18 | Cancer Commissioning Strategy Framework Cancer Commissioning Strategy Framework | 19 Appendix 1 - High-Level North Central London Cancer Commissioning Strategy 2025-2026 Implementation Plan Appendix 1 - High-Level North Central London Cancer Commissioning Strategy 2025-2026 Implementation Plan 3. PERSONALISED CARE INITIATIVES MILESTONES CANCER ALLIANCE STRATEGIC AIM ALIGNMENT A. Lymphoedema Service 1. Single, system-wide service spec developed and embedded into provider contracts. Q1 25/26 2. Provide support to RFL Trust and Charity to develop and implement lymphoedema offer for Barnet. Q1-4 25/26 3. Work with ICB colleagues to ensure Lymphoedema is included in the community core offer. Q1-2 25/26 SA2, SA6 B. Prehabilitation and Physical Activity 1. Undertake legacy planning to mitigate risks of the specialised cancer prehabilitation/rehabilitation service not being re-commissioned. Q1-2 25/26 2. Provide commissioning support for the development, implementation and monitoring arrangements for specialist/targeted prehabilitation in line with the planned Macmillan/NIHR guidance. Q1-2 25/26 3. Provide commissioning support, where required, for the improvement of the offer of behaviour change interventions to increase physical activity throughout the cancer pathway. In particular, support for system working such as the inclusion of cancer in commissioned programmes for longterm conditions and public health. Q1-2 25/26 SA2, SA4, SA5 C. Psychosocial Support Services 1. Develop local agreements for sustainable commissioning and delivery of the Cancer Alliance integrated psychosocial pathway. Q1-2 25/26 2. In collaboration with the PCC programme, develop relevant service specifications to ensure equitable provision of levels 2-4 psychosocial support across all stages of the cancer pathway. Q1-2 25/26 3. In collaboration with the PCC programme, develop business case templates for acute and community providers. Q1-2 25/26 SA2, SA4, SA5 D. LCS Updates (Prostate, GnRH, ? Breast) 1. Review and update the current Locally Commissioned Services (LCS) specifications to ensure measurable. Q1 25/26 2. Work with ICB colleagues to identify a process for oversight and assurance that delivery of these contracts are clinically effective equitable and safe Q1-2 25/26. 3. Engage with NCL ICB colleagues to identify whether cancer LCS’ can be incorporated into the NCL Long Term Conditions LCS from 26/27 onwards. Q1-4 25/26 SA1, SA5 4. ACUTE DIAGNOSTIC AND TREATMENT INITIATIVES MILESTONES CANCER ALLIANCE STRATEGIC AIM ALIGNMENT A. Breast Hormone Therapy 1. Agreed patient self-admin pathway to be implemented by each provider. Q2 25/26 2. Work with LMC and other stakeholders to mitigate risk of stopping work to implement an equitable primary care delivered hormone injection pathway. Q1 25/26 SA1, SA5 B. Breast Pain Pathway 1. Document clinical pathway, service spec and clinical and operational guidelines for breast pain. Q1 25/26 2. Implement pathway at each of the NCL providers: a. UCHL - Live on an ad hoc basis. Working to full implementation over Q1-2 25-26 (dependent on staff training), b. RFL - Live c. NMUH - Paused. Looking at options as part of wider RFL breast service integration. d. WH - Delayed to Q2 25/26 SA1, SA2, SA3 C. Teledermatology 1. Implement pathway at each of the NCL providers. Q1 25/26 2. Achieve NHSE Deliverable of 50% referrals through USC Teledermatology Pathways. Q2 25/26 3. Implement NHSE guidance relating to USC Teledermatology tariffs ensuring services are funded to take over full BAU funding for 26/27. Q4 25/26 SA2, SA3 D. FIT strategy 25/26 1. Continue to improve the number of patients who are referred on a colorectal USC pathway with a FIT (target >80%). Q4 25/26 2. Reduce the number of patients that have a colonoscopy when there is no FIT present (target <20%). Q4 25/26 3. Continue to engage with GPs with low performance in referring patients on a colorectal USC pathway with a FIT, focusing on areas with high levels of deprivation. Q1 25/26 onwards 4. Finalise decision on FIT<10 pathway in secondary care and move safety netting for this cohort of patients to primary care. Q2 25/26 SA1, SA3, SA4, SA6
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