Policy

This section has been designed to give users an overview of how implementing the intra-operative test into routine clinical practice meets a number of national strategies which have been designed to improve patient care and the services that patients receive. Implementation should be seen as an opportunity to improve the way services are delivered, the mechanism to implement the NICE guidance on Sentinel Lymph Node Biopsy and a means to overcome any perceived barriers to adoption.

However, as with most service improvement initiatives, the principles of commissioning become a crucial part in ensuring the sustainability of the technology and ensuring it remains adopted at Trust level. It is the principles of commissioning effective and efficient services that will underpin successful adoption of the technology - first by removing redundant clinical practice (or practice that will become redundant) and secondly by replacing such practices with a revised model of care.

We've put together a useful table, which provides an overview of how implementation of this technology will impact on key policy areas, from its impact on quality of care, compliance with National access targets, to improving outcomes for your patients. Effective implementation of this technology will support the challenge of ensuring that the NHS continues to improve quality of care during a period in which growth in expenditure on the NHS will be restricted.

Policy Area Affected	Performance Measure
Gaining an overview of the recent Department of Health Initative known as QIPP (Quality, Innovation, Prevention and Productivity)	Length of stay / bed day savings.
Commissioning for Quality and Innovation (CQUIN) Framework	Allocation of providers' contract income to the achievement of locally agreed plans for achieving higher levels of quality.
NHS Operating Framework 2010/2011	Improved patient experience, improvement in quality, effective use of resources and collaboration.
Cancer Reform Strategy 2010	To introduce a maximum wait of 31 days for a second or subsequent treatment, where the treatment is surgery.
Transforming Inpatient Care Programme	Reduction in unnecessary Length of Stay, Improving Patient experience, Improving Patient outcomes
Measuring surgical outcomes	Patient related outcome measures.
Cancer Commissioning Toolkit	The Cancer Commissioning Guidance identifies key questions commissioners should ask about population needs and services. Wherever national data are available, the CCT aims to provide information to PCTs and cancer networks about their current performance and how this compares to elsewhere, in an accessible and usable way, to inform the commissioning process.

To view how implementation of this technology would meet the National Performance Assessment Framework and aspects of the NHS Plan (2000) Click here.

To view the 2010 - 2015 NHS Plan, from good to great: preventative, people-centred, productive click here.

Implementing Key Policy Guidance

There are three additional areas that have been designed to help implementation teams understand the wider concept of adoption and how this aligns with the delivery of an enhanced cancer service at a Trust level. These principles have seen the successful implementation of the technology at the NTAC project implementation and mentor sites and underpinned their business cases. Each link below will open up a new page where the concepts will be discussed in more detail and additional resources will be available:

NHS Improvements 23 Hour Breast Model

The NHS Technology Adoption Centre (NTAC) and NHS Improvement have been working together to align this How to Why to Guide with the Click here.

NHS Improvement are currently working with 13 National Clinical Networks across England, accelerating the pace of spread and adoption of the Breast Surgery Day Case & 23 Hour Model. This model takes a pathway approach that builds upon known best practice and the principle that all patients should be on a clearly defined pathway based on their tumour type and reason for admission and ensures that the patient is in hospital for the appropriate length of time and reduces unnecessary delays and waits - "valuing patients time".

The 23 hour Model acknowledges the importance of staging patients with early invasive breast cancer and embracing new medical technology for procedures such as sentinel node biopsy that can prevent approximately 30% patients undergoing a second operation for axillary node clearance.

Click here to find out more about the NHS Improvement 23 Hour Breast Model.