One-to-One Support implementation project
Today there are two million people in the UK living with and beyond a diagnosis of cancer. This figure is likely to rise to over four million by 2030, as diagnosis and treatment become more effective. Current models of aftercare do not meet the needs of people affected by cancer, so we are testing ways to better provide ‘one-to-one support’ to people following cancer treatment.
Currently, not all people affected by cancer get access to a Key Worker, which we know makes a difference to patient reported outcomes and experience (National Cancer Patient Experience Survey, 2010). Macmillan has been working across the UK to develop solutions to these issues. Redesigning the cancer care pathway, redesigning the workforce, and how it supports the cancer care pathway, and developing new models of aftercare are seen as some of the solutions.
Macmillan knows that a cancer patient’s individual needs are best met through interactions with a mix of people making up the cancer workforce. To ensure people with cancer receive one-to-one support we need to build teams so that they can see the right person with the right skills and knowledge at the right time. We act as a catalyst for change in cancer care and are working with the NHS and other healthcare organisations to develop the cancer care workforce to support the new care pathways.
Macmillan’s approach to One-to-One Support
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What is one-to-one support?
One-to-one support for cancer patients might best be understood as a service delivered by a team made up of cancer specialists (e.g. clinical nurse specialists and associated health professionals) and generalists (e.g. support workers, district and practice nurses) who support the patient across the whole cancer pathway, tailoring support according to individual patients needs.
In February 2010, the previous England Government announced 'dedicated nursing for all cancer patients'. Macmillan grasped the opportunity to give every patient the opportunity of effective support, to live well for longer and take an active role in their own care, throughout their cancer journey.
Workforce experts helped us to develop our Workforce Strategy where we identified four new roles which could work together with the existing workforce and help provide one-to-one support. These four roles are:
The overall aim of the One-to-One Support implementation project is to create a workforce to deliver the best care for people living with and beyond cancer.
Emerging models for aftercare demonstrate that care needs should be assessed at key transition points and supported by a care plan.
The National Cancer Survivorship Initiative has developed a Risk Stratification model which will be used to deliver one-to-one support for patients during this pilot.
Find out more about assessment and care planning and risk stratification.
Macmillan is working with 16 partner organisations to pilot and evaluate the four new workforce roles in practice, as part of local care pathway redesign, providing evidence of cost-effectiveness, quality of patient reported outcomes and patient reported experience.
Project structure and timelines
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The overall project is being delivered over 7-10 years, starting in 2012, when the four new workforce roles will be piloted in practice, as part of local care pathway redesign.
An evaluation focusing on patient outcomes and economic impact and will run throughout the pilot process with a final report available in spring 2015. Read the baseline report [PDF 3.8MB].
One-to-one suport pilot evaluation report
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Macmillan has just completed a two year pilot project across 16 sites in the UK looking to support a more holistic approach to cancer care. The One-to-One Support pilot project funded four new Macmillan roles that sat alongside the existing cancer workforce, com0.prising Complex Case Managers, Community Nurses, Primary Care Nurses and Support Workers.
The final evaluation report indicates that by working together, the new roles and exisiting cancer workforce have enabled people living with cancer to have the time and guidance they require to identify their concerns, manage their own care and take back control. This has also had the positive outcome of helping to improve patient experience at the pilot sites.
Download the one-to-one support pilot evaluation report [PDF].