Innovation Excellence Award

NICE guidance states that patients with potentially curative prostate cancer should have the opportunity to choose between surgery and radiotherapy as treatment options. In Lancashire and South Cumbria, a shortage of consultant oncologists meant patients experienced significant waits to discuss radiotherapy. As a result, many were opting to undergo surgery, rather than waiting to see an oncologist, and therefore forgoing their right to be fully informed of all treatment options. To change this and reintroduce real choice for patients, Tracey took on the pioneering new post of Macmillan Consultant Radiographer – the first of its kind in the UK within prostate cancer.

As a highly experienced and knowledgeable radiographer, Tracey’s role mirrors that of a clinical oncologist for this defined group of patients. Crucially, Tracey can see patients more quickly and offer them enhanced support through evening clinics, holistic needs assessments and individualised care plans. As a result of her hard work, determination and clinical leadership, she has created an astonishing and truly patient-centred service.

‘The aim was to get to people in a timely manner, increase the capacity for patients to be seen, reduce the workload for the oncologists,’ she says. ‘This allows them to concentrate on the more complex patients with more complicated needs who needed more time, and it allows me to spend ample time with patients who are struggling with decision making.

‘I normally see patients in the same week as the urologist sees them to talk about surgery. This, alongside other changes made earlier in the pathway, has shaved about three or four weeks off the pathway, which is important for the patient because it means they are fully informed about what their treatment options are.’

‘Tracey has also been selected as a Macmillan Fellow for her outstanding achievements. As a Fellow, Tracey can access a grant of up to £10,000. Find out more about the Macmillan Fellowship.

If you would like to find out more about Tracey’s work please email Sarah Taylor, Partnership Quality Lead.

Ambulance services regularly encounter patients with cancer, yet they often have very little training about the illness, so may lack the skills and knowledge to provide the best quality care. Sometimes, people with cancer are conveyed to the hospital emergency department when it would be more appropriate for them to remain at home. In the first collaboration of its kind, the South West Ambulance Service NHS Foundation Trust (SWASFT) and Macmillan have come together to fill this this gap in education and provision.

The aim of the Macmillan Cancer Care Development Project is to improve and promote best practice in cancer, palliative and end of life care for patients who access urgent and emergency care by calling 999. As well as creating a broad education package for paramedics, the project team has developed and improved systems and protocols to give ambulance clinicians access to specialist advice and guidance while on scene. Ultimately, this ensures cancer patients receive the right care, in the right place, at the right time.

‘What paramedics within SWASFT now have are options,’ says Lynne Dunn, one of the project’s three cancer care facilitators. ‘They know who to phone, they know what their resources are, both in hours and during the out-of-hours periods, and they didn’t have access to these things before. It doesn’t mean that we don’t take patients to hospital, it means that when appropriate we can treat people at home or facilitate a referral to a more appropriate health setting’.

‘It’s been great for the patients and great for their relatives, but it’s also been great for the paramedics too,’ says Joanne Stonehouse, the Macmillan Cancer Care Project Manager. ‘They now feel confident in these situations and knowing they’re able to do the right thing gives them increased job satisfaction.’

If you would like to find out more about the team’s work please email Amanda Nadin, Partnership Quality Lead.

Established to fill a huge gap in the provision of care for people with Gastro-Intestinal cancers, the GI Specialist Nursing and Dietetics Team has dramatically enhanced the level of person-centred support available. The passionate multidisciplinary team includes specialist nurses and dietitians who work collaboratively to prevent dramatic pre-operative weight loss, boost post-operative outcomes and support self-management.

The team offers a pre-diagnosis advice and support service following a patient’s initial endoscopy. Then, at diagnosis stage, the team completes a screening holistic needs assessment as well as providing swift, bespoke dietetic support.

‘By getting patients to the dietitian early, we know they’ll be in a much better physical condition when they go into surgery, and will be able to cope with it,’ says Moyra Mills, Macmillan Service Improvement Manager.

The team stays in constant contact with patients to keep them informed about their care throughout their journeys. What’s more, a dedicated Macmillan Support Worker is always on hand to triage patients’ calls, alleviate their worries and calm their anxieties.

‘It makes a big difference for people to know that there’s someone from the team they can contact,’ says Annette Mawhinney, Macmillan Colorectal Nurse Specialist. ‘Because we are there for people from the point of diagnosis, we get to everyone as a person and not just as a patient.’

If you would like to find out more about the team’s work please email Claire Black, Partnership Quality Lead.

Older people with cancer often have high levels of co-morbidities, functional needs and high levels of social isolation. To optimise older patients’ health before and during treatment, and to provide oncologists with the support they needed, the Macmillan GOLD service was created. By combining care of the elderly and oncology services, the seven-person team is providing an innovative and robust solution to a real problem in cancer and significantly improving outcomes for patients.

Before, during or after treatment, older patients visit the GOLD clinic to undergo a comprehensive health screening with an advanced nurse practitioner and full medical assessment with a geriatrician.

‘Patients can identify any worries they have and talk about their past medical history, the drugs they are taking, how they are managing at home and what support they have,’ says Sarah Compton, Macmillan Advanced Nurse Practitioner. ‘From blood pressure to incontinence to social isolation, we can help. The service can have a real impact on their health concerns.’

‘Often by talking these things through, we can increase patients’ feelings of control in a situation where they feel they’ve lost a lot of control,’ says Danielle Harari, Consultant Geriatrician.

‘For older people, cancer often comes on top of lots of other difficulties they have,’ adds Karapanagiotou Eleni, Consultant Oncologist. ‘They feel more comfortable undergoing complex treatments if the other issues have been sorted out beforehand. The GOLD service is a big plus for oncologists too because it means we have some help.’

If you would like to find out more about the team’s work please email Steph Hall, Partnership Manager.