Thursday 19th September 2013
Northern Ireland’s Transforming Cancer Follow-up (TCFU) project team on how its survivorship programme of work has benefited people across the country.
The idea for Northern Ireland’s TCFU survivorship programme was first discussed at a Northern Ireland Cancer Network (NICaN) workshop for patients and carers, held in 2009. The key message from the people attending was the need to radically improve aftercare services. This was echoed by professionals at a NICaN workshop in April 2010.
In his opening remarks at this second event, Chief Medical Officer Dr Michael McBride highlighted the need to move away from a model of follow-up focusing solely on physical symptoms and illness, to one that focuses on health and well-being. He emphasised how this would need flexible, accessible, risk-based follow-up models that were personalised to the needs of the individual, with them being a key contributor to setting goals and agreeing plans.
Following on from these workshops, a memorandum of understanding was signed by Ciaràn Devane, Macmillan Chief Executive, and the Northern Ireland Health Minister at that time, Michael McGimpsey.
In 2011, TCFU was established as a partnership arrangement between the Health and Social Care Board, Public Health Agency, NICaN and Macmillan Cancer Support. Since then, the Macmillan TCFU project team has worked with multidisciplinary teams across the five trusts in Northern Ireland to make changes to meet the follow-up and survivorship needs of people completing cancer treatment.
In line with the National Cancer Survivorship Initiative, this service improvement programme is beginning to transform how aftercare services are delivered.
The current core TCFU team consists of a Macmillan Survivorship Programme Manager, alongside one Macmillan project manager for each of the five trust areas. Until the end of March 2013, the team also included a Macmillan Survivorship Programme Lead for NICaN.
The team’s work has focused on a regional approach to a breast and prostate cancer service improvement programme, with three overall aims.
These are to:
1 improve the quality of cancer patients’ post-treatment experience and the promotion of health and well-being
2 reduce inefficiencies in hospital follow-up and to streamline services
3 enhance service coordination and integration.
Successes so far
The breast cancer follow-up programme has been implemented in all five trusts. Selected newly diagnosed and review patients are now entering the self-directed aftercare pathway. This has led to improvements in how outpatient appointments are used, as it avoids duplication between surgical and oncology appointments.
Other successes of the TCFU programme include:
- the establishment of a robust, automated, mammography review system. Reviews are held in a timely manner, in line with NICE guidance, without the need for a surgical outpatient appointment to trigger the mammogram
- a Northern Ireland-wide agreed protocol and pathway for patients who are suitable for breast self-directed aftercare
- improved patient information and decisions made in partnership with patients
- the introduction of a Macmillan holistic assessment and treatment summary
- tailored information with signposting to appropriate services
- an agreed rapid access mechanism, via a clinical nurse specialist, to help patients to get prompt attention if needed
- education and training for health and social care professionals and students, patients and carers on the TCFU principles
- a new regional cancer survivorship website to allow patients and families to identify services in their area. Users have given positive feedback on the site
- local health and well-being events to promote self-management in all five health and social care trusts.
Pathways for the prostate cancer follow-up programme are currently in development. The aim is for a shift from consultant-led follow-up to nurse or remote-led follow-up. A greater focus will be placed on recovery, health and well-being, through the use of a holistic needs assessment and patient empowerment.
Significant progress has been made thanks to the combined efforts of the Macmillan project management team, TCFU’s organisational structure and clinician leadership, alongside collaboration with and engagement from local trusts’ management, administration and support teams. Collaborative working across statutory and voluntary sectors has improved support for patients on completion of their cancer treatment.
Email Mary Jo Thompson, Macmillan Survivorship Programme Manager Northern Ireland Cancer Network.
Macmillan TCFU Team Northern Ireland
Liz Henderson, Macmillan Survivorship Programme Lead, Northern Ireland Cancer Network (until end March 2013)
Edel Aughey, Macmillan TCFU Project Manager, Belfast Health and Social Care Trust
Caroline Lynas, Macmillan TCFU Project Manager, South Eastern Health and Social Care Trust
Martha Magee, Macmillan TCFU Project Manager, Western Health and Social Care Trust
Moyra Mills, Macmillan TCFU Project Manager, Northern Health and Social Care Trust
Annie Treanor, Macmillan TCFU Project Manager, Southern Health and Social Care Trust
Other articles about Northern Ireland from this issue of Mac Voice
Empowering carers - A project in Northern Ireland's Southern Health and Social Care Trust area is supporting carers of people with cancer.
Survivorship - How a survivorship programme of work has benefited people across the country.
Urological cancer follow-up - Looking at a new programme supporting men with prostate and testicular cancers.
Bereavement support - Supporting people bereaved by cancer through a partnership with Cruse Bereavement Care.
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