Strategic Objective 1 - To achieve a patient-focused, de-congested, multidisciplinary/professional combined clinic

Strategic Objective( 1) : Achieve adequate human resources for an integrated interdisciplinary input for all patients: Speech therapy, Physio, OT, Dietetic, MSW, Welfare Benefits, Clinical Psychologist

Strategic Action	Support/resources needed		Who is responsible		Who else to involve		When done		How to measure
Write standards for what should be available Audit standards/ benchmark to show discrepancies and effects (e.g. longer stays)	Standards from other areas, literature searches, help of therapy teams, BAHNO document, Calman-Hine doc., various Govt. docs on first-class service, Clinical Governance etc. Funding – MCR, R&D, Lottery, QOL (Pall care money)?		Maria - SLT Hayley - dietetic Trish - welfare Debbie & Sally K - radiotherapy Gail - O.T. & Physio on Ward 33 Graham (BAHNO doc) Mark- clin. psych		Chief dietitian Physiotherapist Occ.Therapist Maggie Bellew & Lindsay Vickery Elaine Andrews		August 2000		All information collated and standards drafted.
Present evidence to Trust Board	Business case presentation		Every one		Managers		Subsequent to above Sept. 2000		Present to Trust Board- invite to presentation by whole team
Improve recruitment and retention of radiographers by increasing job satisfaction with provision of more training By providing financial incentives as other Trusts do	Funding for training - ask Trust in first instance, also Head & Neck Fund. Recommend to Trust to reconsider financial incentives		Debbie & Sally Kelly		Chris		November 2000		More radiographers able to go on head & neck courses.
Establish resources in peripheral units for post radiotherapy follow up - nursing & dietetics	Cancer Network group Nurses in units		Sally Marshall		Nurses in units		November 2000		Established resources in units
Obtain third Head and Neck Consultant (see strategic objective 1)		Funding - Business Case to Trust		Dr Catherine Coyle		Dr Adrian Crellin		Sept. 2000		Consultant in post

Strategic Objective (2) - To achieve a patient-focused, de-congested, interdisciplinary combined clinic

Strategic Action	Support/resources needed	Who is responsible	Who else to involve	When done	How to measure
Restrict clinic to new and complex patients only (® allocate more time to MDT case conference)	Clinicians write policy/protocol	Catherine Coyle	Everybody	Nov 2000	Protocol written More time for new & complex patients & MDT meeting
Follow up ‘routine’ patients in surgical clinics and oncology clinics in units, Discharge Policy for > 5 years.	Individual clinicians/surgeons to organise Write discharge policy/f-u policy Discuss at Network Group	Catherine Coyle		Jan 2001	No routine follow up in combined clinic.
Organise rehab. follow up in units	Discuss at Network Group Ascertain what’s available in units	Sally, nursing Maria, SLT Hayley, dietetic Graham, clinicians	Nurses and therapists in units	Feb 2001	Identified nurses & therapists in units
Complex/specialist rehab clinics in Centre to be explored	Policy for discharge from medical/surgical clinic to rehab R & D funding for research project (QOL) Trust/Dobson money	To be addressed by Research Group (Trish)		2001
Data collection in units - explore	Discuss at Network Group ? R & D funding/Dobson money	Being addressed by network group currently	Cancer Network	2002	Data collection units up & running
Appoint clinic co-ordinator and data organiser	Business case to Trust Board	Catherine & Trish	David Fox	January 2001	Co-ordinator appointed
Obtain more equipment	Business case to Trust Board	Graham	David Fox	2001	Equipment purchased
Plan for more space	Plan for reconfigurations - find out about and influence	Being addressed	David Fox	Nov 2000	More rooms built

Strategic Objective (3): Achieve adequate environmental and equipment resources to provide a good head and neck cancer service

Strategic Action	Support/resources needed	Who is responsible	Who else to involve	When done	How to measure
Short term - more O₂ & suction points on Ward 33	Funding - find out cost & make business case for Trust (-good time to use infection control as a lever)	Joyce already doing Has go-ahead for 8 beds	Damien	August Summer 2000
Long term - decide: Do we want a dedicated Head & Neck Surgery Ward? What facilities do we want? - in Head and Neck Reconfiguration in Oncology Reconfiguration Quantify, identify, predict	Team to make decision Find out what’s being planned Befriend managers on ‘inside’ Influence planning	(Mike) David Mitchell Graham Joyce & Julia	Managers	5 years	Good representation on reconfiguration groups
HDU : What do we need What have we learned How do we go forward	Funding Management support	Mark Graham Joyce or rep.	Elaine Andrews Anaesthetists	A.S.A.P.	HDU beds working
More space for combined clinic (see strategic objective 2)	Funding Management support	Graham Catherine	David Fox	A.S.A.P.	More consulting rooms on Westmoreland Unit

Strategic Objective (4) : To have a robust Education and Training Programme

Strategic Action	Support/resources needed	Who is responsible	Who else to involve	When done	How to measure
Do market research on topics needed	Make list from various areas of what is needed	Sally K. & Debbie Trish Gail Catherine		Oct 2000	Teaching programme up & running
Structured programme of practical teaching workshops & lectures for all HCP’s Programme for District Nurses and Units - PEG’s, Tracheostomy, NG, Radiotherapy, Mouthcare	Individual team members Drug companies to sponsor	Trish Catherine Gail & Julia Sally K. & Debbie, Myra Dietitians	Relevant individuals to do lectures	Nov 2000	Teaching programme up & running
Continue Cancer Network Days	Cancer Network	Graham to delegate		Ongoing	-do-
Run weekend/Saturday lectures - for Community, medics, nurses, radiographers, PAMs etc. who can’t attend on weekdays.	Individuals to organise Drug companies to sponsor	Gail & Julia Sally K. & Debbie, Trish Myra Catherine		Nov 2000	-do-
Create web-site with lectures/teaching sessions/videos and hard copies.	I.T. support Individual’s contributions	Julian (send contributions to [email protected])	Philip Melling I.T.	Nov 2000	Website up & running
Contribute as a team to Head & Neck module for Leeds University	Individual team members	Gail & Julia Myra	University	January 2001	-do-

Strategic Objective (5) - To have a Corporate Team Identity and raise the profile of the Leeds Head and Neck Cancer Team

Strategic Action	Support/resources needed	Who is responsible	Who else to involve	When done	How to measure
Create a logo	Graham and computer	Graham	-	Done	Logo done
Make letterheads	Graham	Graham	Print Unit	Sept 2000	Letterheads done
Publications should be credited to whole group		Everyone	Everyone		Publications credited to whole group
Set up an Appeal	Appeal co-ordinator Find out about running Appeal Find out about being the Charity for Leeds Marathon	The Group, especially Graham	Annette Day Journalist	December 2000	Appeal started

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Strategic Objective(6) - To achieve a high level of communication in all areas

Strategic Action	Support/resources needed	Who is responsible	Who else to involve	When done	How to measure
Improve documentation of day to day decisions and communications, and post operative instructions on Wards 33 and 92 by SHO’s and registrars and consultants & anaesthetists	Co-operation of medical staff Resource file as per Cookridge Protocols for junior medical staff Check-lists for post-op care Joint records Data forms in Medical Records.	Graham Joyce Julia	Other medical staff	Ongoing August 2000	Better documentation
Improve organisation of consultant team and ward rounds on Wards 33 and 92.	More time! Support of other ENT consultants Discussion of alternative organisation possibilities	Graham	Other medical staff	Ongoing	Ward rounds organised to enhance communication throughout team as a whole
Establish regular ward round meetings for Dr Ash patients.	Dr Ash, and Registrar	Hayley Trish Sally Kelly	Dr Ash	Done	Regualr ward round meetings in place
Obtain third Head and Neck Consultant so consultants have time to communicate (see strategic objective 1)	Funding - Business Case to Trust	Dr Catherine Coyle	Dr Adrian Crellin	Sept. 2000	Consultant in post
Head and neck radiographer to attend combined clinics	Time Superintendent radiographer	Sally & Debbie	Sue Griffiths	2004	Radiographer at clinic

Strategic Objective(7) - To have a robust R & D, Audit, and Data Collection Programme

Strategic Action	Support/resources needed	Who is responsible	Who else to involve	When done	How to measure
Set up a Data and Research Sub-group establish data set to use, including Q.O.L. establish logistics of data collection secretarial time for inputting data obtain software	- volunteers - funding - funding	Graham, Trish, Hayley, Maria, Catherine (plus, also, other consultants may want to be involved - Graham, David, Mike)	Audit Dept. Statisticians (R & D) University to get access to stats software.	Feb 2001	Up & running group
Establish a register of group projects	Paper/PC Person	Catherine	Everyone in Group	Nov 2000	Register up & running
Provide a focus, advice, co-ordination capacity for research as a group	Meetings set aside for this	Catherine Trish	Research support team	Feb 2001	Group up & running
Idea generation for projects (® Apply for funding)	A brainstorm	Everyone on above Group		Mar 2001	Project ideas collated
Establish a research fund for the group	A fund-raiser (as per Strategic Objective 5)	Research group	Annette Day Fundraiser	2001	Research fund started