Covid-19 and Cancer: The innovate and adapt approach

There can be no doubt that the Covid-19 Pandemic has had a profound effect on our Health and Care systems, but it has also provided some opportunity for services to innovate and adapt at pace.

Since the start of the Covid-19 Pandemic, Cancer Services have been responding to the requirements of the Health and Care System, supporting patients to access services while managing increased vulnerability due to coronavirus.

There has been a distinct change to healthcare seeking behaviour, including presentation in Primary Care of patients with worrying symptoms and an increase in DNA’s throughout the patient pathway.  Services have also faced pressure to manage diagnosis and treatment in a timely way, within ‘clean’ environments. All of which has provided a challenging environment in the past months, for both Cancer services and Patients and their families, with the effects of this to be experienced for years to come.

The Third Phase NHS Response released on 31^st July 2020, outlined the expectation for services to return to full operational delivery with a core focus on patient access, waiting times and increasing diagnostic and treatment capacity. There is also a requirement for the health and care system to continue planning and delivering services aligned to Covid-19 activity surges and the management of patient risk.

Working together, in partnership, across organisational boundaries and with the Independent Sector has been core to each phase of the response, and as we move in to the window of opportunity, between now and winter, these working relationship will continue to support service delivery. However, there are key challenges and enablers present, for Alliances and Cancer Services in the coming months, to continue to innovate and adapt,  to increase service capacity, manage growing demand and the backlog, as well as support patients to present with worrying symptoms:

Demand: Understanding current demand, across Alliance footprints, and expected surges in new referrals as more patients begin to present

Capacity: Making the most of capacity across diagnostic and treatment pathways, with a view to increasing patient access and continuing or restarting treatment pathways to best support patients

Primary Care: continuing the work with Primary Care colleagues to support patients to present with worrying symptoms and to further enhance the triage functions as implemented through the initial phase

Workforce: continuing to support the cancer workforce, as well as aligning core skills to the place of greatest need while taking a view of workforce models for the months and years ahead to support service delivery

Complexity: with some delays in access there may be an increased complexity in the cohort of patients presenting, potentially at a later stage with increased acuity and complexity of disease

Patient support: increased communications with patients to support their understanding of current pathways, access and service delivery as well as treatment plans

Rapid Diagnostic Services: expediting plans locally to further imbed rapid diagnostic models to introduce further capacity across the system and support patient access

From our experiences, we have developed an approach to restoring service provision across Cancer Services, to support access, diagnosis, treatment and the workforce. The approach begins with the planning stage, taking a view of the current demand and capacity available across the system through our tried and tested demand and capacity tools. These include a view of equipment, estates, workforce and identify any aspects of service delivery where capacity may be released to manage demand. In addition, it is core that a view from primary care is developed, by working together through established safety netting systems and MDT processes to support patients to access services at the right place and at the right time based on need.

A system wide view of need is a key enabler in identifying how services can enhance joint working relationships and understand any capacity constraints that can be managed jointly, for the benefit of all involved.

Fundamental to this, is the development of practical enablers including further roll out of patient initiated follow up, digital innovation, artificial intelligence opportunities, workforce models and pathway re-design to enhance available resources and take a view of how services will evolve in the months and years ahead to best support patient populations.  At the same time, there is a need to work together to assess the innovative opportunities that have been harnessed in the previous months, and how services maintain this whilst further growing their approach based on local needs.

Our approach includes working alongside you and your team, and collaboratively with partners to develop a solution that is representative of the local landscape and challenges. Embedded into the way we work is a focus on the desired outcomes that delivers to the local system needs, while ensuring that we conduct a full handover to enable knowledge transfer and provide a shared learning environment, to ensure that the work continues to deliver to your needs on completion.

If you would like to discuss our support or require any further information please contact Sophia Malik at Sophia.malik@attain.co.uk