Improvement work opens doors in the North of England

The network organised two and a half day workshops for three general practices in South of Tyne and Wear, using the LEAN methodology developed by Toyota and adapted for a health setting by the Virginia Mason hospital in Seattle.

The most important thing about these ‘Kaizen events’ was ownership, according to network director Roy McLachlan. The practices identified their issues and came up with solutions and a plan for change over 30, 60 and 90 days.

Network public health lead Nonnie Crawford says it doesn’t matter what improvement methodology is used as long as it is structured, effective and any proposed actions are followed up. What does matter is that partner organisations use the same system. ‘The deal is all the partners use it, so there is consistency between the acute trusts and primary care.’ Commissioners in the north are signed up and tend to be more receptive to ideas springing from a Virginia Mason process, she says. NHS County Durham and Darlington ran a similar project using another improvement method, Rapid Process Improvement Workshops (RPIW), which is used locally.

The network is aware that the Kaizen method is resource intensive and could not be done with every practice. But Roy McLachlan suggests that if a planned Kaizen event for consultant radiologists and GPs succeeds in sorting out long standing X-ray reporting problems, GPs will be more inclined to listen to the ideas coming from the workshops. ‘That will give us credibility to say to primary care, we have learned these are the things you could implement quite quickly.’

The network is working directly to influence commissioners through an event for GPs and consultants that will look at the pathways for breast, lung, colorectal and prostate cancers and the importance of increasing awareness so people go to the doctor sooner. This is timed for March, just before the commissioning handover takes place. ‘If GPs are going to become commissioners and can see the influence of the early stage on the pathways, they will find it easy to keep it as a priority.’

Another urgent task is to convince the new commissioners of the value of GP leadership, to support the improvement work.

The network is worried that the new health and well being boards may focus on adult social care or children, to the detriment of cancer.

However the involvement of local councillors in public health provides a great opportunity. The public cares about cancer and politicians care about what matters to their constituents. The message that awareness and early diagnosis can save lives should bring local politicians on board and will be vital if funding for awareness raising is to continue in financial hard times.

• Report - The use of Lean methods for service improvement in the early diagnosis of lung cancer, a realistic evaluation 

This article is based on a presentation made at an event to share learning from the National Awareness and Early Diagnosis (NAEDI) programme of work carried out by cancer networks in 2009/10. The learning events were funded by the National Cancer Action Team and organised by consultants Frontline.

To find out more about the learning events, or to join one, contact Sally Williams at Frontline: Sally.Williams@Frontlinemc.com

North of England Cancer Network director Roy McLachlan Roy.McLachlan@sotw.nhs.uk
North of England Cancer Network public health lead Nonnie Crawford Nonnie.Crawford@sotw.nhs.uk

Article written by Ros Bayley on behalf of the National Cancer Action Team