Agenda item

To receive a presentation from Dr. Robin Hudson, CCG Medical Director and Clinical Lead for Cancer and Amanda Walshe, Lead Cancer Nurse, Northumbria Healthcare NHS Trust.

The presentation (attached as Appendix D) was delivered by Dr Robin Hudson, CCG Medical Director and Clinical Lead for Cancer, Amanda Walshe, Lead Cancer Nurse at Northumbria Healthcare and Paul McNealy, General Manger for Cancer Services. The presentation gave the Committee an update on cancer performance and the impact of COVID.

The Committee were informed that overall cancer performance had been good with a slight improvement this year.  In previous presentations given to the Committee, they had been told of the pressures faced by urology.  The system has since been redesigned which has enabled urology services to improve. 

The Committee were told of the current area of focus such as dermatology.  The 2 week wait threshold had been significantly affected by COVID with social distancing making examinations difficult.  There had been difficulties in bowel, breast and cervical screening; however, the CCG recognised the importance of screening and work had been done to overcome these difficulties.

Across the Northern Cancer Alliance, the number of 2 week wait referrals dropped significantly due to patients not attending primary care during the first lockdown. This had now picked up again; however, lung, head and neck cancer have not returned to pre-COVID levels.  Dr Hudson speculated that this may be because lung cancer presents itself in mild symptoms such as a slight cough which patients may mistake for a cold.

Dr Hudson informed the Committee of the 3-phase recover plan to restore demand, reduce waiting times and ensure sufficient capacity.  Work was also being done to support primary care and ensuring services are up to speed with referrals.

The Committee were shown 62-day performance data which showed Northumbria regularly meeting the 85% performance target last year.  The same level of achievement had not been reached as regularly by other Trusts in the area.

With regards to oncology treatment there had been an increase in the progression of disease and emotional wellbeing of patients due to COVID.  Members were shown a graph which depicted the number of day cases (green line) and ward attendance (blue line).  The red dotted line indicated new types of treatment which was a move to more personalised care; this had led to an increase in treatment. 

Patient surveys had been undertaken to help capture the views of oncology patients to allow greater understanding of their emotional wellbeing.  In August, the views of patients going through the first lockdown showed an increase in telephone consultations whilst video calls had not proved as popular with patients and not everyone had access to digital.  Initially, pre- assessments were done via phone or video; however, nurses found that this did not give enough information or provide sufficient quality.  It was therefore agreed to return to face to face pre-assessments. The survey also highlighted that 96% of patients felt listened to and 98% felt safe on a unit.

The support to patients had changed very quickly in a short space of time.  The Trust recognised that more work needed to be done to capture the impact of COVID on patients. 

The CCG felt that COVID had accelerated the rate of change within cancer services.  Prior to COVID GPs did not have the tools to identify colorectal cancer, GPs had to refer patients into Northumbria Healthcare who undertook a colonoscopy.  This had changed with the introduction of a FIT test which could be carried out by GPs which allows Consultants to examine referrals and better focus colonoscopies to high risk patients and enable low risk to have CT scan.  This has had a positive impact on waiting times for patients.  A new digital dermatology pathway has been developed during COVID which it is expected will have a similar impact on waiting times.

The following comments were made in response to questions raised by members:-

•         Despite the difficulties of COIVD the Committee were assured that the services had adapted to ensure they could continue to successfully diagnose and treat patients. 

The CCG and Trust were thanked for their presentation and were thanked on behalf of Northumberland residents for the work they were doing.  It was RESOLVED that the report be noted.