Transforming Cancer Services Team newsletter: Winter 2023

Welcome to the winter edition of the TCST newsletter, highlighting the range of projects and programmes that the team is currently working on in partnership with stakeholders to improve patient outcomes and support the delivery of cancer services across London.
Key updates this time include:

a roundup of cancer waits guidance training delivered during 2023;
an introduction to the lymphoedema workforce programme;
a look at demand and capacity modelling for chemotherapy services at St. George’s;
Cancer training opportunities across London;
Changes to the referral pathway for soft tissue sarcomas.

I’d like to take this opportunity to wish you all an enjoyable festive season and best wishes for 2024!

A project to promote the use of Faecal Immunochemical Testing (FIT) in hospital emergency departments is now running in north east London.

The pilot project has gone live at the Partnership of East London Cooperatives (PELC) and Urgent Care Department at Queen’s Hospital. The local project team has so far recruited 25 patients with a small number returning FIT positive results. These are being actively followed up locally.

As FIT is not currently routinely available in secondary care, as part of this pilot various resources have been pulled together to support healthcare professionals involved, including an educational video, a physicians’ quick guide and an FAQ.
The pilot is also due to go live at the Urgent Care Department at Whipps Cross Hospital within the next few weeks.

TCST is leading a workforce programme on the provision of care and treatment for people living with lymphoedema in the capital.

The main objectives of the programme are:

defining the career pathway;
identifying opportunities to support workforce growth;
developing a three-tier integrated care model to demonstrate patient needs and workforce skills; and
developing an influencing strategy to support lymphoedema practitioners and other system partners to recognise their role in the sustainability of lymphoedema services.

The programme team has established a Lymphoedema Service User Group to gain a better understanding of the needs of those living with lymphoedema.

The first meeting took place in November, with membership from across London’s lymphoedema community of practice, NHS England, Workforce, Training and Education (NHS WT&E), Cancer Alliances, the British Lymphology Society and third sector organisations.

For more information, please contact Yvonne Damanhuri

The London Lymphoedema Community of Practice (CoP) was established in 2018 to foster peer-to-peer support amongst lymphoedema practitioners and other interested parties and address shared needs across the professional lymphoedema community in London.

To date, the group has delivered several key outputs, including revised commissioning guidance and the development of a service specification to raise the profile of lymphoedema services and patient’s needs. The CoP is an integral partner of the London Lymphoedema Workforce Programme.

The most recent Community of Practice meeting took place on 13 December, exploring the lymphoedema three-tier integrated care model and the lymphoedema career pathway.

For more information, please contact Yvonne Damanhuri

Back in November, changes were announced to the diagnostic pathway for adult soft tissue sarcoma referrals in London. Services will be divided into ‘hubs’ (tertiary services providing treatment and clinical oversight) and ‘spokes’ (services delivering local diagnostics, from further imaging to pathology).

The Hubs are the Royal Marsden Hospital (RMH) and the London Sarcoma Service, which is a joint service between the Royal National Orthopaedic Hospital (RNOH) and University College London Hospitals (UCLH).

In west London, Spokes are currently located at Chelsea and Westminster NHS Foundation Trust (either the Chelsea or West Middlesex site), Croydon Health Services and Kingston Hospital.

In north central London, RNOH will act as a spoke for NCL with Wood Green CDC providing the diagnostic tests.

In east London, a Spoke will be established at Mile End Hospital.

TCST recently worked with colleagues from St George’s University Hospitals NHS Foundation Trust to develop a demand and capacity modelling approach for chemotherapy services.

The initial project scope was to better understand demand for the trust chemotherapy service over the previous three years to explore concerns around lack of capacity and a reliance on overtime. With clear indications that demand for the service was increasing, the modelling project helped to identify potential bottlenecks, support capacity and workforce planning and explore opportunities for improvement.

SELCA recently launched a new education resource to support primary care professionals to identify patients who require an urgent suspected cancer referral. The online resource will comprise of seven bitesize modules, each focusing on a specific cancer or group of cancers, and can be completed within 10 minutes.

The first module on myeloma was released last month. The second module in the series is now available and aims to refresh professionals’ knowledge of lung cancer symptoms and enable colleagues to refer patients with confidence for cancer diagnostic testing.

As symptoms such as shoulder or back pain can potentially be a sign of lung cancer, we’re extending access to the training module to physiotherapists with the aim of improving early diagnosis.

Register for the lung cancer training module.

Register for the myeloma training module.