FIVE-YEAR STRATEGIC PLAN 2021-2025
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FIVE-YEAR
STRATEGIC PLAN
2021-2025
11. OVERVIEW 6
2. WHY WE NEED A NEW STRATEGY 10
3. THE NEXT FIVE YEARS 14
STRATEGIC PRIORITIES
4. BE OUTSTANDING 18
5. BE COLLABORATIVE 30
6. BE A GREAT PLACE TO WORK 36
7. BE RESEARCH LEADERS 46
8. BE DIGITAL 52
9. BE INNOVATIVE 58
10. IMPLEMENTATION 63
11. DECLARATION OF SUSTAINABILITY 64
2 3FOREWORD
The Clatterbridge Cancer Centre (CCC) is one of three specialist While we were getting ready to open
cancer centres in the UK. We have a unique multi-site care model CCC-Liverpool the world changed
– we provide radiotherapy at our three main hub sites, systemic fundamentally. The response of our teams
anti-cancer therapy at seven sites and outpatient care at 17 to the challenges posed by the COVID-19
centres. We serve a population of 2.4 million across Cheshire pandemic has been amazing. We have
and Merseyside. quickly adopted new technology and
made the changes necessary to keep
With 1,500 specialist staff we The 11-storey state of the art our patients and staff safe. As an NHS
are one of the largest NHS
providers of non-surgical
specialist hospital is part of our
£162m investment to transform
we have tackled COVID-19 together and
cancer treatment and we are cancer care in Cheshire and NHS organisations working more closely
consistently rated as one of the Merseyside. We built our new
best performing hospitals in hospital in order to:
together as part of their local systems will
the Care Quality Commission’s be a lasting legacy of this period.
national inpatient survey. • Provide outstanding, cutting
Our vision is to not only edge cancer therapies to
maintain this excellence but to the population of Cheshire We have developed this new five-year strategic plan against this
work with our academic and and Merseyside, backdrop. Through implementing our re-invigorated plan we want to
healthcare partners across the • Collocate oncology with have a positive impact on:
region to ensure that the care, acute services at the
treatment and outcomes of our Royal Liverpool University • Patient outcomes and experience
patients continuously improve in Hospital, streamlining care
the future. • Improved and efficient patient pathways
and avoiding the need for
very unwell patients to be • T
he research culture, ethos and outputs of the organisation and
We have achieved what transferred in an ambulance our reputation for the provision of outstanding cancer care
we set out to do in our last five- to a critical care unit, • Staff engagement, satisfaction, training and education
year strategic plan. We have
• Complement our sites in Wirral • T
he national and international profile of CCC and the
opened Clatterbridge Cancer
and at Aintree and provide Cheshire & Merseyside Cancer Alliance.
Centre-Liverpool
care close to home for cancer
(CCC-Liverpool) and
patients across Cheshire and
embedded our networked
Merseyside,
model of care so that the vast
majority of patients are within • Provide opportunities for
45 minutes of one of our hubs. expanding our cancer
The opening of CCC-Liverpool, research programme through
based in the heart of the city’s the collocation of the
Knowledge Quarter, provides hospital with the University of
us with a unique opportunity to Liverpool.
re-examine, re-invigorate, and
refresh our strategic plan.
4 51. Chemotherapy
and other systemic
anti-cancer
OVERVIEW CCC-Liverpool is our new aims for the next five years. We
therapies at
7 sites
specialist centre and the were also one of the first cancer
location of our inpatient beds. centres in the UK to use our own
It is also the hub for the central highly-trained nurses to deliver
sector of the region. CCC-Wirral cancer treatments to patients
1.1 About The Clatterbridge Cancer Centre is the hub for our southern sector in their own homes through our
and CCC-Aintree is the hub for Clatterbridge in the Community
the north. programme.
As one of the leading cancer centres in the We operate a networked
All new outpatient appointments Our primary aims are to Radiotherapy at
model of care, with
3 sites
UK, with a track record of developing new services for non-surgical
are concentrated in sector hubs, deliver the best cancer care,
which have increased provision continuously improve treatment
and better ways of treating cancer, The oncology spread across of supportive care services. We and care through research
the different ‘sectors’ of are currently working with our and innovation, and work
Clatterbridge Cancer Centre contributes to the region that we serve. partners on the development of collaboratively with other
improved outcomes for patients with cancer The model is based on the the hub for the eastern sector
and this will be one of our key
providers of cancer care for the
benefit of our population.
principle of providing care
in Cheshire and Merseyside.
locally where possible and
centrally where necessary.
1.2 The best care
We have an excellent track
The Trust has a consistent record of excellent record of financial performance
top level performance across all aspects of and have been consistently
given a low risk rating by our
CCC in numbers We care for over care delivery and patient experience. This regulator. We were one of the
35,000
first NHS Foundation Trusts in
includes results from national inpatient and the country and have a well-
Our sector hubs serve outpatient surveys, national accreditation for developed governance structure
with a high quality Board and
populations of around safety and quality, and some excellent scores Council of Governors. However,
patients per year
500,000
the economic climate and
in staff survey results. the cost of delivering cancer
care means that financial
This is a reflection of the skills sustainability over the next
1,500
and commitment of our staff. five years remains a significant
We have a strong commitment challenge.
to developing our workforce and
have embedded an electronic As cancer incidence increases
We manage in excess of appraisal and staff development and new treatments allow us
250,000 specialist staff system. Over recent years our to significantly improve survival
staff have been working to a set we will face increasing pressure
of values that they developed to on our services, facilities and
reflect what they do every day. staff. In particular our capacity
patient contacts These values have provided a
firm foundation for the delivery
to deliver the national 62-day
target and the new 28-day
Outpatient care at of the best patient care, service Faster Diagnosis Standard will
delivery and research. be put under pressure. We are
17 sites
also faced with the workforce
challenges of recruiting and
retaining the best staff and
adapting the workforce to
reflect increasingly complex care
and treatment.
6 71.3 Research and innovation 1.4 Working collaboratively
We undertake research With more than 300 active
clinical trials and 1,200 We host the Cheshire
into new cancer
patients a year entering
studies we ensure that as
many patients as possible & Merseyside Cancer
therapies through our get access to the very
latest treatments. Alliance, one of 19
academic partnership cancer alliances in
with the University of England tasked with
Liverpool. delivering the cancer
As a specialist cancer care As a specialist provider we
elements of the NHS
Long Term Plan.
provider we are duty bound also have a responsibility to
to ensure that patients innovate and ensure that we
have access to novel and can act as a test bed of best
emerging therapies as part practice for the NHS. We have a
of interventional studies as history of developing innovative
well as delivering a balanced radiotherapy techniques,
research portfolio that includes delivering early phase drug trials The Long Term Plan outlines In response to the NHS Long
observational and real-world and designing new models of the need for improvements Term Plan we are working as
data studies. Over the next care, such as chemotherapy in in diagnostic, treatment and part of the cancer alliance to
five years we will see exciting the home and workplace. We follow-up pathways that are pioneer new models of care
new developments in fields also have a strong track record underpinned by research and that address to the needs of
such as molecular diagnostics, of creating innovative new innovation. our population. As an example
genomics, biobanking and data roles. Recent examples include our region has particularly
driven research. As a Trust we consultant radiographers to The priorities set out in the poor outcomes from lung
need to be ‘research ready’ improve the efficiency of the plan include a radical overhaul cancer. As such the Cheshire &
to ensure that we are ideally patient pathway and early of diagnostic standards and Merseyside Cancer Alliance was
placed to secure funding for diagnosis support workers to services and a national roll out the first team in the country to
ground-breaking research that enhance patient care. of Rapid Diagnostic Centres. deliver the Lung Health Checks
will benefit our patients, both The Cheshire & Merseyside model of care which is aimed
now and in the future. Cancer Alliance is the vehicle for at diagnosing lung cancer at
delivering this locally. an earlier stage to improve
outcomes.
8 92 For the ambitions contained in the NHS
Long Term Plan to be met in our region:
WHY WE NEED A 2.2 The local landscape
NEW STRATEGY The Cheshire and Merseyside region has BY
2028
a unique blend of circumstances that
2.1 The national landscape contribute to our cancer outcomes, including:
• Two parts of our region, •S
ome areas in Liverpool To achieve 75% of
It is estimated that one in two people will Although survival is improving,
Liverpool and Knowsley, are in have the highest rate of
some patients are still being people diagnosed at
the five most deprived areas presentations through
develop cancer at some point in their lives. diagnosed late in the pathway.
of England and a further three emergency routes and it is well stage 1 or 2, the system
More than 360,000 people in the UK are Early diagnosis followed parts of our region are in the recognised that such patients will need to diagnose
by access to the best, most deprived 20%. have the poorest outcomes. approximately 300
diagnosed with cancer each year. By 2022 it is evidence-based and efficient
• The region currently has • This high level of diagnosis additional people at an
projected that this figure will reach 422,000. treatment is critical to achieve
improvements in outcomes and considerably higher mortality through emergency early stage every year
meet the increasing demand. rate from some cancers presentation is at least partly – approximately 3,000
compared to England as due to suboptimal uptake
a whole. and delivery of screening
additional people in
Despite advances in treatment,
cancer remains one of the programmes across the region. total by 2028
top five causes of early death • The region has the second
in England. It is the highest highest rate of co-morbidities •R
egional recruitment into
cause of death in Liverpool, that impact patient outcomes clinical trials, although
accounting for at least 37% of in the country. improving, has historically
all deaths in the region. lagged behind national
averages and comparable BY
2028
hospitals.
The NHS Long Term Plan sets out
two key ambitions for cancer:
Five year survival will
need to increase
BY from 53% (2017) to
2028 64% which equates
to around 1,000
more people surviving
The proportion of cancers BY every year
2028
diagnosed at stage
one and two will rise from
just over half now to three
quarters of cancer patients
55,000 more people each year will
survive their cancer for at least
five years after diagnosis
10 112.3 Cancer care is changing
Cancer care is increasingly delivered on an
2.4 Our main risks
outpatient or day case basis rather than
as an inpatient. As cancer incidence and Workforce challenges Clinical sustainability grant and commercial income
has increased our research
referrals grow, this will place additional We have developed this The National Centre for Eye
productivity and structures have
strategy in the context of some Proton Therapy will continue
pressure on these ambulatory services. significant workforce challenges to be a flagship service for the been put in place to ensure
within a number of our existing Trust but will require a significant there is improved scrutiny
We expect to see a number of trends staff groups. Some of these upgrade during 2021 to ensure on both research portfolios
and financial management.
developing over the life of this strategic plan. challenges are well within our sustainability. We will work with
However, if the scale and impact
ability to address. Others, such Alder Hey and The Christie, which
as skills shortages for oncologists now also provides proton beam of research is to continue it is
and haemato-oncologists, will therapy, to ensure there is a likely that there will be a need
• With the focus on earlier and • Though the radiotherapy require a huge amount of focus, sustainable service for children for increased financial support
faster diagnosis, there will be treatment population will hard work, and innovation on with cancer across the region. from The Clatterbridge Cancer
an increase in cancer surgery. increase, the number of the part of the whole team to Charity. An active and exciting
While we do not deliver attendances should remain overcome. Financial sustainability research portfolio will support
surgery, it will be important to stable as advances in these fundraising efforts.
The financial sustainability of the
work closely with the cancer radiotherapy techniques will Challenges with radiology NHS and therefore the pressure
surgery community across the lead to more treatments being capacity and the ability to Cyber security
on the financial position of
region to ensure delivery of given over fewer attendances. deliver turnaround times are Cyber security remains a high
the Trust is greater now than
the NHS Long Term Plan. The complexity of treatment likely to continue with the risk. We remain aware of the
it has ever been. We will need
will increase, however. national shortage of radiologists. ever increasing, changing
to continue to develop more
• There will be an increase Workforce shortages and and challenging threats
efficient pathways of care
in non-elective admissions • R
esearch activity will continue changes to the skills mix of our cyber attacks pose to the
and increase private care and
for both solid tumour and to grow as a result of the staff will add further complexity organisation. We will continue
subsidiary profits in order to
haemato-oncology patients collocation with the University to operational delivery. Regional to actively invest and develop
maintain financial stability.
due to the ageing profile of of Liverpool, the increase in issues such as shortages of capabilities in cyber assurance
Access to capital will be a risk
patients with cancer. academic appointments, and surgeons and diagnosticians to protect patient and
factor and we will need to
the opening of the dedicated could impact on the ability to corporate information.
prioritise the internal capital
• It is anticipated there will be clinical research facility at keep services within the region programme and increase
an increase in attendances at CCC-Liverpool. and put pressure on the delivery fundraising to support state of
our clinical decisions unit as of the cancer waiting time the art facilities.
we endeavour as a system to • P
rivate care activity will standards.
keep cancer patients out of grow in line with the increase
hospital where we can. in cancer incidence and in
Research funding
Recruiting and retaining a high
particular with the opening Funding for research is a key
calibre workforce that meets
• Acute oncology services, of CCC-Liverpool and strategic risk. There is not the
the needs of a changing service,
which manage the the addition of haemato- track record in cancer research
with new models of care and
unexpected care needs of oncology services. to secure National Institute for
the latest technology, will be
cancer patients, will need Healthcare Research (NIHR)
paramount. In addition to this,
to expand to meet growing • S
ervices will need to recover Biomedical Research Centre
our ability to deliver our research
demand. Services will need to from the impact of the funding in 2022; however,
ambitions will be dependent on
be coordinated across COVID-19 pandemic while there is an opportunity to
our ability to attract academic
the region. sustaining the positive secure Experimental Cancer
clinicians to the University of
changes that have been Medicine Centre funding in
Liverpool and the Trust.
• Inpatient activity will made through the adoption 2022 with the aim of supporting
potentially increase if of technology, reduced face- the University of Liverpool to
haemato-oncology inpatients to-face appointments and a secure Cancer Research UK
from the North Mersey area more agile workforce. funding. Recent increases in
transfer to CCC-Liverpool.
• Chemotherapy care closer
to home will continue with
patients being treated in
regional chemotherapy units
and the three hubs in Wirral,
Aintree and Liverpool.
12 133.
THE NEXT
FIVE YEARS
Having delivered our last five-year strategic To deliver this mission we have developed our plans to
plan, opening CCC-Liverpool and embedding address six strategic priorities:
our unique networked model of care, our
attention for the next five years needs to be on
maximising the benefits of these developments
for patient outcomes and experience. To this
end we have developed a new statement of
BE OUTSTANDING
BE COLLABORATIVE
our mission for the next five years. We will:
Drive improved outcomes BE A GREAT PLACE TO WORK
and experience through BE RESEARCH LEADERS
our unique network of BE DIGITAL
specialist cancer care across
Cheshire and Merseyside. BE INNOVATIVE
While these strategic priorities research ambitions, which will,
are displayed as distinct and in turn, improve the outcomes
separate they are clearly closely and experience of our patients
interwoven. Achieving our and contribute to our financial
digital ambition will support performance.
the delivery of our plans to
address each of the other five In addition, everything we do
strategic priorities. Key service in the next five years will be
developments in areas like underpinned by a refreshed set
interventional radiology will of values and behaviours that
support the delivery of our we will develop with our staff.
14 15Our strategic priorities
and key outcomes
Our Mission
BE OUTSTANDING BE COLLABORATIVE
Drive improved outcomes and Deliver safe, high quality care and outstanding Drive better outcomes for cancer patients, working with
operational and financial performance our partners across our unique network of care
experience through our unique network Outstanding CQC rating
Top decile NCPES survey
Improved 5-year survival
Increased early diagnosis
of specialist cancer care across
Cheshire and Merseyside.
BE RESEARCH LEADERS BE A GREAT PLACE TO WORK
Our Values
Be leaders in cancer research to improve Attract, develop and retain a highly skilled, motivated
outcomes for patients now and in the future and inclusive workforce to deliver the best care
Retain ECMC status Top decile staff survey
Gain CRUK centre status Teaching hospital status
New values that support our
mission and priorities to be developed
with staff in Year 1.
BE DIGITAL BE INNOVATIVE
Deliver digitally transformed services, empowering Be enterprising and innovative,
patients and staff exploring opportunities that improve or
support patient care
Develop a digital strategy
Achieve HIMSS level 7 Develop and implement an
innovation strategy
NCPES: National Cancer Patient Experience Survey
ECMC: Experimental Cancer Medicine Centre
CRUK: Cancer Research UK
HIMSS: Healthcare Information and Management Systems Society
16 174. Deliver safe, high quality care and outstanding operational
and financial performance
4.1 Quality and safety
We are renowned for our high quality care. We
consistently achieve excellent outcomes in patient
experience and safety, external regulatory inspections
and research quality. High quality care for all will
continue to be a guiding principle in the next five
years. Through the implementation of our Clinical
Quality Strategy we will focus on continuously
improving the quality of the services that we deliver.
Patient safety In addition, through implementing
We will continue to provide the our dementia and learning
disability strategies we will
BE
safest healthcare for patients,
led and monitored from ward continue to ensure that patients
to board. Staff will continue to get the expert help and
feel empowered to report near adjustments that they need to
OUTSTANDING
misses and incidents and will receive the best care.
be treated fairly when they do
so. We will demonstrate how we Our volunteers and Council of
actively learn from incidents and Governors actively participate
patient feedback to continually in a wide variety of committees
improve the safety and care and research forums across
we provide to improve patient the Trust. We will continue to
outcomes and experience. As an develop and enhance patient
indicator of our patient safety and public involvement through
culture we will remain ‘highly our Patient Experience and
recommended’ by our staff as Involvement Group. We have
an organisation where they or developed a Patient and Public
their family would wish to receive Involvement and Engagement
health care. Strategy and through the
implementation of this we will
Patient experience and deliver a number of pledges to
involvement our public and patients.
Delivering an excellent patient
Quality improvement
experience is at the core of what
we do. We will continue to strive We have an excellent reputation
for the best patient experience. for innovation and quality
As a measure of this we will improvement and this will
aim to achieve top-decile continue to be a key focus. Over
performance in key national the next five years we will work
patient experience surveys, through the NHS Advancing
such as the National Inpatient Quality Alliance (AQuA) to
Survey and the NHS England review and refresh our quality
National Cancer Patient improvement methodology.
Experience Survey. We will also provide training for
staff in quality improvement
skills, with the aim of equipping
staff to lead change and
improvement throughout the
Trust and across all sites.
18 19Clinical governance Regulation and Supporting quality of care
accreditation
Our Site Reference Groups (SRGs)
We established a new clinical The Clatterbridge Cancer
governance structure in We will aim to maintain or Charity supports the Trust in
2019 and this will be further exceed our regulatory markers our mission to not only improve Comprised of groups SRG annual business plans
embedded over the life of over the next five years. We will outcomes from cancer but also of clinicians involved in will support the delivery of:
this strategy. This includes the maintain our good rating from improve the quality of life for the care of patients with
better management of our risks the Care Quality Commission people living with the disease.
particular cancer types • This five-year
through the full use of the Datix while striving for an outstanding Working with the charity we will strategic plan
risk management system and rating. We will also maintain develop a quality of care grant Responsible for overseeing
improved process to learn from the key clinical and research to continue to fund services
the quality of care, • Our research strategy
and respond to complaints accreditations which make that are over and above those
and incidents. us stand out as a leader in commissioned by the NHS,
developing services, • The Cheshire & Merseyside
cancer nationally and achieve but that make a significant and driving research Cancer Alliance plan
We will also ensure that we and maintain compliance difference to our patients and innovation for their
implement all relevant national with all necessary regulatory and their families. This may particular cancer types • The NHS Long Term Plan
policy and guidance, such as standards, including: JACIE include psychological support,
the NHS Patient Safety Strategy, accreditation for the haemato- a range of complementary
and work with our partners in oncology bone marrow therapies that help relieve
the region, by strengthening transplantation programme, patients’ symptoms, or other
clinical pathways of care the Quality Standard for services as arise and approved
across the system and through Imaging, Human Tissue Authority by the Patient Experience and
programmes that share learning standards, NICE guidance, and Involvement Group.
across Cheshire and Merseyside. Emergency Planning Resilience
and Response standards (for
COVID-19 and exit from Europe).
4.2 Operational performance
Our clinical services are delivered through
Our patient & public
involvement & engagement pledges
clinical divisions that work in close partnership
with the research and innovation department
and corporate services within the Trust.
1. 5.
Each clinical division contains Our operational plans for the
Improve the use of our Deliver personalised care
a number of Tumour Site next five years, including those
members and patient council Reference Groups (SRGs). In the of our divisions and SRGs, will
6. early stages of this strategic
plan we will reorganise our
include focus on some key areas:
2. Use digital technology to clinical divisions to underpin • Maximising the benefits of
the SRG model and the clinical CCC-Liverpool
Understand patient empower patients to manage leadership that this provides. • Developing our services
experience & improve signage their care Implementing these service
• Embedding our clinical model
changes will not only enhance
the operational running of the • Improving urgent and
3. 7. SRG teams through improved unplanned care
and efficient patient pathways, • Meeting operational targets
Proactively share ‘you said, Increase the number of our it will deliver equitable access • Delivering financial
we did’ messages patients taking part in research for patients across our sustainability
networked model and ensure
improved patient outcomes and
4. 8. experience across the footprint
we serve.
Incorporate mental health Utilise the arts to support
awareness in everything we do holistic care
20 21Maximising the benefits of The transfer and integration We will also work closely with our
CCC-Liverpool of the haemato-oncology partners at Liverpool University
In July 2017 we took over the services historically based in Hospitals to review and manage
management of the Royal the Royal Liverpool University the comprehensive service
Liverpool University Hospital’s Hospital has paved the way for level agreement that we have
haemato-oncology service. the further integration of our put in place to ensure that our
haemato-oncology services patients at CCC-Liverpool have Embedding our clinical model
The service remained within the
Royal while the construction with those in the North Mersey access to acute care and other
of CCC-Liverpool took place. area. We will work with clinical specialist services at all times. CCC-Liverpool forms the central hub of We will also continue to work
and managerial colleagues at We will also carry out a with our partners on the
Having successfully moved
our haemato-oncology Liverpool University Hospitals post-project evaluation of the our networked delivery model of care for development of the CCC
and beyond to bring our teams opening of the new hospital. eastern sector hub set out
service into CCC-Liverpool,
together as appropriate into a non-surgical oncology across Cheshire in our clinical model. All new
our priority will be the full and
outpatient appointments and
planned integration of services single sustainable CCC service
for the benefit of patients.
and Merseyside. Each of our Site Reference systemic anti-cancer therapy
for haemato-oncology and
solid tumour patients in the Groups will develop plans that ensure that (SACT) for some less common
cancers for the population
chemotherapy unit and non-
chemotherapy day case area of
they continue to deliver and develop their of the eastern sector will be
concentrated on this one
CCC-Liverpool. services based on the principles of this hospital site, improving access
for patients to the necessary
clinical model. expertise and supportive care.
This will ensure that we learn the lessons relevant to any future large
scale projects and it will be the first step in ensuring that we realise in
full the expected benefits of the development of CCC-Liverpool.
The principles of our clinical model
Developing our services
We will also work with our
We will develop proposals to fully open our
teenage and young adult (TYA) unit in CCC- partners on the Isle of Man to
Liverpool. Our TYA team works across Cheshire
and Merseyside providing treatment, care and ensure that a sustainable and Services as local as possible within Clinical care delivered by
support to patients with cancer aged between 16-
high quality model of care is in the bounds of quality, safety, and consultant-led multi-
24 years and their families. CCC-Liverpool houses
affordability disciplinary teams, not single
a state of the art eight-bedded TYA unit that is place for their cancer patients. practitioners
designed to allow the team to deliver the best
possible care to their patients. Patients only treated outside of
The opening of CCC-Liverpool has also paved the
their local area by choice or for Services aim to minimise the time
way for the development of our interventional clinically justifiable reasons patients wait for appointments
radiology service for patients with cancer in the
future. We will develop our proposals for this as
a priority as it will have positive impact on both
Patients given choice in time and All patients have access to cancer
patient care and our ambitions for research. place of treatment whenever support workers, holistic needs
possible, including the expansion of assessments, signposting to
The National Centre for Eye Proton Therapy will
continue to be a flagship service for the Trust. services at home other services, and supporting
With our commissioners and partners we will work information
towards the significant upgrade that this service
requires to ensure its sustainability.
22 23Improving urgent and We will work with our partners
We are also Meeting operational targets Our services also support the
unplanned care across the system to place regional delivery of the new 28-
Our SRGs will also
While operational targets
Acute oncology teams manage this acute oncology work at committed to in cancer are in large part day Faster Diagnosis Standard continue to work
the unexpected care needs the heart of a comprehensive a measure of how the wider and the revised cancer waiting
of cancer patients, including and coordinated approach to continuing to system is working outside our time standards. To maximise to make sure that
urgent cancer care. This urgent performance in the future our
emergency situations and
and unplanned cancer care support initiatives Trust (again see section 5), we
operational team will manage advice and guidance
acutely unwell patients. Acute are committed to maintaining
oncology services are in place at programme will increasingly
focus on admission avoidance
aimed at tackling good internal performance the waiting list daily and
continue to monitor the internal
arrangements
the seven acute hospitals within during the life of this strategic
the Cheshire and Merseyside and ambulatory care, supported emergency and late plan. All of our cancer services ‘seven days to first appointment’ are in place to
region. Acute oncology services by a more comprehensive will be delivered in accordance and ‘24 days to treatment’
will need to expand to meet cancer advice (see box below). cancer presentation, with the agreed Cheshire & targets for all patients on a 62- support colleagues
day pathway.
the growing demand for urgent
Our Clinical Decisions Unit (CDU) including vague Merseyside Cancer Alliance
in secondary and
cancer care and there needs optimal cancer pathways.
to be continued coordination is currently open from 8am to symptom pathways We will also contribute We will continue to use good
primary care to
across the region. We will 8pm, five days a week. As part to the implementation of capacity and demand planning
support this expansion of acute of this comprehensive urgent and the evolving optimal timed pathways for to minimise waiting times within manage their
oncology services and their cancer care programme we will haematological, lung, upper the department when we do ask
coordination to ensure that consider whether the operating Rapid Diagnostic gastrointestinal, prostate and patients to attend face-to-face patients and
hours of CDU should be appointments. All outpatient
patients have access to services
extended to cover the weekend
Centres. For more on colorectal cancers.
clinics will also be delivered make appropriate
and are cared for in the most
appropriate place. as well. this see section 5. according to a standard
onward referrals.
template agreed by the
relevant SRG.
A system of urgent cancer care advice
Community acute oncology awareness Professional advice for other
initiatives, training for GP & community healthcare professionals through our
teams and enhanced patient helpline service
education
Our clinical decisions unit service
Increased provision of ambulatory care, for rapid face-to-face assessment
in partnership across the region, for less of patients with treatment related
urgent unplanned cancer care toxicities, delivering efficient
assessment by the oncology team
Triage, assessment and admissions to enable our patients to access
through our 24-hour telephone helpline timely care and potentially avoid
service providing advice and support to unnecessary admissions
patients receiving cancer care from all
CCC sites and network clinics
24 254.3 High quality environments
We have been investing in the development of high
quality patients and staff environments for over a
decade. We opened CCC-Aintree in 2011 and CCC-
Liverpool in 2020. CCC-Liverpool was developed
as part of an ongoing £162m investment that also
includes the redevelopment of the CCC-Wirral site.
The redevelopment of CCC-Wirral will be the focus
of the next five years and this programme will begin
early in the life of this strategic plan.
The Spine will house the northern
headquarters of the Royal College of
The Clatterbridge Cancer It is equally important that we
Charity has identified patient provide the right facilities for Physicians (RCP), as well as providing high-
environments as one of its our staff as people increasingly
priorities for the next five work more flexibly across sites quality work spaces for our staff. It will
years. It will be involved in the and from home. This will be
development of the plans to a key consideration in the
enable us to develop our relationship with
redevelop the CCC-Wirral site. In refurbishment of CCC-Wirral. our neighbours at the RCP and we hope to be
addition we will be supported by
the charity in the development able to make use of the building’s excellent
of a plan for the upgrade of
priority patient environments education and meeting facilities. Paddington
across our sites.
Village is just a short walk from CCC-
Liverpool and will also be the location of
We designed CCC-Liverpool
our staff and patient parking when the new
to maximise the amount of space for
multi-storey car park opens in 2021.
our patients and our clinical teams. This
will be complemented by superb office
accommodation very close by in The Spine,
one of the Knowledge Quarter’s most iconic
new Paddington Village developments, when
it opens in 2021.
26 27Partner programme The continued growth of
The Clatterbridge Cancer Clatterbridge Private Clinic,
Charity is a key part of our a joint venture with the
financial profile, and will Mater Private since 2012, will
continue to financially support continue to support financial
the Trust in delivering the best sustainability, and allows the
patient care. The Charity raises Trust to reinvestment into front-
money solely to support the Trust line care for all our patients. The
and deliver improved clinical CCC-Liverpool private clinic
outcomes. The Charity plans opened in 2020. While there is
to continue the considerable increased competition in the
success in fundraising over the local private care market the
last five years and double its investment in new capacity in
Liverpool will result in additional
4.4 Financial performance annual income over the next
income streams into the
three to five years. The Charity
has identified four key priorities joint venture from haemato-
for fundraising over the next five oncology and new privately
The healthcare environment remains challenging, years: patient environments, medical insured patients from
North Mersey and across
with a number of external factors providing both research and innovation,
the region.
technology for patient benefit,
risk and opportunity for the Trust. We recognise quality of cancer care.
that to deliver our strategy and maintain a
balanced financial position we must have a
strong commitment to clinical and operational
transformation. We also need to be at the forefront
of innovation and development. This includes
optimising efficiencies across our services so we
can reinvest in patient care. Our approach to
sustainability over the next five years will be based on
the following programmes:
Productivity improvement Capital programme The funding for our capital
How we will know
programme We understand that our programme is driven by
To ensure that we continue to infrastructure is critical to internally generated revenue.
deliver value for money, and delivering safe and leading Importantly, we will also bid for
live within our funding envelope
every year, the Trust will focus on:
edge patient care, and that
this is supported by an effective
additional funding where grant
or external opportunities arise
that are consistent with our
if we are successful:
• Medicines management capital programme. Our five-
year capital plan includes: investment plan.
• Workforce efficiencies
• Replacement of large
• Patient pathway optimisation
diagnostic and treatment
• Procurement equipment
• Digital productivity, and • Redevelopment of the ocular Outstanding Care Quality commission rating
• Estate rationalisation proton facility
We will use peer review,
benchmarking techniques and
• Development of the
CCC-Wirral site
Top decile National Cancer Patient Experience
service transformation methods • Maintenance of the new
Survey results
to support ongoing improved CCC-Liverpool hospital, and
financial performance and
deliver required efficiencies.
• Continued investment in Performance against cancer waiting times
digital infrastructure
Redevelopment of CCC-Wirral
Financial sustainability and ability to invest
in services
28 295. Drive better outcomes for cancer patients, working with our
partners across our unique network of care
During 2020 we opened CCC-Liverpool on
the site of the Royal Liverpool University
Hospital. Over the next five years we will take
the opportunity that this presents to raise
the profile of the Trust and consolidate our
leadership role for cancer across the region.
We will work with a range of partners from
across the Cheshire and Merseyside system
and beyond to deliver our shared plans for
the benefit of our patients and population.
BE
5.1 Cheshire & Merseyside Cancer Alliance
COLLABORATIVE
The Cheshire & Merseyside Over the n ext f i ve years Early diagnosis
Cancer Alliance is responsible we wi l l work as par t of We will work within the cancer
for leading cancer planning, the Cheshi re & Merseysi de alliance to support work and
delivering transformation Can cer Al l i an ce to b ui l d on initiatives that aim to ensure
and working with statutory thi s success. We wi l l seek that cancer patients in Cheshire
to exten d our i nfl uen ce and Merseyside are diagnosed
organisations and wider
b eyon d the speci al i st at the earliest possible stage.
partners to effect change
par t of the can cer The NHS Long Term Plan makes
in cancer services. We
pathway to contri b ute a commitment to develop Rapid
host the alliance and our
towards preventi on , Diagnostic Centres (RDCs)
Chief Executive Officer pub l i c awaren ess an d
is its Senior Responsible across the country as part of a
can cer di agn osi s. The wider strategy to deliver faster
Officer. The alliance has Cheshi re & Merseysi de and earlier diagnosis. Through
already made significant Can cer Al l i an ce’s f i ve year the Cheshire & Merseyside
progress: for example faster pl an has a focus Cancer Alliance our region has
diagnosis pathways have on preventi on , earl y implemented a number of RDCs
been implemented across di agn osi s, stan dardi si n g for patients with non-specific
all providers for lung and care, an d i mprovi n g symptoms suggestive of cancer.
colorectal cancer and can cer performan ce.
endoscopy and radiology The RDC programme will be
clinical networks have been Prevention expanded over the coming
established. Stakeholders in Cheshire and years to include additional sites
Merseyside have expressed in the region and to speed up
a strong desire to focus on the pathway for patients with
the prevention of cancer. A specific symptoms suggestive
Cancer Prevention Steering of a particular cancer type. We
Group has been established to will work through the alliance
implement and oversee projects over the coming years to explore
in key preventative areas such whether we could play a greater
as smoking cessation and role in early diagnosis in future
supporting the uptake of the through the development of
human papilloma virus (HPV) RDC models on our sites.
vaccine. We will play a full part
in the work of this group over the
life of this strategic plan.
30 31Standardising care Cancer performance
The Cheshire & Merseyside As a region we have made
Cancer Alliance continues to significant improvements in
work on the rollout of best meeting the cancer waiting
practice across the whole time standards. We are
system in order to reduce committed to supporting
variation in outcomes. Where Cheshire and Merseyside in the
it makes sense to do so we will implementation of new care
5.3 Radiotherapy operational delivery network
use our specialist expertise to pathways and referral processes
lead this process, for example that will reduce waiting
by exploring the potential to times, improve the region’s
standardise haemato-oncology performance against the The national modernisation programme for
protocols across the region. 62-day standard and enable
patients to move through the radiotherapy, led by NHS England, aims to invest
local health care system more
seamlessly. We will continue to £130m in the replacement and upgrade of equipment
work with partners to embed
and improve the delivery of
and to modernise services. Radiotherapy operational
the 28-day Faster Diagnosis delivery networks have been established to support
Standard and faster diagnosis
pathways to speed up the partnership working across radiotherapy providers.
diagnosis of cancer.
5.2 Cheshire & Merseyside Health and Care Partnership
Through our active It is likely that the partnership
will become an Integrated Care
involvement in System during 2021. We will
play a full and active role in the
the Cheshire & partnership as it continues to
develop. As an example we will
Merseyside Cancer work within the partnership’s
Alliance we will radiology network to explore
whether we can offer imaging
be at the heart of capacity on any of our hub
sites to support our partners
enabling a whole in the region.
pathway approach
for cancer for
The North West Radiotherapy Centre Chief Executive Officer
the Cheshire Operational Delivery Network is the Chair. Strong working
& Merseyside (ODN) spans Cheshire and
Merseyside, Greater Manchester,
relationships have been
established and the work
Health and Care and Lancashire and South programme has begun with the
Cumbria. It is the largest aim of implementing national
Partnership. radiotherapy ODN in England in service specifications by 2022.
terms of both scale and breadth
of resource. As part of the ODN we will
also support and mentor
We will play a full and active services outside of the
role in the ODN in the coming North West to develop
years. The Christie hosts the their stereotactic ablative
management of the ODN and radiotherapy (SABR) services.
The Clatterbridge Cancer
32 335.5 Other partnerships
Where necessary we will develop other partnerships
where this delivers patient and organisational
benefit. For example, we are working with three other
specialist trusts in Liverpool (Alder Hey, The Liverpool
Heart and Chest Hospital, and The Walton Centre)
to explore where there will be benefits to working
5.4 Genomics together.
Increased genomic testing has the During 2020 we worked with management. Over the life
potential to improve both opportunities these partners to create the of this strategic plan we will
Specialist Trusts Procurement explore the opportunities for
for research and opportunities to deliver Alliance. Through this alliance collaboration in other areas
tailored treatments to patients. In line with Alder Hey supports the Trust
in ordering and The Walton
such as estates, innovation
and research.
the requirements of Genomics England, Centre supports us in material
early work to achieve increased access to
genetic testing has begun in our region.
We will work with our partners and the
North West Genomics Service to ensure
molecular diagnostic testing is available
and access to molecular testing is
embedded into pathways.
In addition we will continue to support the regional
How we will know
Haemato-Oncology Diagnostic Service (HODS), which is hosted by
Liverpool Clinical Laboratories. if we are successful:
Improved 5-year survival
Increased early diagnosis
System-wide cancer waiting times performance
Progress against radiotherapy operational
delivery network plan
Increased involvement in diagnostics through
rapid diagnostic centres
34 356. Attract, develop and retain a highly skilled, motivated and
inclusive workforce to deliver the best care
We recognise that our people are our greatest asset.
Their dedication, talent, knowledge and experience
are at the heart of everything we do and have a big
impact on the care that we provide.
BE
We want to attract, retain Over the next five years we will
and develop the brightest and develop a new Workforce and
best people locally, nationally Organisational Development
and internationally through Strategy to set out how we will
our reputation for excellence implement the NHS People Plan
in patient care, research and in our Trust. Our strategy will
A GREAT
education, and our commitment focus on continuing to develop
to the health, wellbeing and a positive culture of compassion,
experience of staff. high performance, team ethos,
continual improvement and
innovation. We will support
all staff to fully reach their
PLACE TO
potential.
We believe that there are a
WORK
number of areas for priority
action which will support us
to build successful teams
and continue to be a great
place to work.
36 376.1 Leadership
We recognise that 6.2 Recruitment
effective leadership
and positive
Key to successful delivery of the strategic plan will be our ability
to attract the brightest and the best academic and clinical
people. By promoting a compelling employer proposition we
management enables We are fully committed to
enhancing leadership skills
will place emphasis on the harder to recruit groups such as
oncologists, specialist nurses and radiologists.
the development of
and capacity across all levels
of the Trust, with an increased As a great place to work and
focus on supporting middle The profile and impact of research within a local employer we will
high performing teams the Trust will be increased through delivery
managers and developing a work with schools, colleges,
pipeline of talent to support universities and community
effective succession planning of the five-year research strategy and groups across the region to
and provides a positive we will focus on the recruitment of a
and staff retention. improve access routes for
local people into jobs at the
Our clinical leadership is research workforce for the future, including Trust and will actively support
staff experience which
apprenticeships and widening
provided through clinical
directors for each clinical division
academic clinicians and clinician scientists, participation activities.
and site reference groups (SRGs) the latter in collaboration with the
in turn creates the comprised of groups of clinicians
involved in the care of patients
with particular cancer types.
University of Liverpool.
right environment for The SRGs are responsible for
overseeing the quality of care,
developing services, and driving
our patients to receive research and innovation for their
6.3 Workforce transformation
particular cancer types. The SRG
model provides an opportunity The Trust plans to further develop agile and sustainable
the best possible care. to develop the culture and ethos
within the organisation.
workforce models to meet the needs of patients and the
evolving health system.
Since August 2019 SRG research
We have invested in a range Prior to 2020 we were
leads have been appointed and
of advanced practitioners in developing plans for our staff
they will play a key role to ensure diagnostics, nursing, pharmacy to be more agile in support of
that the proposed research and physicians’ associates our multi-site clinical model. The
strategy is implemented over between 2015 and 2020 to COVID-19 outbreak in 2020 has
the next five years and beyond. improve continuity of care and meant that we have had to go
During 2021 we will reorganise reduce reliance on doctors in considerably further and faster
the divisional structures to training who are a relatively with this work than we were
ensure the SRGs are embedded transient element of the planning to. In so doing we have
and supported to lead and workforce. We will continue
demonstrated that we have
drive service improvement, to develop our innovative
both the capacity and the tools
efficient care models and approach to workforce
necessary to work in a much
high quality research. planning, creating new roles
more agile way. In 2021 we will
and new career pathways
that support the sustainable work to sustain these ways of
In December 2019 we appointed
provision of services. working into the future.
our first Chief Allied Health
Professional (AHP) to represent
all AHPs. We will develop an
AHP strategy which will seek
to harness the AHP workforce’s
potential for system redesign
and enhance the value of AHPs
within the Trust.
38 396.5 Culture and engagement
6.4 Retention We aspire to foster an open,
To be able to meet the evolving needs of patients and the
health system, the Trust will need to ensure sufficient workforce
transparent and high performing
culture, where staff feel valued
supply and will increasingly depend on an enhanced ability to
retain and develop a highly skilled and flexible workforce.
We will focus our efforts to
provide a comprehensive
reward and recognition
The successful rollout of our
electronic personal appraisal
and development review process
and recognised for the important
package to support staff
retention.
(e-PADR) in 2019/20 will continue.
contribution, actively participate
in service improvements and feel
The process will be empowered to raise concerns.
refined further to
ensure that all staff are
At a time when significant We will do this by involving
transformation is required staff from across the whole
and the NHS goes through organisation as well as through
supported in their roles
challenging times, maintaining patient and stakeholder
an engaged workforce is more groups. The revised values and
important than ever. supporting behaviours will be
and have a personal We will continue to develop
an inclusive and healthy
the principles that guide the way
we work every day, to ensure our
services are the very best they
development plan to environment where everyone is
treated with respect and dignity.
We will commit to a range of
can be for our patients and for
our staff.
optimise individual diversity and inclusion pledges
to ensure positive promotion
of equality and inclusivity in
We will continue to
develop a range of staff
recognition processes to
performance the workplace. We will actively
engage with and involve our
diverse communities. We will
ensure staff feel valued and
recognised by the Trust for their
contributions. We will continue to
alongside developing ensure that marginalised and
seldom-heard groups are
included from both a patient
listen to staff views through
staff engagement events and
using intelligence from our staff
their careers and and staff perspective and we will
work proactively to increase the
diversity of our workforce.
survey and quarterly staff Friends
and Family Test.
ensuring job The Trust’s current values
satisfaction.
statement has been in place
for a number of years and has
served us well. However, the
expansion of our clinical model
and a new configuration of
services provides the ideal
opportunity to review our values.
40 416.6 Health and wellbeing
Staff wellbeing is
now recognised This includes support
as an integral
part of good for staff through our
business practice
with research
employee assistance
showing the
clear association
programme,
between promoting
a culture of
occupational health
6.7 Education and training
employee wellbeing services, mental health
Through our excellence
As a tertiary centre and
and increasing
performance. first aid and resilience system leader we aspire to
be recognised regionally and
and expertise in
nationally as a leading
The NHS workforce is large and programmes and also provider of cancer education
and training.
education and training,
improving the health of staff
and their families has enormous
potential in preventing future developing the skills of As part of this we will strive to
achieve teaching hospital
we will continue to
ill health not only for them but status during the life of this
also for the wider community.
The Trust is committed to being our leaders to better strategic plan.
achieve excellence in
the employer of choice and We have developed a
recognises that an important
aspect in achieving this is the understand the value standalone education strategy
that sets out our ambitious and
patient care, service
promotion and maintenance of dynamic approach to shaping
the physical and psychological
wellbeing of its entire workforce. and importance of and leading cancer education
across Cheshire and Merseyside.
Our Health and Wellbeing
Plan sets out our aims and staff wellbeing. We will delivery and cutting We will work to implement this
strategy over the next five years.
goals to support both the
physical and mental wellbeing
of our workforce. implement this plan fully edge research across
over the life of this five- the region.
year strategy.
42 43Our education strategy
Support all staff to develop and
maximise their potential through Work collaboratively with the
high quality education provision Health Education England, the
which responds to the wider cancer alliance and primary
NHS national priorities and care partners to provide cancer
engages with new advances education and training that is
and innovations in cancer care targeted and relevant
Continue to develop and We will increase academic-led
enhance our education and education and training to
training for all cancer care optimise patient-focused
students and professionals of educational development at
the future in conjunction with the forefront of cancer care How we will know
the University of Liverpool and
Higher Education partners if we are successful:
We will continue to develop
our career pathways and
frameworks for nursing, allied
Top decile national staff survey results
Further strengthen our health professionals,
centralised model of pharmacists and other staff,
Performance against key workforce metrics
education governance, offering new challenges, new
promoting and consolidating ways of working, and
collaborative working encouraging career ambition Performance in equality and inclusion metrics
between everyone involved
in education at CCC Refreshed values and behaviours
High rates of performance appraisal and
development reviews
Achievement of teaching hospital status
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