Agenda item

Alexandra Poole (Lead Cancer Nurse, Oxford University Hospitals NHS Foundation Trust) and Nicky Swadling (Cancer Manager, Oxford University Hospitals NHS Foundation Trust) have been invited to present a report on Cancer Services in Oxfordshire. The Committee is particularly interested in waiting times as well as treatments being offered for cancer patients.

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

Oxford University Hospitals NHS Foundation Trust were invited to present a report on Cancer Services in Oxfordshire. The Committee was particularly interested in waiting times as well as treatments being offered for cancer patients.

Felicity Taylor Drewe (Chief Operating Officer, Oxford University Hospitals NHS Foundation Trust), Andy Peniket (Clinical Director for Oncology & Haematology OUH NHS FT), Matthew Tait (BOB ICB Chief Delivery Officer), and Ansaf Azhar (Director of Public Health), attended to answer questions from the Committee in relation to the cancer wait times and treatment report.

The Chief Operating Officer at Oxford University Hospitals (OUH), discussed the Annual Cancer Survey feedback, noting improvements and performance against other trusts. The report included Cancer Outcomes and Services Dataset (COSD) data on treatment access and clinical outcomes, with an emphasis on personalised care.

Members inquired about the methods used by staff to provide patients with relevant information on available support and treatments. The Chief Operating Officer at OUH and Clinical Director for Oncology and Haematology described the various approaches utilised to inform patients about available support and treatments. These methods included distributing informational leaflets, offering direct communication during appointments, and employing marketing strategies to promote NHS hearing tests and treatments. Additionally, there was a strong emphasis on patient follow-ups to ensure the effectiveness of treatments and to promptly address any issues. This comprehensive approach aimed to enhance patient awareness and engagement with the services provided.

The Committee inquired about the support available for patients who do not speak English, citing a Healthwatch report that highlighted an instance where a non-English speaking patient was unaware of their diagnosis due to communication barriers. Members asked about the challenges and monitoring of support for these individuals. The OUH Chief Operating Officer acknowledged that providing support for non-English speaking patients was a significant concern. The Committee therefore reiterated the need to address the challenges and monitor the support mechanisms for such patients.

Members inquired about the commitment to the well-being of patients and their families, particularly concerning mental health, and whether this responsibility rested with the hospital or was referred back to the local GP. The Chief Operating Officer and Clinical Director explained that the responsibility for the well-being of both patients and their families, especially regarding mental health, was recognised as significant.

The Officers clarified that this responsibility was shared between the hospital and the local GP, depending on the specific circumstances and needs of the patient. The hospital provided immediate and specialised mental health support, while ongoing care and follow-up were typically managed by the local GP. This collaborative approach ensured comprehensive and continuous care for the patient's mental health and overall well-being.

Members inquired about OUH's performance in the National Cancer Patient Survey, particularly concerning the KPI that measures patients definitively receiving the appropriate level of support from their GP practice during treatment, which was at 50%. They also asked about patient involvement in discussing their treatment and ways to enhance the support experience from GPs.

It was acknowledged, by Officers, that the 50% KPI indicates an area needing improvement. Efforts are being made to ensure patients are more actively involved in discussions about their treatment. To improve the experience of support from GPs, it was suggested that better communication and coordination between the hospital and GP practices were essential. This would help ensure patients receive consistent and comprehensive support throughout their treatment journey.

Members inquired about the increase in cancer referrals across Oxfordshire, seeking to determine whether this rise was associated with specific towns, districts, PCNs, or GP practices, and if there were any demographic factors influencing this trend. The Chief Operating Officer and Clinical Director clarified that the rise in cancer referrals was not linked to specific locations or PCNs. Instead, it was observed as a general trend throughout the region, with no particular demographic factors identified as contributing to the increase. The rise in referrals appeared to be part of a broader pattern rather than being connected to specific localities or demographic groups.

Members inquired about the challenges faced by the workforce in cancer services and discussed the potential impact and necessary support if the assisted dying Bill, which was under review in Parliament, were legislated. The Clinical Director emphasised that the workforce in cancer services was experiencing significant difficulties, including high demand and staffing shortages. These issues were adversely affecting the ability to deliver timely and comprehensive care to patients. 

Concerning the possible implications of the assisted dying Bill, it was recognised that substantial support and resources would be required for effective implementation if it became law. This included training for healthcare professionals, the establishment of clear guidelines, and robust support systems to ensure the new legislation could be integrated into existing cancer care services without compromising the quality of care.

Members enquired about the role of co-production in the development of cancer services and requested an update on stakeholder involvement in this process. Officers clarified that co-production had played a significant role in the development of cancer services. Key stakeholders, which included patients, healthcare professionals, and community organisations, were actively engaged in the process. This collaborative approach ensured that the services were tailored to meet the needs of those affected by cancer. Regular engagement sessions, feedback mechanisms, and working groups were utilised to gather input and integrate it into service planning and improvement. This approach aimed to create more patient-centred and effective cancer care services.

Cllr Leverton left the meeting at this stage.

Members inquired about the modifications to the national cancer standards of measurement, specifically addressing the rationale behind these changes, the implications of eliminating the two-week waiting period for patients, and the performance of OUH in relation to these new standards. The Clinical Director and Chief Operating Officer elucidated that the revisions to the national cancer standards were implemented to streamline procedures and enhance patient outcomes. The elimination of the two-week waiting period was designed to minimise delays and ensure timely and appropriate care for patients.

The expected impact on patients was positive, with an emphasis on quicker diagnosis and treatment. OUH was performing commendably against these newly established standards, meeting the targets and ensuring that patients received necessary care within the updated timeframes.

Members inquired about the significance of outcome data in cancer treatment, the national comparison of OUH's outcomes, and the gap in treatments to achieve optimal results. The Chief Operating Officer and Clinical Director underscored the vital role of outcome data in cancer treatment, as it provided valuable insights into the effectiveness of therapies and highlights areas needing enhancement. OUH's performance favourably compared to national outcomes, excelling in several key areas.

Nonetheless, there remained a recognised treatment gap in achieving the best outcomes, attributed to factors such as resource limitations and the necessity for ongoing improvements in treatment protocols. Initiatives were underway to address these gaps and improve the overall quality of cancer care.

The Committee AGREED to recommendations under the following headings:

1. For further detail to be shared on outcomes across different cancer types, and how that compares nationally and regionally.

2. For there to be clear communications with cancer patients who cannot speak in English (or who struggle to communicate in general), and for mechanisms to be in place to help with advocacy for such patients.

3. For OUH to collaborate with the Oxfordshire County Council Public Health Team on awareness campaigns with communities with low take-ups of cancer screening.