Wednesday 3rd April 2013
A new Macmillan role is helping to provide a more responsive service to people with upper GI cancers.
At Bradford Teaching Hospitals NHS Foundation Trust, people with upper gastro intestinal (GI) or hepato biliary (bile duct, liver and gall bladder) cancer receive support and information from a team of upper GI cancer nurse specialists (CNSs).
Career progression for one team member led us to consider how we could develop the service. The team had always had two whole-time equivalent posts covered by three CNSs. We explored the ‘specialist’ aspects of the CNS role, concluding that while some aspects were not specialist, it was still hugely important to patients. The vacant post provided a great opportunity to rethink how we work.
With support and funding from Macmillan, we focused on the non-specialist components of the CNS role and decided to introduce a new healthcare coordinator role (band 4). The key aspects include:
- Coordinating high-quality care (along with the nursing team) through telephone and face-to-face assessment, and identifying needs using basic clinical knowledge, tools and procedures.
- Ensuring the provision of appropriate services to maximise the health and quality of life of the patient.
- Acting as a single point of contact for patients, carers and the healthcare team; triaging enquires to the right hospital or community department; and providing routine information and advice for patients and carers.
- Documenting and monitoring all aspects of patient care coordination and service delivery, supporting data collection for audit.
Promoting and explaining the role has been easier than anticipated. We produced a leaflet explaining the role and give it to all patients at their first consultation.
Patients, families and colleagues have accepted and welcomed the role. The coordinator has developed strong relationships, resulting in a service more responsive to patient needs, and more accessible. The CNSs can now focus on the specialist aspects of their role.
The coordinator has time to explore patient needs such as social care requirements. This has always been important, but the coordinator can use our holistic needs assessment as a baseline to explore options in the local community. Patients also have a point of contact when they have concerns not directly related to their clinical care.
It is a multifaceted role and the many skills that the coordinator has brought to it show in the way the team now works. It has allowed us to organise and deliver educational events, host awareness days, present work at national conferences and continue to deliver high-quality, individualised care.
We have received positive verbal feedback from patients and now have plans to evaluate the role by adding questions about it to our annual patient satisfaction survey.
We would wholeheartedly encourage colleagues to consider this new way of working. Our one concern is the career progression pathway for the coordinator – something that we will be looking at going forward.
Tracey Wilcocks, Specialist Nurse Upper GI, Bradford Teaching Hospitals NHS Foundation Trust.
Emma Jehan, Macmillan Care Coordinator firstname.lastname@example.org