The Trust has worked through a detailed action plan relating to Cancer Services, specifically in relation to the oversight and support for MDTs and has addressed the issues identified in the SAIs in urology. Extending the work to include dimensions of quality, safety and strategic planning in Cancer Services would be of benefit. The Trust has understood the need for further improvements in the management and leadership of Cancer Services and has recently told the Inquiry that they have created a new senior manager role. This role includes overseeing safety and quality and bringing oversight of Cancer Services into a quarterly strategic Cancer Board. The Inquiry recommends that the Trust consolidates all current work into a project led by SMT to consider the following:
• Development of the medical leadership of Cancer Services at the Trust so that there is a more strategic view of the delivery of services for patients with cancer, including an emphasis on quality standards and strategic planning for the service.
• The Department and Trust should devise a programme to support the key role of nurses in cancer care and to develop senior cancer nurse leadership as part of the leadership team in Cancer Services. This should be done both at Trust level and regionally.
• Cancer Services should be led by a formal triumvirate comprising a senior manager, a doctor and a nurse who would share decisions. The Inquiry considers that this style of coordinated triumvirate leadership would be beneficial across the Trust. We recognise that nurses already make very significant contributions in leadership roles and could significantly enhance management structures. Development of this type of triumvirate of clinical leadership should be added to the overall project on medical management and leadership led by the Medical Director.
• To ensure that the Board is fully aware of the risks to quality care and plans to mitigate these, Board committees should receive regular reports on the service. These reports should bring operational performance, quality and strategy together to enable informed discussion.
• As the focus on Cancer Services came about because of the SAIs in urology related to patients with cancer, the urology service should be used to test new ways of bringing cancer data together. The data should be integrated in a way that would help staff and patients understand the overall quality of care being provided.