Making a difference


julie jonesMy name is Julie Jones and I am the Macmillan Services Effectiveness Lead, in post since August 2014.

During this time, I have been impressed by the dynamic and active partnership between Macmillan and the NHS.

I feel strongly that there are opportunities to further develop, extend and recognise the benefits of the partnership in actively contributing to the work programmes of the NHS and other partners to deliver a better patient experience and improved patient outcomes.

To be seen as a person and not as an illness is what we would all wish for our families, our friends and ourselves.  So, how do we do this?

The expected increase in patient numbers and people living with cancer has been well documented.

To implement new innovative ways of meeting this challenge we have embarked on a number of work streams to ensure a person-centred approach to patient care.  These already involve not only the NHS and Macmillan but also the third sector, local authorities, and patients and families.

Working in partnership in this way is important.  It recognises the expertise and role of everyone involved, especially the experience of people affected by cancer.

With this in mind, a number of pieces of work have commenced across Wales based on local need and identified as areas for improvement in a recent all Wales Cancer Patient Experience Survey.

I call these pieces of work ‘work streams’ and they all have one thing in common, that is to support people who are living with or affected by cancer. Work streams involve a diverse range of people including patients and their families, health care professionals such as hospital doctors and general practitioners, nurses, physiotherapists, occupational therapists, dietitians etc. and non clinical staff such as information coordinators, admin staff, as well as non-NHS staff such as social workers, counsellors, welfare benefits advisers and many more.

So, what are these work streams? They include new approaches to existing ways of working and bring together both NHS and non NHS expertise.

The following are some examples of these but the list is by no means exhaustive:

  • ensure all patients have access to a key worker from the point of diagnosis onwards. They have the expertise to co-ordinate ongoing care in a timely and effective manner such as the Cancer Clinical Nurse Specialist In the acute phase of treatment and care.
  • promotion of health and well being including physical activity to support independence and self management.
  • enabling personalised care through the use of Holistic Needs Assessment and Care Plans.
  • development of treatment summaries, using a pre-defined template, for patients, general practitioners and other relevant services to improve communication across all parties.
  • provision of relevant, up to date information and advice to support patients with areas such as; maintaining physically active, accessing financial advice and self-management.

As the work streams become established, we are beginning to see how together they contribute to delivering a better experience for patients as well as for those looking after them.  Examples of this are as follows:

  • Key worker contact details are included on the treatment summaries as standard. Sharing the name and contact of the key worker ensures that patients and other health care professionals know who to contact for a first line response.

As the key worker it best placed to have a helicopter view of a patient’s treatment and use their expert knowledge to support and inform joint decision making. Many Key Workers are now using or piloting the Holistic Needs Assessment to identify patients unmet needs and generate a care plan with the patient.

  • Treatment summaries produced in a timely fashion for primary care and patients, as well as other relevant health care professionals has been shown to improve communication across all parties.

Giving patients their copy ensures they feel involved and informed about their own care and management.  A section on the form will clearly identify actions for other health care staff which should result in reduced delays and ambiguity for future care and management.

  • Completion of the Holistic Needs Assessment (HNA) is an opportunity to identify patient’s unmet needs as a consequence of their diagnosis and/or treatment. As a result, these can often be addressed before they become urgent such as referral for financial advice, or being signposted to a local support group/forum.
  • Part of the recovery package involves providing access to health and well being events to support individuals to self manage and to live with what is often called the ‘new normal’.

This includes support to become physically active in a way that is appropriate for them such as returning to the gym, walking the dog or may be just moving a little more than yesterday.

Healthcare professionals can signpost patients to local health and well being events and local activities, a need often identified through completion of the HNA.

It is important that across Wales we make opportunities to learn from each other as to how different work streams and changes in practice are managed at a local level.

We can then share best practice, understand the implications of change and ensure that across Wales, we can deliver services that are based on evidence, engage with local resources but importantly meet local needs in a way that is achievable and sustainable to each area.

So, in practice, putting the patient at the centre of what we do allows us to provide appropriate care and support at the time of diagnosis through to treatment and beyond and making sure that we understand the consequences of treatment and living with cancer.








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