisation looking to develop prehabilitation services.

Background

Prehabilitation services across the SWAG region are at differing stages of development, leading to variation in service provision. Few integrated services are up and running, whereas others remain fragmented or limited by resource. Patient education and activation may suffer because of prehabilitation resources not being available during their cancer journey, leading to health inequalities across the region and poor patient experience. Prehabilitation service design leads looking to develop their prehabilitation services may not be able to source patient educational materials and creating their own Trust level content may be a barrier for some. Occasionally, patients do not engage with prehabilitation due to their rural living or cultural or socio-economic backgrounds and so having electronic access to this information may enable their understanding of prehabilitation and self-care and address variation in care.

Project Objectives

• Align SWAG regional Healthcare Professionals around standardised prehabilitation content and facilitate their involvement in the development of the platform
• Reduce the variation in the quality of prehabilitation services across the region
• Reduce health inequalities for underserved populations and who find healthcare services difficult to access
• Patient engagement, education and activation may increase, enabling the patient to make more informed choices regarding their health
• Improve patient’s ability to build mental and physical resilience’s during and beyond their cancer journey
• Support and potentially improve patient health literacy
• Improve patient experience

Benefits

Benefits to the patient

• Improved experience of cancer prehabilitation support
• Receive more readily available guidance to maintain or improve fitness
• Access to broader treatment options due to maintained or improved fitness

Benefits to SWAG Cancer Alliance

• HCP stakeholders engaged around the platform will help meet the Integrated care agenda¹
• Reduction in variation of prehabilitation support provision, with more equitable provision of services²
• Meets Health Literacy / Health Inequalities agenda³
• Prehab service development with standardised information available across the region
• Meets SWAG ‘Let’s Do Digital’ agenda
• Project management support with associated expertise

Benefits to MSD

• Enhanced reputation of MSD through partnership work
• A better understanding of the cancer patient’s pathway and the role of prehabilitation

As a pharmaceutical manufacturer of NICE approved medicines, MSD may see more (indirect) appropriate usage of their medicines.

Funding & Resources

This project is a shared contribution of time between the NHS and MSD

References

• ¹ NHSE Integrated Care – https://www.england.nhs.uk/integratedcare/
• ² Prehabilitation for people with cancer; Macmillan, pg 20 column 2;
  • https://www.macmillan.org.uk/healthcare-professionals/news-and-resources/guides/principles-and-guidance-for-prehabilitation
• ³ https://www.england.nhs.uk/personalisedcare/health-literacy/

Job Code GB-NON-07006 | Date of Preparation February 2023

Project Title

Immuno-oncology Nurse Led Service

Organisations involved

University College Hospital London (UCLH) and MSD

Summary

The collaboration will support the set up and development of an “Immuno-oncology nurse led service” for patients receiving immunotherapy treatments.  This would involve UCLH recruiting a nurse to deliver and evaluate the nurse-led service for the duration of 15 months. This would be supported by a Specialist Cancer Pharmacist and Oncology Consultant at UCLH, project management support from MSD and financial input from both parties.

The project will aim to demonstrate the value for patients who are treated with immunotherapy for cancer, primarily checkpoint inhibitors, in reducing the variation of education and support across different cancer types. This will be achieved through consistent education of staff involved in managing patients on treatment and support within a dedicated immuno-oncology service.

The goal is for long term funding to be achieved after the project and to collate detailed information on the setup and running of the service that will enable other trusts nationwide to implement a similar model of care.

Background

UCLH had recently conducted a clinical audit of 62 patients that received checkpoint inhibitors (CPI) and identified a variation in the education and management of patients receiving such treatments.  The current use of CPI was 123 patients per month across 5 different cancer types and they expect this to increase with both indications and new tumour groups and there is a need for patients to be educated by a trained individual in immunotherapy.  This education needs to be individualised for patients that are diverse in their cancer type, intent of treatment and their prior treatment history.  This will reduce the variation in support that patients receive whilst on checkpoint inhibitors. This project will aim to drive consistency of support across different cancers for patients treated with immune-oncology agents.

Project Approach

To successfully initiate an immuno-oncology service (primarily for checkpoint inhibitors), and to share the learns with peers and the wider NHS.  The nurse once recruited will be involved in:

• Management of the Immuno-oncology Service, including participation in clinic, meetings and follow up.
• Supporting the patient’s journey when on immune-oncology treatment; specifically check-point inhibitors.
• Educating patients on their treatment, developing and providing patient information for a diverse population.
• Offering Adverse Event (AE) management support including advising treating clinicians on an individualised basis.
• Education of staff – such as nurses, pharmacists and oncologists on specific patient needs.
• Co-ordination of care, supporting the patients, managing investigations and appointments.
• Support innovation and improving services by adopting best practices.
• Ensuring adherence to best practice and local guidelines.

Project Objectives

The service will aim to achieve the following:

• Establishment of a dedicated service to run for 12 Months within the scope of the project, followed by 3 months evaluation.
• All new patients will have access to the educational element of the service including those that are changing therapy to an immunotherapy.
• Patients experiencing toxicities on current immunotherapy will be flagged to the service and advice given will be tailored to meet the patient’s needs and circumstances. Advice can be given either to the patient directly or via the managing clinician. The aim is that all eligible immunotherapy patients believe they have been adequately educated and given the correct information to be able to identify and report AEs in a timely manner.
• All staff working with patients being treated with immunotherapy feel adequately upskilled to support patients through their journey, measured via questionnaire across nurses, pharmacists and oncologists.
• The impact on bed days, compliance with CPI’s and the treatment rate of CPI’s will be evaluated.
• Patient experience and psychological impact will be measured.
• Funding to be secured by UCLH to continue the service after the project.
• The project will be evaluated, and the results will be published (to be decided on publications).

Benefits

Benefit to Patients

• Patient will have a dedicated service and confidence of their point of contact to manage their treatment and concerns
• Patients will receive consistent education on immunotherapy irrespective of what their cancer type alongside their tumour related education
• Patients will seek appropriate help and advice in a timely manner
• Dedicated service may improve treatment compliance

Benefits to the NHS Partner

• Patients managed within the nurse led service may result in consultants having more available time for complex cases
• There may be a reduction reduction in bed days associated with I/O usage due to the consistent education and support given
• Provide other hospitals with information to support business cases in adopting a similar service
• Addressing patient concerns will continually improve the service for subsequent patients
• Data from the project may be supportive, informative and compelling to lead to wider adoption of such a service therefore reducing variation for patients across the NHS

Benefits to MSD

• NHS Stakeholders may be willing to share experience of working with MSD to support future collaboration to the wider NHS
• Reputational benefit of working with UCLH
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of this project could be that MSD may see appropriate use of their NICE approved medicines.

Funding

This project is a shared contribution between UCLH and MSD UK Ltd. The total project cost is £70,000

GB-NON-06876 | Date of Preparation January 2023

Project Title

University Hospitals Plymouth Chemo capacity and treatment delivery Pathway Development Project (PDP)

Organisations involved

MSD

University Hospitals Plymouth NHS Trust

Summary

There is an opportunity in Plymouth, Devon to optimise the Cancer treatment and prescription pathway to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  Treatment pathway  and achievement of the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 28/11/2022 and anticipates a finish date on 25/09/2023

Project Objectives

The primary objective of this project is the optimisation of treatment and prescription  pathways across Plymouth, Devon. Specifically contributing towards; –

• An optimised treatment and prescription pathway
• Achievement of the 31-day treatment target and 62 day Cancer Waiting Time targets

Project Approach

•  Pathway mapping of each treatment and prescription service in Plymouth, Devon and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing cancer patients in Plymouth Devon
• Implementation of an optimised pathway for each site managing cancer patients across Plymouth
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the Treatment and prescription pathway in Plymouth, Devon.
• Quicker diagnosis and treatment of cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in  Treatment and prescription across Plymouth, Devon  hospital sites resulting in

• Achievement of the  31-day treatment target and 62 day  Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of cancer patients
• Increase in treatment rates for cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £31,155; MSD contribution = £17,380 NHS Contribution = £ 13,775

Job Code GB-NON-06898. Date of Preparation – January 2023

Project Title

Oxford Cancer Treatment and Prescription Screening Pathway Development Project (PDP)

Organisations involved

MSD

Oxford University Hospital NHS Foundation Trust

Summary

There is an opportunity in Oxfordshire to optimise the cancer treatment and prescription screening pathway   to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  treatment pathway  and achievement of the  31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 21/11/2022 and anticipates a finish date on 25/09/2023

Project Objectives

The primary objective of this project is the optimisation of treatment and prescription screening pathways across Oxfordshire. Specifically contributing towards; –

• An optimised treatment and prescription screening pathway
• Achievement of the 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets

Project Approach

Pathway mapping of each cancer treatment and prescription screening service in Oxfordshire  and creation of Lucid charts depicting the current pathway

• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing cancer patients in Oxfordshire
• Implementation of an optimised pathway for each site managing cancer patients across Oxfordshire
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the cancer treatment pathway in Oxfordshire.
• Quicker diagnosis and treatment of cancer and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in all cancers across Oxfordshire  hospital sites resulting in

• Achievement of the cancer 31-day treatment target and 62-day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of cancer patients
• Increase in treatment rates for cancer
• Optimisation of service delivery

MSD Benefits

• Better understanding of cancer patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £29,597; MSD contribution = £17,380; NHS Contribution = £12,217

Job Code GB-NON-06834. Date of Preparation – December 2022

Project Title

South Yorkshire & Bassetlaw Cancer Alliance Pan Tumour Pathology Pathway Development Project (PDP)

Organisations involved

MSD

Sheffield Teaching Hospital NHS Foundation Trust, Barnsley Hospital Foundation Trust, The Rotherham NHS Foundation Trust, Doncaster and Bassetlaw Teaching Hospital Foundation Trust and Chesterfield Royal Hospital Foundation Trust

Summary

There is an opportunity in the South Yorkshire &Bassetlaw and Chesterfield area to optimise the  pan tumour pathology testing  pathway   to improve the service quality, service efficiency, productivity and patient experience. The desired outcome of this project is an improved  pan tumour pathology pathway  and achievement of the  relevant targets associated with, head and neck/upper GI/skin/breast/lung/gynaecological cancers,   28 day Faster Diagnostic Standard and the 31 and 62 day Cancer Waiting Time Targets. The project intends to begin on 1^st October 2022 and anticipates a finish date on 30^th September 2023

Project Objectives

The primary objective of this project is the optimisation of pan tumour pathologypathways across South Yorkshire & Bassetlaw and Chesterfield. Specifically contributing towards; –

• An optimised pan tumour pathology pathway
• Achievement of the head and neck/upper GI/skin/breast/lung/gynaecological cancers 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment) Cancer Waiting Time targets

Project Approach

• Pathway mapping of each pathology service in South Yorkshire & Bassetlaw and Chesterfield  and creation of Lucid charts depicting the current pathway
• Gap analysis contributing towards co-creation of service re-design plans from gap analysis outputs for each site managing head and neck/upper GI/skin/breast/lung/gynaecological cancers patients in South Yorkshire & Bassetlaw and Chesterfield
• Implementation of an optimised pathway for each site managing head and neck/upper GI/skin/breast/lung/gynaecological cancers patients across South Yorkshire & Bassetlaw and Chesterfield
• Both parties commit to measuring the outcomes of the project and disseminating these outcomes within 6 months of the project completion

Benefits

Patient Benefits

• An improved patient experience of the head and neck/upper GI/skin/breast/lung/gynaecological cancers pathway in South Yorkshire & Bassetlaw and Chesterfield.
• Quicker diagnosis and treatment of head and neck/upper GI/skin/breast/lung/gynaecological cancers and hence improving the chance of successful treatment

NHS Benefits

An optimised pathway in head and neck/upper GI/skin/breast/lung/gynaecological cancers across South Yorkshire & Bassetlaw and Chesterfield hospital sites resulting in

• Achievement of the head and neck/upper GI/skin/breast/lung/gynaecological cancers 28 day Faster Diagnostic Standard, 31-day treatment target and 62 day referral to treatment Cancer Waiting Time targets
• Earlier referral, diagnosis and treatment of head and neck/upper GI/skin/breast/lung/gynaecological cancers patients
• Increase in treatment rates for head and neck/upper GI/skin/breast/lung/gynaecological cancers
• Optimisation of service delivery

MSD Benefits

• Better understanding of head and neck/upper GI/skin/breast/lung/gynaecological cancers patient needs
• Enhanced reputation of MSD through partnership work
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of an improved pathway may be that MSD see more appropriate usage of their NICE/SMC approved medicines

Funding

Total Project = £36,278.87; MSD contribution = £19,900; NHS Contribution = £ 16,378.87

Job Code GB-NON-06488. Date of Preparation – September 2022

Project Title

GM Cancer Alliance – MDT Reform Implementation project

Organisations involved

GM Cancer Alliance

MSD UK Ltd

Summary

The project will provide project management support for a maximum of 6 months to support the implementation of the Greater Manchester (GM) Multi-Disciplinary Team (MDT) standards across Greater Manchester, but with a stronger focus on the NCA (Northern Care Alliance) which has the larger number of trusts, and to implement these standards into the annual quality assurance process. The standards have been developed by GM Cancer Alliance, as part of an eighteen-month MDT Reform project which ended March 2022. The project aimed to drive forward National recommendations and guidance for GM and East Cheshire (EC) cancer MDTs to deliver an improved process, ensuring streamlined processes and standards of care pathways are developed and implemented to make the best use of clinical time and resources and thus improve effectiveness.

Additionally, an MDT toolkit will be developed, to be utilised by MDTs to share best practice and advice on how best to achieve the GM MDT standards. The toolkit will include examples linked to the following improvements that have been identified throughout the project and which will form part of the GM MDT standards: Standardised referral forms, streamlining patients for discussion and outlining pre-triage meetings

As a result of this project, patients may benefit from an accelerated review through the MDT or outside an MDT, using pre-agreed protocols for those less urgent or severe cases, and as a result, treatment decisions are likely to be made earlier than in current practice, thus facilitating accelerated treatment timelines, less anxiety for patients waiting for this decision, and potentially patients deemed as fit for additional treatment giving patients more options.

Outcomes of the collaborative working project will be published within six months of project completion.

Background

MDTs were introduced in the late 1990s and early 2000s in the NHS with the purpose to increase evidence-based practice and prevent implementation of treatments outside of accepted standards. MDTs are considered the gold standard for cancer patient management and mandated by the National Cancer Plan in 2000; with the pledge that all patients with cancer have their care reviewed by an MDT. However, the health services have changed significantly since their introduction and MDTs have come under increasing pressure due to:

• Significant increases in caseload
• A change in case-mix including patients with greater comorbidities as a result of an ageing population and increasing number of complex treatment options
• Increase in numbers and/or complexity of cases to be discussed has not been matched by any increase in time set aside for the MDT
• Some MDT meetings are sometimes poorly attended by individuals, others by speciality expertise, and there are issues relating to consistent, reliable information technology, data collection and infrastructure such as videoconferencing

Following completion of the MDT reform project, and launch of the regional standards in March 2022, GM Cancer Alliance require project management resource to support the implementation of the GM MDT standards, and to implement these standards into the Trusts annual quality assurance process.

Project Approach

To provide project management for a period of six months to support in the implementation of the GM MDT standards into the Trusts annual quality assurance process. This will involve a project manager from MSD working with GM Cancer Alliance and the local Trusts to create a toolkit and implement the required standard including GMs own Patient Impact Statement.

Data generated by the project will be controlled and processed by NHS only. Only anonymised and aggregated data will be made available to MSD for the purpose of the reporting of the evaluation progress and release of milestone reports.

Project Objectives

• Creation of a Toolkit to instruct, support and inform Trusts wishing to streamline their own MDTs
• Process in place to ensure Pre-MDT triage meeting occurs
• Each MDT to utilise the GM Patient Impact Statement resource to ensure the patient voice is factored into MDT discussions and decision making
• Each MDT to have established clear lines of responsibility to inform patients of MDT decision
• Implementation of GM Cancer patient resources to support patient understanding of MDT process and their cancer journey
• GM MDT standards to be included into Trusts annual quality assurance process

Benefits

 Funding

 MSD Contribution – £19,350; NHS Contribution – £10,755; Total Project – £30,105

Job Code GB-NON-06306  Date Of Prep – August 2022

Project Title

Ovarian Cancer Maintenance Therapy clinic

Organisations involved

MSD (UK) Ltd and The Christie NHS Foundation Trust

Summary

The project will be an eighteen-month pilot of a “one stop shop” dedicated Ovarian Cancer Maintenance Therapy (OCMT) Clinic at The Christie, with a proposed start date of February 2022.  The service would be nurse led, supported by a pharmacist and with clinical expertise provided by an oncology consultant. The proposed pilot will provide a dedicated ovarian cancer maintenance therapy clinic which will concentrate clinical expertise in this specific group.

Background

The Christie manages patients from across Greater Manchester, with a population of 2.8 million ⁽¹⁾, which is the largest cancer network in the UK. It also provides second opinions for patients nationally and additionally, there is a private patient service available through HCA Christie. The Christie treats ovarian cancer patients from across Greater Manchester and currently patients on ovarian cancer maintenance therapies are managed in the medic-led outpatient clinic together with patients on active chemotherapy regimens. The numbers of patients requiring this treatment are growing and there is a backlog of patients due to the Covid pandemic ^(1). The clinic will aim to manage these patients within a dedicated service, alleviating the backlog of patients.

Project Approach

The project aims to enable The Christie NHS Foundation Trust to successfully set up and implement a “one stop shop” dedicated ovarian cancer maintenance therapy clinic, and to share lessons with peers and the wider NHS. The service would be nurse led, supported by a pharmacist and with clinical expertise provided by the oncology consultant. There will be a mix of virtual and face to face appointments, and treatment to be offered at home where appropriate. Additionally, the clinic will aid COVID recovery plans, by alleviating the back-log of patients due to the additional nurse time provided within the 5 weekly sessions in the clinic.

Project Objectives

•  The clinic will aim to treat 90% of eligible patients with ovarian cancer by the end of the pilot
• The Christie will capture and collate the data, and results will be reviewed, with success measured via patient experience
• Help improve patient experience through patients having a designated time for their appointment
• Aid COVID recovery plans through the additional nurse time provided by the clinic to support patient awaiting treatment
• Funding to be secured to continue the clinic post pilot

Benefits

Patients:

• Dedicated service and point of contact to manage their treatment

• Addressing patient concerns will continuously improve and develop the service for subsequent patients
• Patient experience data may prove sufficiently compelling to lead to wider adoption of the service in other Trusts and reduce variation across the NHS
• Dedicated service may improve treatment options, compliance and experience for patients

NHS

• Patients managed within a nurse led OCMT clinic may result in consultants having more time available to deal with complex cases
• Continuously improve the service (e.g. highlighting areas of need or dissatisfaction)

• Provide other hospitals and services evidence to form business cases to adopt a similar service

• Dedicated clinic to providing additional nurse time will aid with reducing post COVID backlog

MSD

• Lead consultant may be willing to share experience of working with MSD to support future partnerships with the wider NHS
• Reputational benefit from partnering with The Christie
• As a pharmaceutical manufacturer of oncology medicines, an indirect result of the ovarian cancer maintenance therapy clinic project is that MSD may see more appropriate use of their NICE approved medicines

Funding

From MSD (or budget to be covered by MSD):

• MSD £45,150 (based on Band 8 nurse (c£60k salary) 0.5 WTE. 5 sessions per week (3 patient facing, 1 MDT, 1 admin)
• To be phased in over 2 years:
  • 2022 £30,150
  • 2023 £15,000
• Project management- £6,000 (1 day per month)

From the NHS:

• NHS Pharmacist – £45,000 (salary c£60k)
• Consultant expertise – £6,980 (salary c£98k) (0.5 days per week)

Total MSD £51,150

Total NHS £51,980

Total project= £103,130

GB-NON-05464  |  Date of Preparation January 2022

References:

• Dr Jurjees Hasan, Consultant in Medical Oncology, The Christie NHS FT

Project Title

SIMP-L

Social Isolation Management Programme – Lothian

Organisations involved

NHS Lothian and MSD

Summary

NHS Lothian are working with MSD to develop and support two community link worker roles focused on working with the socially isolated elderly in the south west of Edinburgh with the primary aims of improving patients’ quality of life and improving primary care capacity. In light of the Covid-19 pandemic the Community Link Workers will use their knowledge and experience to act as virtual liaison between the socially isolated elderly and the health, social care and third sector.

Background

Social isolation has detrimental effects on health, having been identified as a risk factor for all-cause morbidity and mortality with outcomes comparable to smoking, obesity and high blood pressure.

The socially isolated elderly are especially at risk with significant increases in the rates of CVD and diabetes, poorer cancer survival rates and decreased resistance to infection.

The socially isolated elderly are also the significant users of GP and practice nurse appointments, with a Royal College of General Practitioners survey finding that 75% of GPs see between one and five people a day who have come in mainly because they are lonely.¹

The Scottish Government has recognised the impact on health and service capacity that social isolation can cause and recently implemented a national consultation in this area and there have been several studies looking at ways in which to tackle this issue.

In studies link worker models have been shown to have significant benefits to both patients and primary care capacity as well as positive financial outcomes for the local health economy.

Project Objectives

The project proposal involves working with NHS Lothian and the Edinburgh Health and Social Care Partnership (EHSCP) to develop and support two community link worker roles focused on working with the socially isolated elderly in the south west of Edinburgh.

The project is a pilot run for 27 months now that an evaluation of the original 15 month project signalled positive outcomes for patients and the NHS in Scotland. If successful, the model will be evaluated and may well be of interest to other health economies across Scotland.

The Link Workers would focus on socially isolated over 65’s (over 55’s in steering group approved practices) with objectives of:

• Working to prevent social isolation in at risk patients
• Improving the health/quality of life of the socially isolated
• Building community capacity so that there is a robust infrastructure to support the socially isolated
• Upskilling primary care healthcare teams to help identify socially isolated patients and signpost those patients to the appropriate support
• Reduce workload for GPs/PNs so that they can focus on healthcare management rather than dealing with social issues

Benefits

Benefit to Patients

• Aim to be less socially isolated/lonely
• Possible improved health/quality of life
• Possible prevention of illness
• Aim for an improved management of chronic illnesses
• Aim for an improved service provision allowing patients to access healthcare more easily

Benefits to NHS Lothian

The project will aim to help to meet a number of the priorities from the Edinburgh Health and Social Care Strategic Plan 2016 – 2022 including:

• Tackling inequalities
• Prevention and early intervention in disease management
• Ensuring a sustainable model of primary care
• Improving care and support for frail older people
• Improving outcomes for people living with long-term and multiple conditions
• Improving the understanding of the strengths and needs of the local population
• Living within our means

As well as potentially:

• Improving GP/PN capacity
• Reducing A&E admissions/delayed discharges
• There may be a reduction in drug spend (antidepressants, pain medications) although may not be directly attributed to the project
• Improving community capacity
• Improving service provision over the South West Locality

Benefits to MSD

• Support and reinforce MSD’s aim to be the healthcare company of choice in Scotland
• Indirectly benefit MSD as a result of potential improvements in capacity and service design, meaning more patients may be identified and they may go on to be prescribed an MSD product where deemed clinically appropriate
• Opportunity to engage as a partner with NHS Lothian rather than just a supplier of medicines
• Reputational benefits would be immediate and long lasting and the financial benefits would start to develop as more patients had access to primary care services

Funding

The project is being funded with equal allocation of resources to the project from NHS Lothian and MSD.

References

1. RCGP calls for social prescriber in every practice to tackle ‘epidemic of loneliness’ http://www.pulsetoday.co.uk/news/commissioning/commissioning-topics/prescribing/rcgpcalls- for-social-prescriber-in-every-practice-to-tackle-epidemic-ofloneliness/ 20036746.article Last accessed [December 19, 2018]

Date of Preparation: Aug 2022 | GB-NON-06279

Project Title

Diabetes Informatics Project – NHS Warrington CCG

Organisations involved

NHS Warrington CCG and MSD

Summary

NHS Warrington CCG will work with MSD to improve the quality of their diabetes service by understanding the community’s needs better, working with the community to meet care needs earlier and by looking at new and innovative ways to help them address the challenges set out by the burden of diabetes and to standardise the approach across the practices involved

Background

In March 2018, Warrington CCG embarked on a 2 Year Change Management Programme to increase the number of diabetic patients receiving high quality care in the community and a reduction in the number of un-scheduled admissions to secondary care. Year 1 was supported in part by MSD via a Joint Working Change Management programme called Evidence into Practice. This project aims to build on the improvements observed in Year 1 and embed a sustainable model that will enable continued improvement and proactive care of diabetic patients in the community setting.

Project Approach

• Diabetes Dashboard will provide all 26 practices with their baseline diabetes performance against project deliverables and will update to reflect changes throughout the year providing practices with a visual way to review their clinical care improvement trajectories.
• MSD will deploy a suite of searches written by a third -party search writing company (VIPC) across all 26 practices in Warrington CCG. VIPC is an Information management and technology solution company that specialise in search writing for General Practice. VIPC will write a suite of searches for the two IT systems used across Warrington CCG; EMIS and TPP. The specific searches will be agreed in collaboration with Warrington CCG’s Clinical lead to ensure an effective transition from the Evidence into Practice suite of searches to the VIPC suite of searches.
  The list of searches will be clinically validated and signed-off by Warrington before implementation in practice and will appear in a format that visually displays the number of Patients the search pertains to and the % of Patients that may/may not benefit from a review. All 26 Practices will download the VIPC suite of searches application independently following communication from Warrington CCG. VIPC will support any download/functionality queries on a practice by practice basis.
• The DSN’s and Practice team will review the suite of searches to effectively identify and manage their Diabetic Patients in the practice on an ongoing basis.
• Patients identified for Structured Education will be referred into the service as per the local Pathway.
• A project manager will be assigned from MSD and the programme will be facilitated by this project lead.
• The DSNs will provide clinical education during practice visits and review agreed patient groups at practice level.
• Practices will review their Diabetes dashboard every 3 months and provide an anonymised report to the CCG 4 times per year.
• Warrington CCG will evaluate project outcomes and share this with MSD
• Warrington CCG intend to secure funding for VIPC beyond the initial 12-month project as part of its long term sustainably plan.

Project Objectives

• Provide high quality Clinical Care in the community
• More Patients achieving all 3 NICE prescribed clinical targets
• More Patients receiving all 8 Care processes
• Deploy a suite of searches written by a 3^rd-party search writing company across all 26 Practices
• Raise awareness of performance in diabetes care at practice level
• Practices to adopt a more proactive approach to diabetes management.
• Reduction in diabetic un-scheduled admissions
• Adherence to Warrington CCG local pathway and National Diabetes guidelines
• More Patients attending the Structured education programme to improve patient engagement and self-care.

Benefits

Benefits to patients

• Treatment closer to home
• In the long-term a proactive approach aims to support a reduction in diabetes related complications, hospital admissions and improved life expectancy.
• People with diabetes feel better supported by having a greater understanding of their condition and treatment options available to them – Warrington CCG to measure through Patient feedback survey.

Benefits to the NHS partner

• Service delivered closer to home contributing to Warrington CCG’s aims.
• HCP’s delivering diabetes care can provide the best support and care in the community.
• In the long-term a proactive approach will support a reduction in diabetes related complications, improved adherence to care plans through self-management and reduced complications and hospital admissions

Benefits to MSD

• Demonstrate MSD as trusted partner through deployment of skills & resources to support higher quality care for Diabetic patients.
• Improved relationship with Warrington CCG.
• Data – 6 months/12-month evaluation shared with MSD
• Data – Outputs of the 2-year programme to be shared with MSD
• Opportunity for MSD Medicines – may benefit MSD indirectly from changes in Clinical behaviour as National and local guidelines are implemented.

Funding

This project involves pooling of skills and resources between the NHS and MSD over 12 months.

NHS Contribution; £31,410. MSD Contribution; £13,200. Total project cost £44,610

Date of Preparation: January 2022 | GB-NON-05450

Project Title

Over 65s Vaccination GP Cluster Project

Organisations involved

MSD and Afan GP Cluster, Swansea Bay University Health Board

Summary

The objective of the project is to increase access to the National Immunisation Programmes (NIP) applicable to the over 65 age cohort. This will be achieved through collaborating with General Practices in the Afan Cluster to increase the uptake of Flu, Shingles and Pneumococcal vaccinations in line with the respective NIP within eligible cohorts of patients across the cluster.

Background

Currently vaccination rates for shingles, pneumococcal disease and also flu are low across Wales. The creation of GP clusters across Wales was designed to allow GP surgeries to work together to achieve shared targets across patient care. Due to the resourcing issues and stretched services GP clusters have not been able to provide this cluster approach and demonstrate their potential within vaccination services.

Project Approach

This project aims to pilot the use of GP clusters to enhance vaccination services and patient uptake of these services. It is proposed that the increase in vaccination uptake will provide enough revenue through vaccination administration payments to allow this project approach to become sustainable and replicable in other geographical areas.

A partnership between MSD and the Afan cluster will enable collaboration around improving care, eligible patients will receive an increased access to vaccinations in line with Public Health Wales and the National Immunisation Programme (NIP). A remote triaging service and subsequent vaccine administration will be provided by one of the surgeries situated within the cluster (Rosedale Medical Practice) who operate some other cluster services under the name – GP Hub. This will be a 6 month service addressing 3 areas of vaccinations in the over 65 year olds. The project would focus on over 65s who are eligible to receive all 3 vaccinations thereby maximising the impact that the approach will have.

Project Objectives

The objective of this project is to increase vaccination rates amongst eligible patients for the three National Immunisation Programmes within scope.

Benefits

Patients

• An increased number of patients will receive access to vaccinations in line with Public Health Wales and the NIP
• Reduce the risk of associated complications of shingles, pneumonia and Flu

NHS

• The benefits to the GP practices will be that the respective uptake of vaccinations within their service will increase
• Reducing the incidence of associated disease within the NIP and the cost utilization to the NHS
• Increasing focus on over-burdened services such as long term conditions clinics as resource will not be pulling from existing services e.g. Diabetes- COPD
• Sustainability post MSD Exit from project – business plan with economic service benefits to take to Public Health Wales

MSD

• As a vaccines manufacturer MSD may see an increase in the uptake of certain vaccinations that they produce in line with Public Health Wales policy and the NIP
• There is an additional reputational benefit to be gained through working in collaboration with the NHS to improve outcomes for patients

Funding

The total project budget is £36,702.40. This is made up from a contribution of £21,550 by MSD and a contribution of £15,152.4 by the Afan cluster group (Swansea Bay University Health Board).

Date of Preparation: January 2022 | GB-PNX-00164

Project Title

Cardiff and Vale University Health Board Diabetes Informatics Programme

Organisations involved

MSD and Cardiff and Vale University Health Board

Summary

Cardiff and Vale University Health Board will work with MSD to improve the quality of their diabetes service by understanding the community’s needs better, working with the community to meet care needs earlier and by looking at new and innovative ways to help them address the challenges set out by the burden of diabetes and to standardise the approach across the practices involved.

Background

General Practice and secondary care diabetes services within Cardiff and Vale University Health Board are working collaboratively to provide coordinated, high quality clinical care, in the community, offers a positive patient experience and improves patient outcomes.

Across Wales and Cardiff and Vale UHB, there is a variation in the percentage of people with diabetes receiving the 8 care processes and achieving the NICE 3 treatment targets.

Project Approach

• Diabetes Dashboard will provide all 62 practices with their baseline diabetes performance against project deliverables and will update to reflect changes throughout the year.
• All 62 Practices will review the Diabetes Dashboard with their community diabetologist or DSN in an ongoing basis to discuss progress against the specific deliverables.
• MSD will deploy a suite of searches written by a third -party search writing company (VIPC) across all 62 Practices in Cardiff and Vale UHB. VIPC is an information management and technology solution company that specialise in search writing for General Practice. VIPC will write a suite of searches for the two IT systems across Cardiff and Vale UHB; EMIS and VISION. The specific searches will be constructed in collaboration between clinical leads within Cardiff and Vale UHB and ViPC to ensure an effective transition from the Evidence into Practice suite of searches to the VIPC suite of searches.
• The list of searches will appear in a format that visually displays the number of patients the search pertains to and the % of patients that may/may not benefit from a review.
• All 62 Practices will download the VIPC suite of searches application independently following communication from lead clinicians within Cardiff and Vale UHB. The searches will be clinically validated and signed-off by Cardiff before implementation in practice. VIPC will support any download/functionality queries on a practice by practice basis.
• The community consultants, DSN’s and practice teams will review the suite of searches to effectively identify and manage their diabetic patients in the practice on an ongoing basis.
• Patients identified for structured education will be referred into the service as per local Pathway.
• A project manager will be assigned from MSD and the programme will be facilitated by this project lead.
• The community consultants and DSN’s will support clinical education during practice visits and review agreed patients groups at practice level.
• Cardiff and Vale UHB will evaluate project outcomes using National Diabetes Audit data and share this with MSD.

Project Objectives

• Standardise and harmonise ways of working by implementing NICE NG28
• More cost-effective care: Cost effective prescribing, fewer admissions with diabetes complications, reduction in referrals to diabetes services.
• Greater patient access based on need.
• Workforce transformation and stability.

Benefits

Benefit to Patient – Patients feel better supported to manage their condition by having a greater understanding of their condition and the treatment options available to them which supports self-management leading to improved management and a better quality of life.

Benefit to NHS – People delivering diabetes care are able to provide the best support and care possible for people with diabetes by implementing NG28 which will lead to improved patient management and a reduction in the cost burden of managing diabetes. This will support an improved quality of care; a reduction in diabetes related complications and improved self-management.

Benefit to MSD – Supporting Cardiff and Vale University Health Board to improve outcomes for diabetic patients will demonstrate MSD as a trusted partner through deployment of skills and resources to support and facilitate higher quality care for all appropriate patients. The collaboration may benefit MSD indirectly from changes in clinical behaviour as National Diabetes guidelines (NG28) is implemented locally.

Funding

The total project budget is £45,700.00. This is made up from a contribution of £13,200 by MSD and a contribution of £32,500 by Cardiff and Vale University Health Board.

Date of Preparation: January 2022 | GB-NON-05449

Project Title

Derbyshire pharmacy testing initiative for hepatitis C and HIV.

Organisations involved

MSD UK, Derbyshire LPC and Derbyshire County Council Public Health.

Summary

Aims: To determine if testing for hepatitis C and HIV in pharmacies delivering needle exchange and/or supervised consumption services can reduce the impact of on-wards transmission of hepatitis C and HIV and reduce the reinfection. This will be done by identifying infection hot spots and potential treatment networks to facilitate access to diagnosis and ensure transition into treatment for this vulnerable mobile population.

Methodology:
The results will be measured by the pharmacists and a report of the results shared with ODN’s, public health, LPC, commissioners and other interested stakeholders both locally and nationally.
The following will be measured and assessed: 1.) Pharmacist engagement and total number of tests undertaken; 2). No. of patients tested and counselled; 3.) No. and % of positive diagnoses; 4). % of patients referred into care; 5.) % of positive patients successfully following treatment pathway

Timing:
1.) Kick-off meeting (15/01/18); 2.) Pharmacists training meetings (Apr 2018); 3.) Pharmacy testing of hepatitis C and HIV (July – Nov 2018) and with phase 2 testing ( Mar- May 2019) ; 4.) Interim project results (Jul 2019); 5.) Data assessed and shared (PHE Registrar) by Sept 2019; 6.) Monthly project Review Meetings; 7.) Project outcomes and results communicated (Sep 2019)

Outcomes Expected:
1.) Increased engagement of both patients and pharmacists; 2.) Increase in referrals, diagnosis and treatment; 3.) Improved patient outcomes and reduce reinfection rate; 4.) Positive patient experience; 5.) Increased engagement between all stakeholders; 6.) CCGs to fund service longer term

Background

75% of needle exchanges are in pharmacies rather than within drug and alcohol treatment services. This is therefore an environment where current drug users are likely to attend and can be offered hepatitis C and HIV testing. Currently there is little or no hepatitis C or HIV testing undertaken at this first and regular point of contact. The project will also provide onward referral to assessment and treatment for patients who inject drugs (PWIDs) and especially people currently using drugs have found services difficult to access.

Project Approach

This is a Proof of Concept project that will support Derbyshire Public Health in the development of their strategy moving forward with regard to the sustainability of community based services. If successful, there is also the opportunity to recruit additional pharmacies to deliver the testing service outside of the pilot pharmacies subject to funding being made available via NHS or Public health. The evidence from this project will be shared to support other CCGs to obtain longer term financial commitment to fund the service. The project also intends to lead to an increase in engagement of patients and an increase of referrals. This in turn should lead to more diagnoses and an increase in treatment by identifying more patients requiring treatment.

Project Objectives

Patients: 1.) To receive point of contact testing in community pharmacies that offer needle exchange/ supervised consumption. 2.) For a positive screening test to have referral into appropriate treatment pathway.

NHS / LPC / Public Health: 1.) Identify barriers in the pathway of testing in the needle exchange, to accessing assessment and treatment through the Operational Deliver Network (ODN) Multi-Disciplinary Team (MDT). 2.) Provide information to the CCGs and Public Health regarding the services to support funding requirements. 3.) To provide a health economic guide for CCG’s local population.

MSD: 1.) Partner with the ODNs / secondary care regionally to identify novel pathways for both identification of the viral burden and developing strategies to best target resources. 2.) Determine if the model of treating drug user networks could be applied to the wider Derbyshire population and reduce transmission as indicated by research in Scotland.

Benefits

Patients: 1.) Provision of quick and easy access to testing and a clear pathway into assessment and treatment in specialist care. 2.) Increased engagement in testing service. 3.) Improved outcomes.

NHS : LPC and Public Health:1.) Provide information to the CCG’s and public health regarding the services they will be required to fund for longer term sustainability. 2.) Optimise the patient pathway to reduce the barriers of testing in the needle exchange and accessing assessment and treatment through the Operational Deliver Network (ODN) Multi-Disciplinary Team (MDT) Secondary care. 3.) The findings will inform ODN’s regionally and nationally, providing a template for effective case finding and onward referral and treatment.

MSD: 1.) MSD is currently a supplier of NHSE approved HCV and HIV medications and patients may have access to these treatments, however there will be no preferential arrangement in place over other available treatments. 2.) The project will provide a seat at the table for population health initiatives in HCV and allow MSD to strengthen relationships with PHE, NHSE, ODNs, the local authorities involved as well as patient group stakeholders. 3.) From a policy perspective, it will provide an evidence based proof of concept to support our thinking around the sustainability of HCV / HIV services.

Funding

Derbyshire LPC and Public Health are supporting the training of pharmacists, the delivery of the testing service, client testing fee and data capture including final write up for publication at a cost of £11,330. MSD are funding £10,479,72 which includes testing kits, screening analysis, clinical waste management and project management support. Following the completion of the project £5,719.09 was returned to MSD as unused funds.

Date of Preparation: March 2021 | GB-NON-04270