Aintree University Hospital NHS Foundation Trust prides itself on placing service users at the centre of any redesign process, in order to improve access to services and increase patient knowledge of their condition and their ability to self-care. The success of this approach is demonstrable in terms of improvements in access, efficiency, effectiveness and value for money.

During 2012, the Intensive Support Team, (IST), was invited to undertake a review of the Trust’s cancer services, who applauded the Trust for its approach towards patient focused pathway improvements.

Building upon this initial review, the Trust undertook a further review, during 2015, which culminated in a unique portfolio of cancer pathways, with an emphasis upon access to services. The Trust utilised the following key approaches within its review method:

• Building upon best practice: Utilisation of relevant NICE guidelines, and peer review recommendations, ensured pathways were fully aligned to current best practice.

• Increase access to specialist services: Innovative pathway redesign, improved access to specialist services, including; ‘electronic referral and day case booking systems, and one-stop pre-operative clinics for tertiary referrals’, (Liver)

• Focus on the needs of users: Pathways focused upon the needs and preferences of users of specialised services, and placed patients at the heart of the design process, including; ‘one-stop AHP pre treatment Assessment Clinics’, (Head and Neck)

• Moving care closer to home: Pathways included provision of cancer services closer to home for the service users, to ensure pathways were accessible and convenient, including; ‘streamlining GP access to CT through cancer alerts’, (Lung)

• Increasing patients’ knowledge of their condition, and ability to self-care: Pathway design included condition specific information to increase patient knowledge and bolster the ability to self-care, including; ‘educational and psychological support from CNS and key workers’, (Liver)

• Involvement of all stakeholders in the service redesign: Active involvement from all members of the Multi-professional team during pathway reviews, ensured pathway improvements were patient centred, clinically led and jointly owned by the cancer teams, (All pathways)

• Improved outcomes for patients: Utilisation of general and Trust specific findings from the National Cancer Patient Experience Survey, 2014, in addition to feedback from service user groups, patient satisfaction surveys, and Trust performance data, ensured pathways could provide demonstrable evidence that pathway efficiency and clinical effectiveness had been improved.

• Better value for money: Process mapping of each cancer pathway, with participation from all members of the Multi-professional cancer teams, validated with clinical performance data, ensured pathways could provide demonstrable value for money (Urology).


The above approach has enabled the Trust to assure service users and Commissioners that it has improved access to specialist cancer services, which deliver value for money and demonstrable benefits for outcomes, efficiency, safety and the quality of the service user experience.

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