Quality Improvement Excellence Award
Cancer Haematology and Palliative Care Psychology Service
Gloucestershire Hospitals NHS Foundation Trust
Historically, the Cancer, Haematology and Palliative Care Psychology Service in Gloucestershire hospitals operated more like separate, tertiary services with little integration into treating teams. They offered individual therapy to cancer patients, but when Covid led to a significant increase in referrals the team knew they needed to do things differently to meet the demand.
An ambitious programme of change aimed to create a proactive, preventative and integrated service that offers psychologically-informed care earlier in the patient pathway. The team have developed numerous initiatives including webinars for patients packed with proactive psychological tips, a pilot offering early psychological support to under-represented head and neck cancer patients, and impactful interventions with the prehabilitation and rehabilitation teams. Alongside their patient-facing work the team also offers an extensive package of training and supervision to their non-psychology colleagues.
"It's about more than one-to-one referrals, it's about making psychological knowledge accessible to patients in different ways," says Macmillan Consultant Clinical Psychologist Hilly Webb-Peploe.
Fraser Breed
Macmillan Project Dietitian NHS Borders
Evidence demonstrates that good nutrition can lead to better outcomes for people with cancer. In NHS Borders, only two groups of cancer patients were automatically referred for specialist dietetic assessment and support – upper GI patients and head neck cancer patients. Anyone else who needed nutritional support had to wait to be seen by community dietitians with heavy caseloads.
Keen to provide equity of care, Macmillan Project Dietitian Fraser Breed developed a service that proved all cancer patients benefit from timely nutritional support. He worked with CNSs to create bespoke nutritional care pathways for different tumour groups. Fraser ensured that each pathway could be easily managed and incorporated into the daily workload of clinicians and provided full training.
"Diet is one of the elements of someone’s cancer treatment where they have control," explains Fraser. "It's great that NHS Borders patients now have someone to provide them with the right nutritional information at the right time."
Greater Manchester Cancer Workforce and Education Team
Greater Manchester Cancer Alliance
Primary care has a crucial role to play in supporting people to live well with and beyond cancer, however there is often a disconnect between primary and secondary care. As a result, patients have reported feeling like they are in a ‘blackhole’ when transitioning between the two sectors, which can be anxiety-inducing. To address this and create an adaptable, innovative workforce solution, the Greater Manchester Cancer Alliance piloted the role of the cancer care coordinator (CCC) in Primary Care Networks (PCNs).
Nine CCCs were recruited to nine PCNs across Greater Manchester. The CCCs acted as a single point of contact for patients in their locality, offering them cancer care reviews and personalised holistic support. As well as improving patient satisfaction, the CCCs have provided additional capacity, thereby reducing workload for primary care staff.
"They are an inspiring, motivated and compassionate team who have built bridges between primary and secondary care to meet patients’ needs," explains team leader Louise Retout.
Theresa Clarke
Clinical Nurse Specialist - Southern Health and Social Care Trust
Many people with cancer experience concerns around sexual wellbeing, yet very few seek help. The subject remains a taboo topic of conversation between patients and clinicians, often as a result of cultural beliefs, a lack of specialised training and feelings of personal embarrassment.
When Theresa Clarke, a CNS at the Southern Health and Social Care Trust, discovered that patients weren’t receiving the psychosexual support they needed, she undertook a quality improvement project to enact change. She assembled two focus groups that helped to identify various initiatives which have subsequently been put into place across the Trust. As well as ensuring all cancer patients receive information about sex and cancer as standard, Theresa also provides training and education to staff, and she has created a SharePoint resource to help professionals provide better support.
"It makes such a difference now that patients have the information they need and staff are able to initiate those important conversations," says Theresa.
Finalists
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Find out about our Quality Improvement Award 2023 finalists.