Tuesday 16th December 2014
Mac Voice, the magazine for Macmillan professionals: Winter 2014
Amanda Watson explains the development and testing of eHNA
In 2010 Macmillan, in partnership with the National Cancer Survivorship Initiative
, began testing HNAs with 11 NHS test communities. This led to a small pilot project to trial the concept of an eHNA with four test sites. The aim of this project was to understand the impact an electronic assessment tool would have on the HNA process and its impact on assessment and care planning for the future.
The initial testing was conducted over one year, and began with scoping and developing the eHNA tool. Macmillan sought expressions of interest from sites that had been involved in the testing of the paper HNA tools, as they had the experience and knowledge of the HNA process. The sites chosen to test were Guy's and St Thomas' NHS Foundation Trust, North Bristol NHS Trust, East Kent Hospitals NHS Foundation Trust, and St Helens and Knowsley Hospitals NHS Trust.
Working together with these sites, Macmillan identified how and where the assessments would be carried out and the type of technology that would be needed to support this.
A six months live test period followed. All sites were keen to continue using the system and the test period was therefore extended to twelve months. Overall the testing had a positive impact. Both staff and people living with cancer told us it was generally easy to use and had the potential to save time.
There were some initial concerns around security of equipment and that the elderly would struggle to use the tablets. However, the final project report for the pilot project highlighted that these were not issues. Although not originally part of the project scope, it was recognised that the aggregated data from the assessment and care plans could be used to support service development and commissioning.
As this was only a small pilot to test the concept across four test sites, Macmillan needed to identify how the eHNA could be scaled up.
Testing the eHNA helped to define a standard process for delivering assessments, and a format for care planning that could be measured through the use of live aggregated data. The data could identify the needs and concerns of the person affected by cancer at key points of their cancer journey.
Realising the future potential of the eHNA to transform cancer services was a defining moment, and helped to change the small pilot to one of Macmillan's bigger projects for investment.
In 2012 the decision was made to move to a larger 'prototype' project phase, which would include more cancer service providers from across the whole of the UK. Our early evaluation showed that sites found it much easier to move to an electronic approach if they were already providing paper assessments and care planning routinely. Macmillan therefore made it a requirement of the prototype sites that they needed to have used a paper assessment tool for a minimum of six months before adopting the eHNA. The project has recently been extended and will now end in June 2016.
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