RM Partners, the West London Cancer Alliance, was looking for expressions of interest from bidders to act as a lead provider to deliver the national Targeted Lung Health Check (TLHC) Programme in North West and South West London as a single programme.
This project was to support InHealth (lead provider for the bid) and the NHS consortium prepare for the bid submission to deliver the national TLHC programme in North West and South West London as a single programme. We did so by acting as an independent facilitator to convene key stakeholders in three workshops to develop the delivery model for the service.
Lung cancer is often diagnosed in its advanced stages when treatment options are limited.
As a result, when symptoms appear the cancer has already spread, making treatment more difficult and less effective. By screening for lung cancer using low dose computed tomography (CT) scans, we can detect the disease in early stages, before symptoms appear, leading to improved treatment outcomes and survival.
We were invited by the Royal Brompton Hospital (RBH) and Royal Marsden Hospital (RMH) to act as an independent facilitator in the bid process. InHealth was the primary lead contractor, and they subcontracted a consortium of NHS and independent partners to handle specific components of the lung screening pathway: InHealth to provide the majority of CT scanning capacity, Heart Lung Health to take on a majority of reporting by radiologists while RBH/RMH led on multidisciplinary group meetings and onwards referrals (working out these roles was part of the scope of this work).
We facilitated three workshops to map the patient pathway, including referrals, and data transfers. In the first workshop, we traced the patient journey from cohort selection to CT scanning and reporting. The second workshop focused on onward referrals and multidisciplinary team meetings, while the third workshop focused on mapping data transfers for both service delivery and research purposes. Overall, our workshops aimed to answer outstanding questions in the bid about how the service would be delivered by partners.
In addition to the workshops, which were our main deliverable, we conducted additional work to inform the workshop prep and final outputs, consisting of site visits and interviews. We conducted two ethnographic and pathway mapping site visits to existing TLHC sites: one to an RBH TLHC facility, and a second to an InHealth TLHC site in North East London. These visits provided us with an in-depth understanding of TLHC operations and allowed us to compare and contrast the delivery and processes in sites led by two different bid partners. We also conducted semi-structured interviews with clinical staff to identify potential areas for improvement in TLHC delivery with a particular focus on data systems and transfers.