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Welcome to the latest update from 
Greater Manchester Cancer Vanguard Innovation

ISSUE 2: MARCH 2017
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Welcome to our latest update
We are committed to updating you regularly on Greater Manchester Cancer Vanguard Innovation, highlighting progress and focusing on key areas of our work.

We very much welcome your comments – our contact details are at the end of this newsletter.
Funding boost for pioneering projects
NHS England has awarded Vanguard Innovation a further £2.3m in funding.

The cash award, for 2017/18, matches the sum we received for the current financial year and will help us continue our innovative work in cancer prevention, early diagnosis, raising standards of care, aftercare, developing cancer intelligence and supporting changes to the way cancer services are commissioned and provided.

Roger Spencer, Chief Executive of The Christie, which is a partner in Vanguard Innovation, said: ‘This is excellent news because it will allow us to build on the rapid progress we’ve made in developing new ways of delivering services.

‘We aim to do things in highly innovative ways and create a blueprint for services that can be reproduced in other parts of the country. The cash award will help us to continue doing that.’


Richard Preece, Executive Lead for Quality, Greater Manchester Health and Social Care Partnership, said: ‘The devolution programme in Greater Manchester has given us the opportunity to do things differently and in a way that genuinely meets the needs of our population.

‘Having control of our own health and social care arrangements has also helped us develop new partnerships which means we can make very best use of our resources.' 
Digital platform for GPs reaches pilot stage
Our digital platform, Gateway-C, which supports GPs in recognising when patients may have cancer, is now being piloted at surgeries in Wigan and south Manchester.

And the early evidence is that Gateway-C is already proving popular with GPs. The platform’s courses feature a series of films that help GPs explore the consequences of 
their decisions in various consultation scenarios. Gateway-C, which will also act as a repository for primary care cancer education resources, was unveiled to an enthusiastic response at our December Showcase event.

Feedback from the pilot, which was held at eight surgeries, has been collected and a full evaluation is expected in spring 2017. Gateway-C will then be promoted more widely across eastern Cheshire and Greater Manchester.

Dr Liam Hosie, GP partner in the Dicconson group practice in Wigan, which took part in the pilot, said: ‘I have spoken to a number of my GP partners who have also completed the learning modules, and they all agree that this has been one of the most useful educational experiences they have had, and there is evidence that the learning has already begun to change practice.

‘Further modules will be added in the future, concentrating on other tumour sites, to help promote the early diagnosis message further.’
Focus on prevention
Our revolutionary scheme is now under way to ultimately recruit 20,000 ‘cancer champions’ in Greater Manchester to support people in leading healthier lives.
 
The project is the centrepiece of our prevention work and is the most ambitious scheme of its kind ever undertaken in Greater Manchester. Cancer champions are individuals from all walks of life whose role is to spread key health messages and galvanise people into taking charge of their own health and wellbeing. They might simply share messages about improving lifestyles with family and friends, or form links with existing groups to find novel ways of promoting cancer prevention. While the cancer champion is not a new phenomenon, our efforts to connect and catalyse existing networks of such individuals on this scale are ground-breaking.

The aim is to create a social movement, a large body of people with shared aims and ideals who can help shift attitudes about healthier lifestyles and tilt the balance towards cancer prevention.

Jane Pilkington, Vanguard Innovation prevention lead and Deputy Director of Population Health at Greater Manchester Health and Social Care Partnership, said the creation of a social movement reflected one of the priorities of the NHS Five Year Forward View. This calls for the health services to work alongside patients and communities – a great untapped resource – and develop approaches that put them at the heart of their health and wellbeing.

 ‘The devolution programme in Greater Manchester has given us an opportunity to forge a new relationship between the people of the region and the services they use,' she said. ‘We want people to become more engaged in their own health and wellbeing. By harnessing the energy of the third sector and ‘citizen power’ we hope to achieve that.

‘This is pioneering work and to some extent we can’t easily predict how the project will develop, but that is the nature of social movements. The key is for the project to grow and grow and develop a momentum of its own.’

The project is spearheaded by Ben Gilchrist, Vanguard Innovation's Social Movement Project Lead, Voluntary Sector North West, and aims to recruit 5,000 champions by the autumn of 2017 and a total of 20,000 by 2019. You can see The Guardian's coverage of the scheme here.

The scheme is supported by a number of further projects, all of which contribute to our prevention work stream.

Social marketing

Firstly, we are conducting a social marketing exercise to help boost the uptake of bowel screening in Greater Manchester.

This work will feed directly into the current joint Cancer Research UK and Public Health England campaign across the North West to increase participation in the bowel screening programme.

Social marketing involves holding in-depth interviews with a large range of people to gain insights into their attitudes, and specifically into the barriers preventing people taking up screening offers.

It can engage with people earlier in their lives and helps shift the emphasis towards prevention and earlier detection of disease. Around 200 interviews have been held and a ‘spoken word campaign’ is in development, using the rich understanding of the Greater Manchester audience to develop key messages appropriate to the identified population typologies. Work is under way to mobilise a cross-societal network of frontline staff, for example cancer champions, who will have conversations with the eligible population to reframe screening so that it is attractive to the audience.

Enhanced screening

The third prevention project is an enhanced screening offer for Greater Manchester residents, designed to improve access to and uptake of the national screening programmes for bowel, breast and cervical cancer.

It focuses on improving the effectiveness of the letters inviting people to screening, identifying and removing the barriers to attending, and engaging with patients to identify ‘always events’, those experiences patients feel should always happen during the screening process.

Lifestyle-based secondary prevention

The fourth prevention project is lifestyle-based secondary prevention and offers support to the growing numbers of people living with and beyond a cancer diagnosis. It has two elements: we aim to improve exercise referral across Greater Manchester for patients by creating a standardised pathway, and we will develop a Greater Manchester digital platform for cancer survivors that gives them access to a network of support, including social media groups and a number of apps.

Our pictures show (top): Social Movement Project Lead Ben Gilchrist, cancer champions Zoe Ashworth and Gilbert Morgan, and Jon Rouse, Chief Officer of Greater Manchester Health and Social Care Partnership, at the project launch at Maggie’s centre in January 2017, while (below) cancer champion Gilbert Morgan takes his healthy lifestyle message to the streets
Helping patients make informed decisions
A pilot scheme is under way for a project aimed at better supporting patients to make informed decisions about cancer treatment.

The Goals of Care Initiative – or GOCI – is a pioneering project that promotes and helps documentation of discussions between patients and clinicians about the patient’s goals of care. Discussions include clear aims and potential outcomes of treatment to ensure the patient is best informed about their options, and conversations regarding the patient’s personal goals and priorities to inform and tailor potential treatment plans.

GOCI is a scheme unique to Greater Manchester and the pilot project has just been launched at The Christie. It will capture documented treatment aims in conjunction with what is important to the patient, in a way that is shared between oncology teams, GPs and patients and can be revisited over time.

Our project team has carried out a great deal of consultation so far and has just completed interviews and focus groups with 45 stakeholders including oncologists, nurses, GPs, patients and carers to canvass opinion. Overall the project has been well received and feedback has been positive. We are now moving to the next stage which involves the development of a decision-making aid to help underpin GOCI.

The project is led by Prof Janelle Yorke (pictured), professor of cancer nursing at the University of Manchester and The Christie, and Dr Wendy Makin, Medical Director at The Christie and clinical lead of Vanguard Innovation’s living with and beyond cancer work stream.

Professor Yorke said: ‘This is a very important project that aims to improve communication between patients, oncology teams and community-based teams, including GPs. It is based on a shared understanding of the patient’s goals for their own care alongside the aims of any treatment that is offered. Communication is central and this initiative aims to optimise that.’
 
Service user's perspective
 
Vanessa Denvir, 46, from Stretford, was diagnosed with colorectal cancer 12 years ago. She is now a service user involvement representative
with Vanguard Innovation
and is active in a number
of our projects.
'My involvement with the Vanguard has introduced me to the wealth of work being carried out in Greater Manchester and London to speed up diagnosis and treatment of cancers.

'Having had and cared for people with cancer, this gives an interesting insight in to the potential of this regional pilot project, the knowledge, experience and learning from which will help and support organisations and individuals on a nationwide basis.

'Service user involvement in these pilot projects helps commissioning bodies, clinicians and, ultimately, patients. Their valuable experiences will assist in pathways that will ultimately benefit the patient and create a greater awareness of patient needs.

'The Vanguard has a professional, inclusive approach and the team is accountable for their work. With service users, like myself, this will drive us to diagnosing and treating people more quickly and, hopefully, in a less stressful manner.

'My roles have included interviewing clinical pathway directors and staff members, contributing to focus groups, research and clinical standards and bringing both my personal cancer experiences and professional skills to the table.

'I have great respect for the work that the Vanguard is carrying out. It is no mean feat. I’m only too happy to support it, personally and with other service users, and I can only hope it is to the benefit of the greater good.'
Progress in the spotlight
 
We hold regular Showcase events at which we turn the focus on key areas of our work. These events are free and are open to everyone in the health community in Greater Manchester and eastern Cheshire.

The next Showcase will focus on our prevention plans  and takes place at the Blackett Theatre, Schuster Building, University of Manchester, Brunswick Street, Manchester on 28 March 2017. It runs from 5.15pm until 6.15pm, with tea and coffee served from 5pm.

Reviews of our Showcases, including full presentations, are posted on our website. You can find examples here.

 
For more details of any of our Showcases, please contact us at cancervanguard.gm@nhs.net
News round-up
Pharma Challenge

Our medicines optimisation work, which aims to make better use of cancer medicines, has caught the eye of the trade media and leading pharmaceutical magazine Pharma Times recently carried an article about the project here.

Rob Duncombe, chair of the national Cancer Vanguard’s medicines optimisation group, was also interviewed by Pharmaceutical Market Europe as part of a feature on innovations in patient care. You can read that feature here.

The national Cancer Vanguard, of which we are a part, launched a project last year, called the Pharma Challenge, which invited pharmaceutical companies to work in partnership with us to make the best use of cancer medicines.

We have so far signed agreements with two pharma companies: one with Amgen, to map out the out-of-hospital use of a therapy for patients with advanced breast cancer, and the second with Sandoz, who have proposed an education programme for health professionals about the use of a new type of medicine known as a biosimilar. We expect to sign more agreements shortly.

 

National sharing event

The Cancer Vanguard is holding a major event this month aimed at sharing our experiences with the cancer alliances.

Cancer Alliances are a means to bring together clinical and managerial leaders representing the whole cancer patient pathway across a specific location. They will lead the local delivery of the Independent Cancer Taskforce’s ambitions for improving services, care and outcomes for everyone with cancer.

We are staging the national sharing event with our partners RM Partners, based at The Royal Marsden, and UCLH Cancer Collaborative, based at University College London Hospitals, and will share learning about cancer prevention, early diagnostics, primary care education, cancer medicines use and establishing an accountable cancer network.

Cally Palmer, NHS National Cancer Director, will open the event while The Christie Chief Executive Roger Spencer, who is also Chair of the the Cancer Vanguard oversight group, will give an overview of the programme.

 

AHSN partnerships

Sam Jones, New Care Models Programme Director at NHS England, visited Manchester in February to discover more about Vanguard Innovation and other work with links to the programme.

Greater Manchester Academic Health Science Network hosted the event at which our Programme Director Jenny Scott outlined the scope of Vanguard Innovation's projects while Rob Duncombe, chair of the national Cancer Vanguard’s medicines optimisation group, described our work to make the best use of cancer medicines.
Want to find out more?
If you’d like to find out more about Greater Manchester Cancer Vanguard Innovation, please contact our programme director Jenny Scott at cancervanguard.gm@nhs.net

Follow us on Twitter @GM_Ca_Vanguard

Visit our website https://gmcancervanguard.org
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