Friday 15th April 2016
Mac Voice, the magazine for Macmillan professionals: Spring 2016
Dr Neil Smith won a Macmillan Professionals Excellence Award last November for his ‘Think Cancer’ project. He speaks to Mac Voice about the project, and about his role as a Macmillan GP.
What inspired you to become a Macmillan professional?
I had been a GP for almost 20 years, seeing the terrible consequences of cancer not only for patients but also the impact on their family and friends. I reviewed the cancer statistics for the area where I was working and realised that some of the outcomes were virtually the worst in the country. This was mainly based on deprivation and having an elderly population. I found some positive reasons for the data, such as good coding of cancer diagnosis and management. My practice was already investing a lot of time and energy in trying to address the problem. I wanted to make changes that really helped my patients. Then I realised I could do even more by becoming a Macmillan GP and having a positive effect on the wider local health environment.
What were the main aims of the ‘Think Cancer’ project?
The main aim was to improve the lives of everybody touched by cancer. I thought I could do that by influencing change within general practice, using my position as a GP and contacts with my peers to encourage practices to think about cancer in a different way.
What does the project involve?
‘Think Cancer’ is very much a team approach. The most important issue is networking and working collaboratively. For example, connecting Macmillan with Clinical Commissioning Groups (CCGs), acute hospital trusts and local authorities, and having them all work as a united front. I wanted to encourage all GP practices to be part of that. That means it’s the complete envelope in our health economy – everyone is involved, from a health professional point of view.
The project is professional-based but working for patient outcomes. For example, all practice nurses can now signpost patients to Macmillan information services. We have increased the number of people referring to and utilising Macmillan’s Move More exercise programme. And although my project is very much primary care-based, there are overlaps and cross fertilisation with local projects, including Macmillan Solutions (a volunteering initiative) and patient participation projects.
What are the positive outcomes?
We have managed to make cancer a higher priority, particularly from a commissioning point of view. CCGs are investing more in cancer care and hospitals are providing much better cancer care.
There’s a lot more ownership within GP practices. Every one of our 89 practices now has Cancer Champions – a GP, an administrator and a practice nurse. They receive information which they disseminate in their practices. Within the project there have been seven main work streams looking at the whole pathway of cancer, including prevention and screening, early diagnosis, and survivorship. These individual work streams can help people at different points in their cancer journey.
I was humbled to find out I had won a Macmillan Excellence Award last year. I am very fortunate to get the opportunity to work for Macmillan and try to make a difference, and I’m really honoured to be recognised; not just for my work – the wider team I’ve established deserves praise for all their hard work.
How does your work on the project combine with your work as a Macmillan GP?
It’s integral to my work as a Macmillan GP. Being a Macmillan GP is a fantastic job because there’s flexibility to work on the needs of your population. I highlighted what I thought needed to be done and I was given the authority and freedom to do that. The project really goes hand in glove with my role as a Macmillan GP. I’m still a partner and a full-time GP, so it improves my skills and ability to detect cancer and support patients I’m seeing face to face.
What are your hopes for the future of the project?
I want to embed the project into normal practice for GPs and CCGs and to create a legacy for Macmillan, with each piece of work creating a foundation to be built on over subsequent years, adding different strands. I’d also love other people to learn from the successes and mistakes I’ve made. Other Macmillan GPs are now contacting me to say, ‘How did you manage to do this? What worked well for you?’ That gives me an opportunity to share the outcomes, so the project can develop onto a national footing.
What are the biggest challenges you’ve faced whilst developing the project?
The complexity. I think the scale of the problem with cancer is often overwhelming and it’s difficult to manage change. I also wanted to do something that was wide-ranging yet focused, so it was a balance of having dedicated projects across the cancer cycle.
What are the rewards?
The main reward is that my team and I really feel we’re making a difference for patients. We created projects which themselves created positive outcomes. I almost looked at it backwards, thinking, ‘What would make a difference for a patient?’ I’m also absolutely delighted that across my peer group, every single practice has signed up to the project and is fully engaged and enthusiastic. The project is very much ongoing. Embedding ‘Think Cancer’ and the cancer priorities within CCGs has meant they are now investing more money which allows us to develop projects further in the future and have more people ‘thinking cancer’.