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SUMMARY:The NCAG Report: Delivering a World Class Chemotherapy Service - P
 rof Roger James\, Previously:  • Deputy Medical Director Maidstone and T
 unbridge Wells NHS Trust   • Medical Director Kent &amp\; Medway Cancer 
 Network
DTSTART:20100420T110000Z
DTEND:20100420T120000Z
UID:TALK22885@talks.cam.ac.uk
CONTACT:Mala Jayasundera
DESCRIPTION:The NCAG Report: Delivering a World Class Chemotherapy Service
 \n\n1.	The National Chemotherapy Advisory Group August 2009 report ‘Chem
 otherapy Services in England: Ensuring quality and safety’ (NCAG report)
 \, like the previous NRAG report\, is commissioning guidance. The term ‘
 crisis’ has not yet been applied to NHS chemotherapy service delivery\, 
 but NCAG highlighted two serious concerns for commissioners:\n\n•	Inadeq
 uate Safety (non-elective care):\n\n>  despite the previous iterative Peer
  Review Programme based on national chemotherapy standards\n\n•	Inadequa
 te Reconfiguration (elective care):\n\n>  despite the release of the C-POR
 T capacity planning tool\n\n2.	Safety and reconfiguration are linked\; any
  ‘over-stretched service’ (where demand exceeds capacity) is unsafe. T
 he NCAG report identified an exponential growth in chemotherapy demand of 
 at least 10% p.a. (four times the 2010 Retail Price Index) and this is exp
 ected to continue. \n\n3.	The NCAG Report was responding to additional con
 cerns: \n\n•	From the safety (non-elective) perspective the 2008 NCEPOD 
 Enquiry\, For Better for Worse? indicated that\n\n>  large numbers of canc
 er patients are receiving chemotherapy towards the end of life\n\n>  this 
 results in a previously neglected non-elective (emergency) burden of activ
 ity associated with palliative chemotherapy\n\n>  palliative chemotherapy 
 towards the end of life is not always delivered appropriately\n\n>  very l
 ittle in the way of demand management tools (2009 Demand Management: Insti
 tute for Innovation and Improvement) have been implemented.\n\n•	From th
 e reconfiguration (elective) perspective (the 2006 End Stage Darzi Report:
  ‘Our health\, our care\, our say’ and the DoH framework 2008 Deliveri
 ng Care Closer to Home)\n\n>  provider capacity planning\, infrastructure 
 planning and business planning had been neglected relative to drug acquisi
 tion and procurement \n\n>  the shift of chemotherapy from the cancer Cent
 re to cancer Units had been implemented in a patchy and unco-ordinated way
 . \n \n4.	What are the remedies? This talk explores the following question
 s: What are expected future trends? Is biological/oral chemotherapy likely
  to increase relative to IV? Are current care pathways for delivery approp
 riate? Can ‘acute oncology’ be linked into the Royal College of Physic
 ians 2009 RCP Recommendations: Strengthening the medical ‘take’? Can w
 e improve the production of adequate business cases for NICE-approved drug
 s? Are lessons from radiotherapy services (QUART\, electronic prescribing 
 and monitoring\, national radiographer and physicist competency frameworks
 ) relevant? Can all these individual projects be linked into a programme t
 hat fulfils the commissioning aspirations of NCAG? \n
LOCATION:CRI Lecture Theatre
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