Agenda item

13.1.      The Committee considered a report providing an update on developments in improving cancer care in East Sussex. The Committee then asked the witnesses present a number of questions.

13.2.      The Committee asked whether the national bowel cancer screening programme had been introduced in East Sussex.

13.3.      Lisa Elliott confirmed that bowel scope screening has not started in East Sussex yet due predominantly to endoscopy capacity. NHS England commissions bowel scope screening and the CCGs are working with them to increase the available capacity. The personal test has recently changed from the FOBT (Faecal Occult Blood Test) to the Faecal Immunochemical Test (FIT).  The implementation of the FIT test for screening began in June 2019 for people over 60-74.  For symptomatic patients presenting to their GP, FIT test is also available.

13.4.      Lisa Elliott said that she would feedback the Committee’s concerns that GPs may not be offering the FIT for people under 60, even those with a family history of the disease. 

13.5.      The Committee asked why there is a lack of endoscopy if there are newly opened units at both hospital sites.

13.6.      Lisa Elliott explained that East Sussex Healthcare NHS Trust (ESHT) has increased its capacity, and endoscopy demand is continuing to increase. The Trust is reviewing how it can increase its capacity further.

13.7.      Ashley Scarff added that Brighton & Sussex University Hospital NHS Trust (BSUH) has similar capacity issues around availability of staffing and equipment, so increasing capacity at the trust’s hospital sites is a key area for improvement.

13.8.      The Committee asked to what extent missing the 62-day referral to treatment was due to a shortage of oncologists and other specialists and whether they could be attracted to work in East Sussex

13.9.      Ashley Scarff confirmed that some of the capacity constraints at BSUH were due to lack of workforce capacity and equipment, as well as the need to improve pathways, and plans are in place to address all of these issues.  ESHT is also experiencing workforce constraints and is continuing work to improve cancer pathways in order to meet the 62-day referral target. The focus of these improvements to cancer pathways will be on deploying existing staff more effectively

13.10.   Ashley Scarff added that the increasing demand for diagnosis and treatment from an aging population and higher referral rates, albeit being offset by increasing preventative services, meant that there would be a longer term need to review the size of the workforce required to deliver the target in the future.

13.11.   Jessica Britton said that there is an improving picture of recruitment at ESHT. Ashley Scarff added that the performance of the providers was a virtuous circle and that for both BSUH and ESHT coming out of special measures would help attract staff.

The Committee asked when the Sussex Cancer Board was established

13.12.   Lisa Elliott said the Sussex Cancer Board was established in August 2019. During the previous three years, strategic guidance had come from the Sussex and Surrey Cancer Alliance. However, the Alliance identified that the Sussex and Surrey areas had different priorities and needs, and the Board was established in response. It had now met twice and is chaired by Lola Banjoko, Managing Director for Brighton and Hove CCG and senior responsible officer for cancer across Sussex. Ashley Scarff said the Board would help deliver the Long Term Plan’s cancer priorities locally, as well as NHS England’s assessment framework metrics for cancer.

13.13.   Ashley Scarff added that there is a long history of working at scale across cancer care, and prior to the Cancer Alliance there was a Cancer Network for Sussex. This is due to the fact that some cancer types are only treated by BSUH, as the local tertiary centre, or at specialist centres in London, resulting in complex pathways for patients who may be initially diagnosed at their local hospital and the need to coordinate these across specialist centres covering large geographical areas.

13.14.   The Committee asked about East Sussex patients accessing cancer services in Kent

13.15.   Ashley Scarff explained that there had been significant improvement with access times for cancer care at Maidstone and Tunbridge Wells NHS Trust (MTW) and this would apply for both East Sussex and West Kent patients.

13.16.   The Committee asked what role clerical staff play in delays to treatment

13.17.   Ashley Scarff explained that patient’s views of the treatment they receive from clinicians is invariably very good. Issues with patient experience tend to arise in the logistical, pathway elements of their care that are critically dependent on administrative support, processes and systems working correctly, for example, ensuring appointments are sent to patients in a timely manner. The patient experience metric CCGs are assessed on by NHS England helps to show whether the logistical element is or isn’t working well. Where it is not working well, further training for administrative support staff may be necessary together with reviews of capacity and ways of working which can help to improve the 62-day target and other access standards.

13.18.   The Committee asked whether additional funding would be received for cancer services.

13.19.   Jessica Britton said that the NHS Long Term Plan has highlighted some national investment in certain specialties including cancer. How this is allocated to CCGs has not been confirmed yet but some will likely be provided specifically for cancer care improvement via primary care networks (PCNs). The Local response to the NHS Long Term Plan would likely provide further details.

13.20.   The Committee asked whether the facilitator role in GP practices was being rolled out

13.21.   Lisa Elliott explained that the role had been funded through the Healthier Hastings and Rother programme and had now finished. Cancer Research UK, however, is now providing a similar dedicated facilitator who will work three days a week across both CCGs raising awareness of cancer in GP practices.

13.22.   The Committee RESOLVED to:

1) note the report

2) confirm via email the number of vacancies in oncology and radiology teams;

3) request an update at a future meeting.