Wednesday 24th June 2015
Mac Voice, the magazine for Macmillan professionals: Summer 2015
Alison Waltho explains how the cancer survivorship steering group at The Christie tested the effectiveness of an innovative role
A pilot project was set up at The Christie NHS Foundation Trust to test the effectiveness of a Macmillan Late Effects Coordinator (MLEC) role. The aim of the MLEC role at The Christie
was to coordinate holistic assessment and management for those with possible unmet needs following pelvic radiotherapy
, promoting supported self-management and signposting to additional help with the consequences of treatment.
Why was the role introduced?
Professional champions across services within The Christie established a cancer survivorship steering group, including staff and people affected by cancer, to promote improvements in the experiences and outcomes for people in the months and years following their treatment. The survivorship project team proposed the pilot.
What the pilot involved
The pilot ran from June 2013 until May 2014. Thirty-six people were referred to the MLEC pathway by three Christie teams (gynaecology, urology, colorectal). Those referred had received treatment more than 12 months previously and were experiencing ongoing symptoms and concerns.
As the MLEC, I undertook a holistic assessment in partnership with each person referred. The Macmillan ‘identifying your concerns’ checklist (part of the Assessment and Care Planning Folder) formed a person-centred starting point. Guided interviews and tools such as the Hospital Anxiety and Depression score and the Fracture Risk Assessment score helped prioritise each person’s needs.
Care-planning was informed by nine management plans that had been previously agreed between Christie experts and the MLEC. These included plans for common problems following treatment.
The MLEC pathway included three face-to-face contacts in locations close to patients’ homes, supporting a partnership approach. I made referrals for ongoing symptoms, discussed a Life Ahead Plan and promoted self-management.
On a scale of 1–10, with 10 the most beneficial, most patients rated their experience of the MLEC pathway as 10, stating that it made them feel ‘listened to’, ‘supported in their own initiatives for self-management’ and ‘less powerless’.
The pilot demonstrated that listening and acknowledging concerns and simple signposting can avoid more complex problems. People felt empowered and confident after MLEC input. They felt encouraged to continue to self-manage.
Lasting influence of the role
The learning from this pilot was shared from an early stage with stakeholders nationally and across Manchester. It has informed an innovative, city-wide, commissioning-led collaborative funded by Macmillan to improve patient experience and outcomes. Activity focuses on the facilitation of holistic needs assessment and care planning, signposting and improved communication including treatment summaries. The Macmillan Cancer Improvement Partnership is enabling improved patient experience, and outcomes, supporting best practice for people and their loved ones throughout the pathway of treatment and care, helping them to live life to the full with and beyond treatment. We hope to share these exciting developments in a future Mac Voice article.
1. Kings Fund. Time to think differently. (kingsfund.org.uk/topics/patient-experience)
2. National Cancer Survivorship Initiative. Living with and Beyond Cancer: Taking Action to Improve Outcomes. 2013. Department of Health. How the cancer survivorship steering group at The Christie tested the effectiveness of an innovative role.
Macmillan Quality Improvement Facilitator, Manchester Cancer Improvement Partnership
The Christie Hospital NHS Foundation Trust