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Following the publication of the NHS Five Year Forward View and the Independent Cancer Taskforce’s Cancer Strategy, there has been a greater focus on and scrutiny of cancer services.

We welcome this increased focus. Cancer survival rates in Bradford have been increasing year on year, however, we recognise that there is still work to be done to make sure our local rates are better than national survival rates.

Our work addresses specific areas cited in the NHS England Five Year Forward View - prevention, early diagnosis, research and innovation. We are looking at these areas to achieve better outcomes for our local population.  

We are working with providers of cancer services that we commission to assess current provision. We are also working closely with the public health team at Bradford Metropolitan District Council to make sure that our local population are cancer aware, especially around how the disease can be prevented. Our work does not cover the commissioning of specialised cancer services which are managed through NHS England

How are we doing?

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Diagnosis at an early stage

Diagnosing cancer at an early stage (known as stage one or stage two) is associated with higher rates of survival than cancer diagnosed at a later stage of development.

There are a number of measures already in place to improve the rates of early cancer diagnosis, including;

  • screening programmes,
  • information and education campaigns,
  • greater access for GPs to diagnostic services.

Improving cancer survival is one of the three ambitions of the Achieving world-class cancer outcomes: a strategy for England 2015-20, which was published by the Independent Cancer Taskforce in July 2015.

During 2013/14:

  • the national average for diagnosis of malignant cancer at an early stage was 48%
  • in our CCG, the proportion of malignant cancer diagnoses at an early stage is was 51%
  • this means we are above the national average for early cancer diagnosis. 

See what we are doing to improve diagnosis of cancer at an early stage and how you can help in the early diagnosis of cancer.

Waiting times

In 2014/15 we agreed a local pathway for patients which resulted in better sharing of information. This allows joint working with local providers to address any issues arising from each breach of the waiting times standard. 

Across West Yorkshire, providers of cancer services developed individual action plans. These detail the way that provider trusts will systematically deliver on the cancer access standards. There was also increased focus on a few individual pathways which caused the majority of pressures. The aim was to identify any areas within the patient pathway that could be streamlined, therefore enabling patients to flow more quickly through their journey. 

To support the timely transfer of patients between local hospital providers and specialist cancer services, Bradford Teaching Hospitals NHS Foundation Trust agreed to an additional local quality requirement - "all patients with diagnosed cancer to be referred to specialist cancer provider within 38 days”, for 85% of patients.

During 2015/16:

  • Bradford Teaching Hospitals NHS Foundation Trust:
    • 411 patients needed onward referred to specialist cancer providers,
    • 272 of these patients were referred on within 38 days,
    • this is equal to 66.2%.
  • NHS Bradford Districts CCG:
    • GPs made 11,147 urgent referrals, where cancer was suspected,
    • 95.6% of these were seen within two weeks of urgent referral.

62 day standard

This standard measures the proportion of people with an urgent GP referral for suspected cancer who began their first definitive treatment within 62 days of the urgent referral. 

Shorter waiting times for cancer patients can;

  • help ease patient anxiety,
  • lead to earlier diagnosis,
  • mean quicker treatment,
  • reduce the risk of complications,
  • contribute towards an enhanced patient experience,
  • improve cancer outcomes.

The cancer 62 day standard is one of the NHS Constitutional standards for waiting times. It aims to span the whole patient pathway, from referral to first treatment. The 62 days covers the time from urgent GP referral, to the first outpatient appointment, decision to treat and finally the first definitive treatment.

For 2015/16:

  • the national average for the 62 day standard is 85%
  • in our CCG 87.4% of patients started treatment within 62 days of GP referral for suspected cancer,
  • this is an increase from 85.5% in 2014/15,
  • we achieve better than the national average.

One year survival from all cancers

This measure looks at the one year survival rate of all adults between the ages of 15 and 99 who have been diagnosed with a first primary, invasive malignancy. 

If comparing the rates of cancer survival with other countries, there have been improvements in all countries for breast, colorectal, lung and ovarian cancer patients. However, the gap in survival between the highest performing countries (which includes Australia, Canada and Sweden) and the lowest performing countries (which includes England) has remained largely unchanged (with the exception of breast cancer where England are narrowing the gap).

Improving cancer survival is one of the three ambitions of Achieving world-class cancer outcomes: a strategy for England 2015-20, published by the Independent Cancer Taskforce in July 2015. 

In 2013: 

  • in our CCG, the one year cancer survival rate was 70.5%,
  • this again demonstrates a continuous improvement on previous years,
  • our ten-year cancer survival rate shows that we are performing well and have made improvements year-on-year:

10 year cancer survival - BD

You can read more about our plans and how they aim to continue to improve the one year survival from all cancers. 

Patient experience

To measure patient experience of cancer care, patients are asked to repsond to the following question - "overall, how would you rate your care?”

Improving patient experience of cancer care, treatment and quality of life, is one the of the three key ambitions set out in the Achieving world-class cancer outcomes: a strategy for England 2015-2020 report.

Patient experience survey

Bradford Teaching Hospitals NHS Foundation Trust: 

  • 88% of patients rated their care as “excellent” or “very good”
  • this is in comparison to the national average of 89%
  • in 2013, the percentage of patients rating their care as excellent or very good was 89%

In our CCG:

  • in 2014, the overall response rating of care was 0.88
  • this is in the second lowest quartile and therefore shows a need for improvement.

See what we are doing to improve your experience of cancer services in Bradford.

What you tell us about cancer services

We make sure that we are listening, engaging and involving patients in the planning and design of their local NHS.

To do this, each programme of work has the infrastructure to engage and collect information from people through:

Cancer service experience

The insight and feedback ensures that we not only collect information but have the means and ability to use it to inform how we commission activity and improve quality. We pull together insight and feedback into what we call Grass Roots. This uses data from our services, individual and public activity to provide us with an understanding of what local patients, carers and stakeholders say about their experience of local NHS services.

For each programme of work, in addition to the above, we tailor engagement to ensure we are reaching people who use the services.

Grass Roots

Grass roots pulls together information reported through NHS Choices, Patient Opinion, Healthwatch, complaints, local groups and direct patient, family and community feedback so that we can understand experiences of local NHS services. This information helps us inform our CCG planning and decision making. 

Cancer grassroots feedback

 

Patient stories

 

 2015/16 - what have we done? 

 

What we are doing in 2016/17

Over the next year, we will be continuing to build on the positive work that we did in 2015/16.

We are focusing specifically on the areas highlighted in the Achieving world class cancer outcomes strategy, 2015-2020, published by the Independent Cancer Taskforce - around catching cancer early and therefore improving survival rates.

How you can help

You, the public, are a key part of making sure that cancer can be caught early and that the survival rate is improved. There are three main things that you can do: 

Attending screening tests - there are three main types of screening tests; cervical screening, breast screening and bowel screening. You are called for these tests at different stages of life, but it is important that you attend when called. Screening tests are vital in helping to spot the signs of cancer early and usually take no longer than 5 minutes. 

Find out more about each screening test and when you can expect to be called.

Living a healthy lifestyle - 40% of cancers could be prevented by making healthy lifestyle choices. Making changes to your lifestyle such as stopping smoking and reducing the amount of alcohol you drink, can make a significant difference to your chances of being diagnosed with cancer.

Find out more about the different lifestyle choices that can have an impact the risk on developing cancer

Giving us your opinion - your opinions and experiences matter. By feeding back to us, you can help us make decisions about the services you receive. We can also make sure that we are designing and buying services that are centered around your needs. 

For more information about how you can give us your opinion, visit our get involved pages. 

What we are going to do

Our challenge is to improve screening rates and increase the life expectancy following a cancer diagnosis. There are a number of areas that, combined with support from patients and the public, we are working on to help achieve this goal:

Engagement workshop - this year we held an engagement workshop with NHS stakeholders, charity partners, the local council, patient representatives and members of the public. Our aim was to discover the barriers that our population face around cancer screening and learn how we can improve by listening to examples of best practice in other areas of the country. 

We have gathered all the feedback from the workshop and are now putting together a plan which will address how to overcome the barriers to cancer screening, improve uptake and increase the proportion of cancers diagnosed at stages one and two (earlier diagnosis). By doing this, we can make a positive difference to survival rates - enabling people with cancer to live longer, and in better health.

What we are doing over the next five years 

Over the next five years we want to improve your care and the quality of services you recieve - we plan to achieve this by developing a system wide model for the delivery of planned care. 

The system wide model will be developed through Healthy Futures - a collaboration between CCGs across West Yorkshire. Healthy Futures is aimed at making sure that you have access to some of the best diagnostic services for cancer which enables earlier diagnosis and treatment.

The system wide model will also form part of our sustainability and transformation plan (STP) which looks at how we can provide sustainable, joined up care, which puts you at the centre. 

Our vision:

Cancer - next five years

Our sustainability and transformation plan will focus on; 

Addressing the whole patient pathway - we are expanding our approach to cancer to include the whole patient pathway. This includes raising awareness, screening, early diagnosis, treatment and recovery. This feeds into our sustainability and transformation plan to deliver patient interventions which go beyond care that is based within a hospital. 

Working more closely with our local partners -  our local partners will cover all aspects of cancer care - including, hospital trusts, community trusts, voluntary and charitable sectors. This close working relationship will mean that we can develop joined-up services.

Raising awareness around cancer prevention - we will be working closely with our public health colleagues at Bradford Metropolitan District Council to raise awareness amongst local people around cancer prevention. This will include encouraging more public engagement with the council-run stop smoking and obesity services and helping you understand how you can reduce your cancer risk.

Closer working with our local GP practices - we have a dedicated primary care team which works closely with local GP practices. Our primary care team will be encouraging our member practices to adopt best practice around screening and cancer care. This will include the use of practice nurse forums and practice visits from colleagues at Cancer Research UK.

Improving your experience by focusing on standards

We want to make further progress in improving how we perform against national cancer standards so that you get the best possible experience. We will be concentrating on the following standards: