C-PORT
Marie Palmer
Deborah Grimes
Jill Ireland
What is C-Port?
Chemotherapy
Planning
Oncology
Resource
Tool
So …
It is a
Tool hat helps Planning Resources in the Chemotherapy and Oncology environments
AND
Will help in answering the broader question of how to plan capacity in chemotherapy
service delivery within the NHS
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The POIP was formed and it initiated the C-Port project
 The Pharmaceutical Oncology Initiative Partnership is a working partnership of the:
• Pharmaceutical Oncology Initiative
Group (POI) of the Association of the
British Pharmaceutical Industry (ABPI)
• The Cancer Services Collaborative
“Improvement Partnership” (CSCIP)
• The Cancer Action Team (CAT) of the
Department of Health (DH)
 The aims and objectives of the Partnership are to identify and implement activities
(projects) of mutual interest that would ultimately benefit cancer patients by
improving uptake and access to cancer drugs.
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C-Port as a means to an end, not an end by itself
 Redesigning chemotherapy services is not just about using a tool
 C-Port aims at facilitating and making more effective the process redesign task, but as a
system, it is only one component within the broader science of process improvement
Understand the
real-life situation
Hypothesise
solutions
Effectively
use C-PORT
• What is the
problem?
• What is the
current situation?
• Break it down into
smaller issues
• Measure and
analyse data
• Translate
hypothesised
solutions into CPORT items
• Validate with
relevant
stakeholders
• What could be the
potential solutions
to the problem?
• What variables are
involved?
• Create scenarios
and run
simulations
• Identify most
optimal scenarios
and optimise
Complement
simulation results
Implement
change
• What additional
data / analysis is
required to
support C-PORT
findings?
• Develop an
implementation
plan with clear
milestones and
timelines
• Formulate your
case thoroughly
• Get buy-in from
stakeholders
• Measure results
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Therefore, C-Port is …
 … A toolkit that helps the NHS better understand resource and capacity planning
 … An initiative launched by the POIP that attempts to address the important and difficult
task of planning capacity in chemotherapy
 … A component within the process redesign science (so, a means to an end rather than an
end by itself)
 FREE to all NHS Chemotherapy services
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Overview of C-Port
The scope of the tool allows effective capacity planning but
not scheduling
In Scope
Medium/Long-Term
Short-Term
• Forward looking 1-3
years
• Annual planning and
input to budget
• Impact of changes in
demographics
• Optimisation of:
• Impact of new drugs
and/or protocols
— Nurses versus beds
versus isolators
— Shift patterns
• Infrastructure planning,
• Develop understanding
e.g. how large should
of impact from new
the unit be, how many
drugs, protocols
beds
Out of Scope
Scenario
Planning
• Immanent term
• Planning holidays,
training and
understanding risks
• Running what-ifs in order
to check coverage
Scheduling
• Which patients will be
treated when
• Allocation of beds
• ..
• Increase usage of
existing protocols
Because of the complex processes involved in chemotherapy delivery, and the innate
uncertainty in many of the variables involved, C-PORT has been developed as a simulator
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Overview of C-Port
The “transformation rules” of the chemo service delivery
involve regimens, cycles and tasks
Cancer types
Regimens
Cycles
Tasks
Resources per task
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We are beginning to be able to make meaningful
comparisons between trust data
Trust 1
Fairly even through the
day with a one qualified
resource to manage
scheduling
Trust 3
Bottleneck and
crazy busy prior to
lunch
Trust 2
Fairly balanced, but
lower utilisation
Trust 4
Erratic
There was a great benefit in debating the reasons for these
patterns across a network.
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Insight vary considerably and the different reports are
useful at reviewing the “Trust Operations” from multiple
angles
Clear Bottleneck
Bottleneck varies throughout the day
Patient View
Regimen View
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Interpreting Reports
Simulation reports
Patient Log
• Displays the event details for each patient that enters the system over the date range of the
simulation, across all cancers and regimens
• Tasks are listed sequentially for each patient
• The raw data is used to generate other C-Port reports, and can be used to create new user-defined
reports
Patient ID – unique for
each patient
Date of
activity
Task sequence #
within cycle
Patient cancer type, and
corresponding regimen
Task patient
engaged in
Cycle at which the patient
has entered the system
Duration of
task
Start and end
time of task
Resource
required to
perform task
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Comparison of process times across the network can be
made…
Note: timings may not be directly comparable
Pre-reconstitution
23mins
68mins
15mins
30mins
13mins
Pharmacy
35mins
65mins
55mins
75mins
63mins
Chemo delivery
30mins
20mins
23mins
60mins
43mins
88mins
153 /
88mins
93mins
165mins
118mins
Consultant
visit and
bloods in
advance
Pharmacy
process
completed
in advance
Consultant
visit and
bloods in
advance
Transfer
decontam
and notes
are long
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There are a number of key success factors that need to be
considered
C-Port is very powerful and WILL help you significantly improve the service that you provide
however:
 The initiative needs to be strongly lead and supported from the network and within the
units
 Spending time getting the initial data is somewhat painful, but the better the data is the
better C-Port can help you reduce time and effort optimising your service
 C-Port is not a one-off exercise – it should be seen as the fastest way of testing any
proposed changes to your service over the coming years.
 Buy-in from clinicians, nursing, pharmacy and managers are all crucial to making C-Port
work – you need to spend sometime “selling” its benefits - we can help you do this
 CAT / CSCIP wants to give as much support as it can – but we can only work at the pace
you set.
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Current Activity for roll out
Western Isles
Moray
Highland
Aberdeen City
Aberdeenshire
Angus
Perth and Kinross
Merseyside and
Cheshire
Dundee City
Argyll and Bute
Fife
Stirling
Clackmannanshire
Dumbarton
East DunbartonshireFalkirk
& Clydebank
Inverclyde
W.
City of
North
Renfrewshire
Glasgow Lanarkshire Lothian
E.
Renfrewshire
North Ayrshire
North Ayrshire
North of England
City of Edinburgh
E. Lothian
Midlothian
S. Lanarkshire
Borders
East Ayrshire
South Ayrshire
Londonderry
Antrim
Tyne & Wear
Tyrone
Durham
Cumbria
Fermanagh
Armagh
LNR
Dumfries & Galloway
Down
ASW
Isle of Man
North Yorkshire
East Riding of Yorkshire
Lancashire
W. Yorkshire
Greater Manchester
Merseyside
Isle of Anglesey
Denbighshire
Gwynedd
South Yorkshire
Lincolnshire
Cheshire
Flintshire
Conwy
Derbyshire
Nottinghamshire
Wrexham
Staffordshire
Leicestershire
Shropshire
Rutland
Norfolk
Cambridgeshire
West Midlands
Northamptonshire
Powys
Worcestershire
Ceredigion
Warwickshire
SUFFOLK
Herefordshire
Bedfordshire
Carmarthenshire
Pembrokeshire
Swansea
Peninsula
Monmouthshire
Merthyr Blaenau
Neath
Gwent
Tydfil
Torfaen
Port Talbot
Rhondda Caerphilly
Newport
Bridgend Cynon
Cardiff
Taff
Vale of Glamorgan
Gloucestershire
Essex
Buckinghamshire
Oxfordshire
Hertfordshire
Greater London
Berkshire
Bristol
Wiltshire
Surrey
Kent
Hampshire
Somerset
Devon
North London
and Mount
Vernon
West Sussex
East Sussex
Dorset
Isle of Wight
Cornwall
Central
South Coast
Kent
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 FOR more info please contact
marie.palmer@cscip.nhs.uk or via mobile 07880725207
3 Newly appointed staff
Claire Barton
John Wheeler
Michael Yare
Download a brochure at www.cancerimprovement.nhs.uk/chemotherapy
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