NHS SY ICB - SYB Cancer Alliance - Lung Cancer Screening

SY ICB are looking to re-new an existing service which is already commissioned across South Yorkshire and Bassetlaw. The SYB Lung Cancer Screening programme has been operational since March 2021, so has made great strides towards 100% roll out.

As an established programme, we are now having to factor in second, third and potentially fourth screening rounds ahead of the transition to becoming a national screening programme (timeline tbc). Incident scans and nodule surveillance scans beyond 24mths were not a consideration when our services were first commissioned, nor is there much in the way of national guidance to support this, but we have a duty of care to our eligible population to continue screening them every two years while ever they meet the eligibility criteria.

This service must be delivered in conjunction with existing services within SY ICB to allow for the best use of resources for SY ICB while ensuring equality of all patients included in the programme both previously and currently. NHS SY ICB are intending to award a contract an existing provider following Direct Award Process C

The lifetime value of the contract is expected to be £4,895,600 The dates between which the contract will run from are: 1st April 2026 – 30th Sept 2028

Key Criteria 1 - Quality & Innovation. - Weighting 30% The purpose of continuing care for all original screening cohorts is to promote health inequalities and demonstrate SY ICB’s commitment to deliver on national guidance to ensure all those eligible are receiving lung health checks.

Key Criteria 2. - Weighting 30% SY ICB are aiming to ensure that the commissioning of continued care in the form of regular incident scans, is done in the most cost-effective manner, enabling the best use of resources for the organisation.

In order to achieve this SY ICB are looking to commission this service to merge with existing resources to reduce the financial and resourcing impact while enabling us to maintain the offer of LCS to all who are eligible on a rolling basis. It is imperative that this service is provided by an existing provider in this space to avoid the need for duplication of resources and thus cost to SY ICB while ensuring that all patients undertaking a LCS are treated the same and placed on the already established pathways.

Key criteria 3 - Integration, collaboration and service sustainability - Weighting 10% Our decision to extend this service is influenced by the NHSE Standard Protocol for LCS which states: '..repeat scan every 2 years until no longer eligible by age or other exclusion criteria'.

As an organisation we remain committed to upholding this obligation, given that these patients have already been assessed as high risk of developing lung disease including lung cancer and their risk will only increase with age. Screening provides the best chance of finding the disease early.

This ambition is reflected within the NHS Long Term Plan to diagnose 3 out of 4 people with cancer at the early stage by 2028. Using the current service would improve the sustainability of the new service by allowing operational flexibility, patient flexibility and minimising time and operational costs for the provider to ensure the best value and service for patients.

See section II.2.14.1 - Additional information for the remaining Key Criteria. Additional information: Key criteria 4 - Improving access, reducing health inequalities and facilitating choice - Weighting 20%

While the initial rollout of SY ICB’s LCS programme was planned to target, cover and provide for those experiencing greater health inequalities while promoting choice and access, its been recognised that this can be expanded further in the five years the programme has been running. As an organisation we were aware via the Standard Protocol of our obligation to ensure all participants receive at least two LDCT screening round scans (baseline or 24 month scan) before exiting the programme, but we hadn't factored into trajectories or contracts, those patients who might qualify for more then two LDCT screening rounds and now better understand the quantity of these patients.

We have now refined accessibility to the service through working with the current provider and their sub-contractors which allows us to target the specific cohorts in question to reduce non-attendance. Key criteria 5 - Social Value - Weighing 10%

The purpose of this project is wholly based on improving patients access to care, early diagnosis and reducing health inequalities. Specifically, this extension to the LCS programme will further ensure equal opportunity is met as we seek to proactively diagnose early-stage cancer in all patients in a mobile setting.

This early diagnosis outcome will also result in a general improvement for wellbeing for those effected as they will either be placed on the appropriate pathway for the care they need or advised of a nil finding despite being eligible due to the risk factors. As this service is mobile in nature and commissioned on a basis in which the existing provider will attend multiple sites at different times this will allow patients to attend appointments that most suit their location, reducing their travel time and increasing uptake by offering them convenience.