1 October 2014
Eight of the capital’s NHS trusts score in the bottom 10 of Macmillan Cancer Support’s 2014 patient experience league table of trusts in England, published today. But for the first time Macmillan says the ‘enormous efforts’ of London trusts to improve their patients’ experience of care are beginning to show results.
The Macmillan league table follows NHS England’s release last Thursday (Sept 25) of the National Cancer Patient Experience survey 2014 of just over 70,000 cancer patients. It asked 70 questions about patients’ experience of care – such as whether their diagnosis and treatment options were explained clearly to them; whether they felt supported in their care; and whether they felt they were treated with respect. The survey does not measure medical care.
Carol Fenton, Macmillan’s General Manager in London, says: “After four years of London trusts featuring in the bottom 10 of our league table, signs of improvement are visible, but there remain significant areas where improvement is needed. London trusts and their dedicated staff are making enormous efforts, but too many cancer patients in the capital are not yet getting the care they deserve. Macmillan Cancer Support is committed to working in partnership and sharing best practice with London trusts and others across the capital in order to urgently improve this.”
Areas where London trusts have shown improvements include :
• patients being given the name of the clinical nurse specialist in charge of their care
• patients being given written information about the type of cancer they have
• patients’ confidence and trust in ward nurses
• hospital staff telling patients they can get free prescriptions
As an example of progress, Macmillan cites one of last year’s bottom 10 trusts, St George’s Healthcare NHS Trust, which this year is in Macmillan’s ‘10 most improved’ trusts in England. Also, in 2013 London trusts appeared in the bottom 20% of survey responses a maximum of 55 times whereas in 2014 this has fallen to a maximum of 49 times.
Areas where London trusts must improve include:
• all patients to be offered an assessment and care plan
• hospital staff giving patients enough emotional support
• patients feeling staff are doing everything to control the side effects of chemotherapy and radiotherapy
The challenge facing some of the capital’s trusts is illustrated by the experience of patient Diane Ennis (42), who was diagnosed with ovarian cancer in 2012 and treated in a London trust. She says the staff often appeared to lack compassion:
“I felt unimportant and dismissed by the staff. There were times when I had to tell them that they had already given me my medication. Once they tried to feed me when I was ‘nil by mouth’.”
Diane adds: “Patients would press their buzzers and nurses would just walk past. They would just leave them. For example, a woman on my ward wet herself and she lay there in her bed for hours. I had to get up and try to help her. I was very lucky that I had family and friends with me and supporting me, so that I wasn’t ignored or overlooked.”
Carol Fenton says enormous efforts are being made across London in partnership with Macmillan by NHS trusts, the Integrated Cancer Systems (London Cancer and London Cancer Alliance), Transforming Cancer Services in London and NHS England (London) to improve the experience of cancer patients. This includes such initiatives as:
• availability of clinical nurse specialists
• information and support for cancer patients
• training courses for NHS staff on how to better support patients
• improving the culture and behaviour of staff
• encouraging cancer patients to give real time feedback on their experience of care via touch screens in hospitals
Concludes Carol Fenton: “Our goal in London must be for every patient to be treated with the highest levels of dignity, respect and compassion. That is not happening yet, despite NHS staff, trusts and others working hard towards it. London must aim to have the best cancer patient experience of any capital city in the world. We will achieve this through a relentless focus on what matters most to patients.”
In support of patients, Macmillan today launches a new patient rights leaflet. Your Cancer Care provides information about patients’ rights by outlining the eight key behaviours in the Macmillan Values Based Standard2. For example, patient should expect to:
• Be involved in decisions, be informed of the treatment options and why recommendations have been made
• Be communicated with in a sensitive way and be offered support. They should also share any concerns about what they are told
In addition to letting patients know the standards they can expect, it introduces practical steps to support patients to engage in their care and what to do if things go wrong.
Macmillan is also urging all political parties to commit in their general election manifestos to ensuring that every single patient is treated with the highest levels of dignity and respect and that staff are supported to deliver this.
Notes to editors:
10 best performing Trusts*
Rank Trust Strategic Health Authority
1 South Tyneside NHS Foundation Trust Northern England
2 Gateshead Health NHS Foundation Trust Northern England
3 Harrogate and District NHS Foundation Trust Yorkshire
4 St Helens and Knowsley Teaching Hospitals NHS Trust Cheshire & Mersey
5 East Cheshire NHS Trust Cheshire & Mersey
6 Northumbria Healthcare NHS Foundation Trust Northern England
7 South Devon Healthcare NHS Foundation Trust South West
8 Queen Victoria Hospital NHS Foundation Trust South East
9 Yeovil District Hospital NHS Foundation Trust South West
10 Luton and Dunstable Hospital NHS Foundation Trust East of England
* Trusts are ranked according to the number of times they appear in the highest 20% on the 61 scored questions. Non evaluative questions (e.g. "have you had an operation") have been excluded. Top 10 are the 10 most often in the ‘green’ top 20%.
10 worst performing Trusts**
Rank Trust Strategic Health Authority
1 Barts Health NHS Trust London
2 Milton Keynes Hospital NHS Foundation Trust East Midlands
3 Imperial College Healthcare NHS Trust London
4 Homerton University Hospital NHS Foundation Trust London
5 Ashford and St Peter’s Hospitals NHS Foundation Trust South East
6 Barking, Havering and Redbridge University Hospitals NHS Trust London
7 Royal National Orthopaedic Hospital NHS Trust London
8 Royal Free London NHS Foundation Trust London
9 North Middlesex University Hospital NHS Trust London
10 Kings College Hospital NHS Foundation Trust London
** Trusts are ranked according to the number of times they appear in the lowest 20% on the 61 scored questions. Non evaluative questions (e.g. "have you had an operation") have been excluded. Bottom 10 are the 10 most often in the ‘red’ bottom 20%.
10 most improved Trusts***
Rank Trust Strategic Health Authority
1 The Dudley Group NHS Foundation Trust West Midlands
2 York Teaching Hospital NHS Foundation Trust Northern England
3 University Hospital of South Manchester NHS Foundation Trust Greater Manchester, Lancashire and South Cumbria
4 Luton and Dunstable Hospital NHS Foundation Trust East Midlands
5 Mid Essex Hospital Services NHS Trust East of England
6 Nottingham University Hospitals NHS Trust East Midlands
7 North Bristol NHS Trust South West
8 Portsmouth Hospitals NHS Trust Wessex
9 South Devon Healthcare NHS Foundation Trust South West
10 St George’s Healthcare NHS Trust London
*** Only improved or declining statistically significant scores between 2013 and 2014 are reported. Scores that do not show statistically significant change between 2013 and 2014 are not included. Scored questions with less than 20 respondents from any particular Trust are excluded. Non evaluative questions (e.g. "have you had an operation") have been excluded.
For further information, please contact:
Keith Ewing (020 7091 2365; 07595 243 109); or
Ali Birtwell (Tel 020 7091 2367; 07894 566 611); or Amy Guest (Tel 020 7091 2366).
Out of hours media enquiries: 07801 307068
1 Analysis by Macmillan Cancer Support based on NHS England’s National Cancer Patient Experience Survey 2014, run by Quality Health. A report on the analysis from Macmillan can be found on Macmillan’s website from midday on October 1st, 2014.
2 Macmillan Values Based Standard®
This is what you and your carers should expect from your care:
1. Naming You’re the expert on you, and the information you give professionals will help them understand you.
2. Private communication You’re entitled to privacy – you decide if information can be shared and who with.
3. Communicating with more sensitivity Expect to be communicated with in a sensitive way and be offered support. Share any concerns about what you’re told.
4. Clinical treatment and decision making Be involved in decisions. You should be informed of the treatment options and why recommendations have been made. This includes how the treatment will make you feel and any longer-term effects.
5. Acknowledge me if I’m in urgent need You can expect professionals to understand your needs and say when these will be met. However there may be times when others are in more urgent need of care.
6. Control over personal space and environment Expect to be cared for in a clean and comfortable setting and say what you need for this to happen.
7. Managing on my own You should be supported to manage your own care but also know where to go if you’re worried or need more help.
8. Getting it right Your feedback is always welcome and your concerns are acted on, as part of a process to improve your experience of care.
* The Human Rights Act is a UK law based on the principles of: Fairness, Respect, Equality, Dignity and Autonomy which are central to the NHS. In England and Scotland, governments have taken further steps to protect and promote patient rights through the
3 The Your Cancer Care leaflet can be accessed through the following link:
About Macmillan Cancer Support
When you have cancer, you don’t just worry about what will happen to your body, you worry about what will happen to your life. Whether it’s concerns about who you can talk to, planning for the extra costs or what to do about work, at Macmillan we understand how a cancer diagnosis can take over everything.
That’s why we’re here. We provide support that helps people take back control of their lives. But right now, we can’t reach everyone who needs us. We need your help to make sure that people affected by cancer get the support they need to face the toughest fight of their life. No one should face cancer alone, and with your support no one will.
To get involved, call 0300 1000 200 today. And please remember, we’re here for you too. If you’d like support, information or just to chat, call us free on 0808 808 00 00 (Monday to Friday, 9am–8pm) or visit macmillan.org.uk