Launch blog post – Cancer – Time to Choose 2016

Susan Morris, Head of Services for Macmillan Cancer Support in Wales

In six months, people across Wales will be voting in the Welsh Assembly election, which will decide who is responsible for devolved areas such as health care, including cancer care.

Photograph of Susan Morris - Head of Services , Wales - Macmillan Cancer SupportThree years on from the Welsh Government’s Cancer Delivery Plan’s publication, now is a good time to reflect on what has been achieved and where work is needed.

The plan committed to achieving outcomes for cancer patients that match the best in Europe.

However, Wales is trailing 10 years behind other European countries when it comes to five-year survival rates for common cancers including breast, colon, lung and stomach.[1]

Macmillan Wales wants the next government to deliver consistent cancer care that matches the best in Europe and is also centred on each individual’s needs.

We think one key way to achieve this is for every person with cancer to have access to a Clinical Nurse Specialist who is also their key worker from their diagnosis and through their cancer treatment.

This will give cancer patients a point of contact for someone to talk to who coordinates their care, navigates them through their treatment, and advises and signposts them to the right people and services for their needs.

We know Clinical Nurse Specialists who are also a key worker have an overwhelmingly positive impact on patient experience, which was shown in the Wales Cancer Patient Experience Survey.[2]

As we approach 2016, the good news is that more people are surviving cancer.

However, this brings new challenges as many people have short or long term side effects of their cancer and its treatment – such as incontinence, fatigue or lymphoedema – which may not get better.

That is why we believe each person with cancer should have a holistic needs assessment to look at cancer’s wider impact on their life from their finances to their emotions to the information and support they need.

The outcomes of this discussion  should be written into the plan of care, which is offered to the patient.

Although the Cancer Delivery Plan already commits to this, less than a quarter (22%) of people surveyed for the Wales Cancer Patient Experience Survey said they were given one[3] so we are some way off achieving this.

The survey also showed that cancer patients are not being routinely referred for financial advice.

Only half[4] of the 7,352 people surveyed were referred for this even though it is a commitment in the plan. This isn’t good enough.

Macmillan knows cancer can have a devastating financial impact on patients and their carers who may be unable to work or need to pay for higher energy bills.

We have been campaigning for all cancer patients to receive financial advice since launching our Counting the Cost of Cancer campaign in 2012 and we are still calling for this to happen.

Another area to consider with the election approaching is making sure cancer patients needing palliative care get the high quality, compassionate care they need.

Macmillan Wales believes advance care planning is essential to ensure their wishes, including where they want to die, are recorded before their health deteriorates as there is evidence that advance care planning can increase the likelihood of people having their wishes met.[5]

We also want to stop avoidable unplanned emergency admissions to hospital to help ensure people can die at their place of choice wherever possible.

As 1 in 2 people are set to have cancer by 2020[6], now is the time to change cancer care in Wales.

We want to make sure cancer patients’ care, experience and outcomes in Wales match the best in Europe and that care is tailored to each patient’s needs as, ultimately that will reduce variation, waste of NHS resources and harm.

[1] The CONCORD Working Group et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). The Lancet. Published online 26 November 2014

[2] Wales Cancer Patient Experience Survey (p.99) http://gov.wales/docs/dhss/publications/140117canceren.pdf. January 2014.

[3] Wales Cancer Patient Experience Survey (p.49) http://gov.wales/docs/dhss/publications/140117canceren.pdf. January 2014.

[4] Wales Cancer Patient Experience Survey (pp.54-55) http://gov.wales/docs/dhss/publications/140117canceren.pdf. January 2014.

[5] House of Commons Health Committee, End of Life Care: Fifth Report of Session 2014-15, March 2015

[6] Macmillan Cancer Support, Mortality Trends 1992-2020 http://www.macmillan.org.uk/Documents/AboutUs/Newsroom/Mortality-trends-2013-executive-summary-FINAL.pdf. June 2013.

Blog Lansio – Canser – Amser Dewis 2016

Susan Morris, Pennaeth Gwasanaethau ar gyfer Cymorth Canser Macmillan yng Nghymru

Ymhen chwe mis, bydd pobl ledled Cymru’n pleidleisio yn etholiad Cynulliad Cymru, a fydd yn penderfynu pwy sy’n gyfrifol am feysydd wedi’u datganoli fel gofal iechyd, gan gynnwys gofal canser.

Photograph of Susan Morris - Head of Services , Wales - Macmillan Cancer SupportDair blwyddyn ers cyhoeddi Cynllun Cyflawni ar gyfer Canser Llywodraeth Cymru, mae nawr yn adeg dda i ystyried yr hyn a gyflawnwyd a lle mae angen gwaith.

Roedd y cynllun yn ymrwymo i gael canlyniadau i gleifion canser sydd gyda’r gorau yn Ewrop.

Ond, mae Cymru 10 mlynedd y tu ôl i wledydd Ewropeaidd eraill o ran cyfraddau goroesi pum mlynedd ar gyfer canserau cyffredin gan gynnwys y fron, y colon, yr ysgyfaint a’r stumog.[1]

Mae Macmillan Cymru eisiau i’r llywodraeth nesaf gyflawni gofal canser cyson sydd gyda’r gorau yn Ewrop ac sydd hefyd wedi’i ganoli ar anghenion pob unigolyn.

Rydyn ni’n credu mai un ffordd allweddol o gyflawni hyn yw i bob person sydd â chanser gael mynediad i Nyrs Glinigol Arbenigol sydd hefyd yn weithiwr allweddol iddyn nhw o adeg y diagnosis a gydol y driniaeth ganser.

Bydd hyn yn rhoi man cysylltu i gleifion canser i gael rhywun i siarad ag ef neu hi. Bydd y person hwn yn cydlynu eu gofal, yn eu tywys drwy eu triniaeth, ac yn cynghori ac yn eu cyfeirio at y bobl gywir a’r gwasanaethau ar gyfer eu hanghenion.

Rydym yn gwybod bod Nyrsys Clinigol Arbenigol sydd hefyd yn weithwyr allweddol yn cael effaith hynod o gadarnhaol ar brofiad cleifion, rhywbeth a ddangoswyd yn yr Arolwg o Brofiad Cleifion Canser Cymru.[2]

Wrth inni nesáu at 2016, y newyddion da yw bod mwy o bobl yn goroesi canser.

Ond, mae hyn yn dod â heriau newydd gan fod gan lawer o bobl sgil effeithiau tymor byr neu dymor hir eu canser a’i driniaeth – fel anymataliaeth, blinder neu lymffoedema – na fydd yn gwella o bosibl.

Dyna pam rydym yn credu y dylai pob person sydd â chanser gael asesiad cyfannol o’i anghenion i edrych ar effaith ehangach canser ar ei fywyd, o’i sefyllfa ariannol i’w emosiynau i’r wybodaeth a’r gefnogaeth sydd eu hangen arno.

Dylid ysgrifennu canlyniadau’r drafodaeth hon yn y cynllun gofal, sy’n cael ei gynnig i’r claf.

Er bod y Cynllun Cyflawni ar gyfer Canser yn ymrwymo i hyn yn barod, dywedodd llai na hanner (22%) y bobl yn yr Arolwg o Brofiad Cleifion Canser Cymru iddynt gael un[3]felly mae tipyn o ffordd i fynd eto i gyflawni hyn.

Hefyd dangosodd yr arolwg nad yw cleifion canser yn cael eu cyfeirio at gyngor ariannol fel mater o drefn.

Hanner[4]y 7,352 o bobl yn yr arolwg yn unig a gyfeiriwyd at hyn er ei fod yn ymrwymiad yn y cynllun. Nid yw hyn yn ddigon da.

Mae Macmillan yn gwybod y gall canser gael effaith ariannol enbyd ar gleifion a’u gofalwyr sydd efallai’n methu gweithio neu y mae angen iddynt dalu am filiau ynni uwch.

Rydym wedi bod yn ymgyrchu i bob claf canser gael cyngor ariannol ers inni lansio ein hymgyrch Cyfrif Cost Canser yn 2012 ac rydym yn dal i alw am hyn.

Maes arall i’w ystyried gyda’r etholiad yn yr arfaeth yw gwneud yn siŵr fod cleifion canser sydd ag angen gofal lliniarol yn cael y gofal tosturiol, o ansawdd uchel, sydd ei angen arnynt.

Mae Macmillan Cymru yn credu bod cynllunio gofal ymlaen llaw yn hanfodol er mwyn sicrhau bod eu dymuniadau, gan gynnwys lle maen nhw eisiau marw, yn cael eu cofnodi cyn i’w hiechyd waethygu gan fod tystiolaeth y gall cynllunio gofal ymlaen llaw gynyddu’r tebygrwydd y bydd dymuniadau pobl yn cael eu cyflawni.[5]

Hefyd rydym eisiau atal derbyniadau ysbyty brys heb eu cynllunio ond y gellir eu hosgoi i helpu i sicrhau y gall pobl farw yn y man o’u dewis lle bynnag y bo’n bosibl.

Gan fod 1 o bob 2 o bobl yn mynd i gael canser erbyn 2020[6], nawr yw’r amser i newid gofal canser yng Nghymru.

Rydym eisiau gwneud yn siŵr fod gofal, profiad a chanlyniadau cleifion canser yng Nghymru gyda’r gorau yn Ewrop a bod gofal yn cael ei deilwra i anghenion pob claf gan y bydd hynny yn y pen draw yn lleihau’r amrywiad,  y gwastraff ar adnoddau’r GIG a’r niwed.

[1] Gweithgor CONCORD et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). The Lancet. Cyhoeddwyd ar-lein 26 Tachwedd 2014

[2] Arolwg o Brofiad Cleifion Canser Cymru (t.99) http://gov.wales/docs/dhss/publications/140117canceren.pdf. Ionawr 2014

[3] Arolwg o Brofiad Cleifion Canser Cymru (t.49) http://gov.wales/docs/dhss/publications/140117canceren.pdf. Ionawr 2014

[4] Arolwg o Brofiad Cleifion Canser Cymru (tt.54-55) http://gov.wales/docs/dhss/publications/140117canceren.pdf. Ionawr 2014

[5] Pwyllgor Iechyd Tŷ’r Cyffredin, End of Life Care: Fifth Report of Session 2014-15, Mawrth 2015

[6] Cymorth Canser Macmillan, Tueddiadau Marwoldeb 1992-2020 http://www.macmillan.org.uk/Documents/AboutUs/Newsroom/Mortality-trends-2013-executive-summary-FINAL.pdf. Mehefin 2013.

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