Macmillan’s new Practical Implementation Guide for Cancer Care Reviews

Published: 15 January 2024
Jacqui Graves, Macmillan National Clinical Nursing Advisor and NHS General Practice Nurse shares her professional learnings about delivering Cancer Care Reviews, and the launch of Macmillan’s new Practical Implementation Guide, designed to help Primary Care professionals deliver more impactful cancer care reviews in their practice.

Jacqui Graves Macmillan National Clinical Nursing Advisor and NHS General Practice Nurse

My experience of delivering Cancer Care Reviews (CCRs)

When I first started in my General Practice Nurse (GPN) role, I was responsible for setting up and delivering CCRs to those living with cancer in our Practice population. Having worked in cancer for over 22 years, most recently as a Cancer Nurse Specialist and having worked in Macmillan during the development of the Recovery Package over ten years ago, I thought I was fully equipped to set up CCR Clinics. How naïve could I have been? 
Over the past two years I have had to learn through a trial-and-error approach, and as a result I have a lot of learning to share with other primary care professionals, both what has worked - and what has not. Many others who are setting up CCR clinics for the first time have approached me for advice or to shadow my clinics to better understand what is involved and what a ‘good’ review looks like.
It was clear that there was a real demand for better guidance around CCRs, especially with the number of ARRS roles (Additional Roles Reimbursement Scheme) currently multiplying in Primary Care.  

A new resource to support Primary Care professionals in delivering impactful CCRs

Macmillan’s Practical Implementation Guide for Cancer Care Reviews is a brand new digital resource to empower and support primary care professionals to set up CCR clinics and provide impactful and meaningful reviews, using learnings and best practice tips from a number of professionals working in Primary Care. The guide is aimed at all healthcare professionals delivering CCRs in Primary Care, from Cancer Care Coordinators to GPs or Practice Nurses, but professionals working in secondary care might also find the guide useful and informative.

What I’ve learnt about delivering a CCR clinic

My first real learning was the realisation that I had no understanding of primary care, its IT systems and the supporting software that is used. I also had to rapidly develop my knowledge about certain cancers and their treatment, particularly prostate cancer, where I had no prior experience to draw from. I also had to accept that I was no longer a Cancer Nurse Specialist but a generalist nurse and expected to know something about over 250 distinct types of cancer and their treatments. However, what transcends all cancer types is the psychological and emotional impact of a cancer diagnosis and the patient’s need to understand what is happening, when so little seems in their control, which was thankfully something I was able to draw on and put into practice.

During my first clinic in July 2021, I had nine patients booked in for a 30-minute appointment slot with no breaks or catch-ups in between and not one patient had completed a holistic needs assessment in advance. All but one of the patients were living with prostate cancer, which I knew little about. It was a steep learning curve.

What matters most to patients during their CCR?

I have recently supported a young patient through their cancer pathway and asked them what they thought Primary Care healthcare professionals should consider when talking to someone who has had a recent diagnosis of cancer.

While there’s not one solution that will fit every patient, here were some of their reflections:
  • Show empathy by listening to their story and making their voice heard. 
  • Reassure them that a treatment plan has been developed for them. 
  • Make sure that the patient is aware of the “next steps”. If not, get a copy of this information from the treating hospital as this would offer a safety net to prevent any potential oversights within the system. 
  • Share information about support groups. Reassure them that these groups come in all shapes and sizes to suit everyone’s needs, including both online and face-to-face. 
  • Keep track of their progress on their treatment plan.
  • Over time keep track of progress and results, offer to do blood tests at the GP practice if the patient is more local to the GP than the hospital as this creates less hassle for the patient.
  • Keep the number of points of contact to a minimum, where possible. It gives the patient a chance to develop a sense of trust and mutual respect for the appointed professional. It offers that extra care and attention to detail that ultimately matters to many patients. 

Read Macmillan’s Practical Implementation Guide for Cancer Care Reviews.

We welcome feedback and any thoughts and comments for further improvements to the Guide. Please email us your feedback.