Service Improvement Excellence Award

This award celebrates four winners who have developed integrated services to greatly improve the experiences of people living with cancer.

Service Excellence Award - Thank you video

2018 Service Improvement Excellence Award Finalists – Thank you

2018 Service Improvement Excellence Award Finalists – Thank you

Macmillan Prehabilitation Team – Manchester University Hospitals Foundation Trust

People living with hepatobiliary and pancreatic cancer (HPB) often suffer from significant weight and muscle loss at diagnosis, which can lead to high complication rates and poor outcomes after surgery. To make patients fitter, better prepared for their surgery and strong enough to deal with post-surgical treatment, a team in Manchester have implemented a unique prehabilitation programme.

The Macmillan Prehabilitation Team offers patients an innovative, integrated pre-operative package of physiotherapy and nutritional support. The team empowers patients to take responsibility for their own care by providing diet and exercise plans tailored to individual needs. They also offer patients rapid access to their clinic, ongoing telephone support and the opportunity to attend gym sessions where they can receive peer support.

‘Having a physiotherapist and a dietitian working together before surgery makes this quite a unique project,’ says Macmillan Senior Specialist HPB Dietitian Neil Bibby. ‘These patients have complex needs to tackle, so you can’t just have a single intervention – it needs to be all hands to the pump.’

‘Physically and mentally the patients are a lot stronger as a result of the service, and our data supports this. Patients just ‘get’ it. It makes sense that getting better before an operation will help you to get better after it.’

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

Surgical Neuro-Oncology Team – Addenbrooke's Hospital, Cambridge

The needs of people with gliomas – the most common type of primary malignant brain tumours – can differ vastly depending on the size and location of the tumours. To better meet these needs, the Surgical Neuro-Oncology Team at Addenbrooke's Hospital have reconfigured their service so patients with favourable long-term prognoses are now followed up in a nurse-led telephone clinic. This, in turn, has freed-up more slots in the consultant-led outpatient clinic for high grade glioma patients and those with secondary brain tumours.

The telephone clinic has negated the need for hospital appointments, reduced waiting times in the consultant-led clinic and dramatically improved the patient experience. ‘People with brain tumours lose their driving licence, which makes travelling to hospital appointments more difficult,’ explains Consultant Neurosurgeon Stephen Price. ‘Previously, people had to get a family member to take time off work to bring them in. Then they had to pay parking fees and wait around for ages if there were delays in clinic.’

‘All of these things added to the stress that these patients were already facing,’ adds lead Macmillan Neuro-Oncology Specialist Nurse Ingela Oberg. ‘But in the telephone clinics, there’s no rush. We have plenty of time to cover their holistic needs whether they are anxieties around explaining things to children, the side-effects of medication, fatigue management, work, driving or anything else. It makes a real difference to patients when they know they have a dedicated point of contact for advice and support, even between appointments.’

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

The Christie Macmillan Secondary Breast Care Nursing Team – The Christie Hospital, Manchester

People living with secondary breast cancer often live with perpetual uncertainty and high levels of physical and psychological morbidity. Unlike patients with primary breast cancer, those with metastatic disease may have a limited support structure. The Macmillan Secondary Breast Care Nursing Team at The Christie Hospital in Manchester recognised this disparity in care. Following a Macmillan service review and an extensive scoping exercise, the team established a dedicated service that provides secondary breast cancer patients with a clear pathway of support.

Currently, all newly diagnosed patients who are having treatment at The Christie are invited for an in-depth Holistic Needs Assessment at a nurse-led clinic where they will receive bespoke information and support. Follow-up care is provided through telephone clinics, invitations to health and wellbeing events, and immediate re-access to the service whenever needed. Face-to-face support is provided to those patients and carers with complex physical or psychological needs.

‘For many, the initial appointment will be the first opportunity patients and loved ones have to truly open up and express their fears and concerns,’ says Lead Macmillan Secondary Breast Clinical Nurse Specialist Sharon Foy. ‘The secondary diagnosis is life changing and their sense of freedom to plan ahead has been taken away. We support people to adjust to the diagnosis and develop coping strategies, and we empower them to maintain their independence as much as they possibly can.’

‘A lot of patients have told us that it’s great to know we’re here, because secondary breast cancer is a very lonely and isolating experience,’ adds Macmillan Secondary Breast Clinical Nurse Specialist Bethan Daniel. ‘While we can’t cure secondary breast cancer, we do try to ease many of our patients worries and help them to maintain their dignity.’

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

Lesley Taylor – Macmillan Advanced Specialist Nurse in Oncology, NHS Tayside

Until 2012, head and neck cancer outpatient services in Tayside were delivered through a medical-led model of care that didn’t take full account of patients’ holistic needs. Driven by the desire to create a person-centred service, Lesley, a Macmillan Advanced Specialist Nurse in Oncology, set out to transform the system through co-production with patients and carers. Thanks to her dedication, patients of different cancer types are now living better.

In collaboration with the University of Dundee, Lesley undertook focus groups with patients and discovered that their individual physical, spiritual and psycho-social concerns were rarely addressed during outpatient appointments. To remedy this, she led a co-design project that resulted in the implementation of HNAs, treatment summaries and a health and wellbeing clinic. She also negotiated a shared model of care that meant patients could alternate medical-led outpatient clinics with a patient-led follow-up clinic.

‘We couldn’t continue to follow up patients in the way we were,’ says Lesley. ‘The numbers were increasing, and we weren’t meeting their needs. We needed to ask different questions about the issues they were facing and explore areas that we hadn’t done before.

‘Quite early on I started to get an inkling that we were really making a difference. Patients were getting better sooner, and we were discharging them from our clinic quicker. We believe this is down to the increased support they get at a strategic point in their treatment.’

‘Seeing patients picking up the pieces of the life they’d had to put on hold while they were going through treatment is great. Knowing that the service can support someone who is having a desperate time and signpost them to help gives us a sense that we’re doing the right thing.’

If you would like to find out more about Lesley’s work please email Jean Sargeant, Partnership Quality Lead.