Tuesday 16th December 2014
Mac Voice, the magazine for Macmillan professionals: Winter 2014
Kay Eaton, Elizabeth Lank and Alison Hill on a community of practice that is helping cancer nurses work together
One of Macmillan’s important partnerships in recent years has been with the University College London Hospitals (UCLH) NHS Foundation Trust, where a major new outpatient cancer centre known as the UCH Macmillan Cancer Centre opened in April 2012.
One of the partnership actions was to invest in developing the community of 55 cancer clinical nurse specialists (CNSs) across the UCLH Trust. These 55 individuals work across 12 tumour types, some in teams and some as lone CNSs. With their busy clinics, they never met as a complete group, and rarely had time to share good ideas.
Kay Eaton (pictured left), Consultant Nurse for Supportive Cancer Care, had completed an in-depth review of the Cancer CNSs across the UCLH Trust in 2013, exploring the breadth of individual CNS roles and identifying the gaps in service provision. Kay felt that the CNSs could best address these challenges by working together as a ‘community of practice’.
What is a community of practice?
A community of practice is a group of people who do similar work and who meet at regular intervals, usually for at least a day, to share ideas, learn together and identify opportunities to collaborate in order to do things quicker, better or more cost-effectively. The relationships that are built during community of practice events create a foundation of goodwill and trust that encourages collaboration and mutual support between the meetings.
Setting up the forum
The decision was made to hold three CNS Forum meetings a year, starting in 2014. Macmillan agreed to fund the community meetings for the first year, including the venue costs and the costs of an external facilitator. Alison Hill (pictured centre), newly-appointed Lead Cancer Nurse for the UCLH Trust, felt the CNS Forum would be crucial, because the CNS role is pivotal to the experience people have during their cancer treatment, and is also a key component to the clinical leadership provided for all nurses and other professionals involved in the patient pathway.
Alison and Kay Eaton agreed to be co-leads for the CNS Forum. Nikki Cannon and Tatyana Guveli from the Macmillan London Service Development Team supported Alison and Kay in planning and developing the community events.
The first CNS Forum meeting was a two-day residential event held in January 2014, with an excellent turnout of 53 of the 55 CNSs. The workshop format enabled the participants to identify the issues they had in common and find opportunities for collaboration – such as working more closely with primary care, running effective telephone clinics, making better use of the Macmillan Cancer Information and Support Service at the cancer centre or having a stronger presence on the wards. Jane Coe, CNS for Uro-oncology, commented on the impact of the first event:
‘We were so busy with our multidisciplinary teams and patients that we didn’t think of ourselves as a team. As a result of the first CNS Forum meeting, we recognise each other in the corridors and lifts, we’re more supportive of each other and even the tone of emails between us is friendlier.’
Building on the first event
The second CNS Forum event, held in May 2014, was a one-day workshop that built on the first event. Katherine Fenton, the Trust’s Chief Nurse, spoke about the future of the CNS role and her support for the community of practice. One of the agreed actions from the first event had been to offer the UCLH Trust Chairman, Richard Murley, an opportunity to shadow a CNS for a day in order to better understand their role. Karen Summerville, CNS for Gynae-oncology, hosted the chairman for a day and reflected:
‘Richard spent a day with me observing and reflecting on the interactions which took place with several gynaecological cancer patients and their families. I was very pleased he took the time to do this as I think the CNS role is not always well understood by people who don’t have direct experience of it.’
Richard Murley gave Karen the following feedback in a thank you note that he sent following his shadowing experience:
‘I was really impressed by the skill, tact, expertise and emotional intelligence with which you approached and handled the cases I saw with you. It has all helped to reinforce my strong belief that CNSs have a crucial and fundamental role in the care and support of our patients and their carers widely throughout the hospital.’
The next meeting
The third CNS Forum for 2014 is planned for late November 2014. Although it is always difficult to find time to meet for a full day, this is a necessary investment in order to achieve the desired learning and collaboration benefits and is a vital part of the CNSs’ continuing professional development.
Elizabeth Lank (pictured right above) is an independent specialist in collaborative working practices and co-author of Communities of Influence: Improving Healthcare through Conversations and Connections (Radcliffe Publishing 2011).
Kay Eaton is a Consultant Nurse for Supportive Cancer Care for the UCLH Trust and Alison Hill is Lead Cancer Nurse for the UCLH Trust. For more information, please contact Elizabeth Lank on firstname.lastname@example.org