How can we bring aspects of cancer care closer?

Should cancer patients be able to access some elements of their care nearer their homes?

This week on Click on Wales we’re featuring a series of practitioner responses to ideas to improve cancer care in Wales, crowdsourced between June and July 2015 through the IWA’s Let’s talk cancer project, in partnership with Tenovus Cancer Care and the Jane Hodge Foundation. Over 6 weeks patients and their carers posted their idea for how to make things better for those affected by cancer in Wales. In all we had around 100 ideas submitted. We’ve taken these ideas to a panel of practitioners who have given their responses to the 12 ideas we shortlisted using voting on the website. Here’s what they’ve said. We’ll be using the responses to help inform our final report which we’ll publish in September.

Bringing care services closer (Sometimes its the Simple Stuff), suggested by ShanEv.

Having recently been through my third cancer diagnosis some of the simple things would make life much easier.  For example bringing care locally wherever possible.  I had a drain in for 19 days post surgery, once I had left hospital I, and my driver, had to make a round trip of over 40 miles 3 or 4 times a week to have the bag changed.  Why couldn’t this have been done either at local hospital (not a district general hospital) or my local surgery?  I could even have changed it myself and emailed photo/measurement in if needed.  Making patients and their families spend hours and £££ on these types of journeys is unnecessary and delays recovery.  Whilst I was still in hospital I complained about having to go back to have the bag changed and suggested local solutions, the response was to threaten to keep me in hospital for another fortnight until the drain could be removed.

Practitioner responses:

Kath Elias, Macmillan Oncology Physiotherapy Specialist:

I am in complete agreement with this idea. The fact that people affected by cancer (PABC) often travel long distances for treatment, rehabilitation, etc this can be often be counterproductive. For example, in terms of travelling for specialist rehabilitation for help with fatigue. Also another issue with bringing care closer is that PABC feel more confident receiving treatment by professionals. Unfortunately, there are currently not enough specialists to be out in all healthcare settings. Up skilling non-cancer specialists would be one way forward but they will still often be scared of “cancer”. Therefore, PABC may not receive the best care that is possible for them.

Gareth Thomas, Lecturer / Diagnostic Radiography, Vice-President –  Society & College of Radiographers:

Couldn’t agree more! Though this sounds like an individual case where the drain had to be specifically monitored by the patient’s surgeon?

Stephen Thomas, Patient Representative:

Wales have some problems with geography and population density, Tenovus Cancer Care through its mobile units is an example of meeting those challenges. More could be done, we are a small country and should take advantage of that by becoming an integrated and joined up service, with patient welfare at the centre.

Phil White, GP:

Agree, much can be done in primary care, but we are currently running at capacity. Resource would be needed to train additional community / practice nurses to undertake these relatively straightforward tasks. Secondary care often finds it difficult to “let go”.

Annmarie Nelson, Scientific Director Marie Curie Palliative Care Research:

Some issues can be managed with telephone support. There is a care setting that uses a Caretracker system that helps to avoid visits unless necessary. The Caretracker is a nurse who regularly telephones lower need patients to monitor progress. At any sign of change, the caretracker alerts the clinical team who then arrange to see the patient.

What are your views on this idea? How can we enable cancer patients to access services closer to where they live? We want to hear what you think in the comment section below.

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