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Promoting integrated cancer care

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Macmillan Cancer Relief and the Department of Health are working in partnership to establish the role of primary care cancer lead clinician.

Macmillan Cancer Relief and the Department of Health are working in partnership to establish the role of primary care cancer lead clinician.



Funding is being provided to appoint a lead clinician for cancer in every primary care organisation (PCO) in England. Since last October, 300 such posts have been established across the country.



This is aimed at ensuring that each lead clinician has dedicated time in which to raise the standards of cancer care in their community and to enable them to contribute to the development of cancer networks.



There are five objectives that the lead clinicians must meet:



- Provide strategic leadership within the PCO to develop cancer services for patients



- Contribute to developing cancer networks and to represent their PCO in the network



- Contribute to developing service delivery plans



- Raise standards of cancer care within their PCO



- Ensure that services are responsive to the needs of people affected by cancer.



The cancer lead posts are open to all members of the primary health-care team, not simply to GPs. Appointees include highly skilled nurses and pharmacists.



Getting started
Wendy Hardicker is one of the nurses to have taken up the challenge of this ground-breaking role. Her first priority within South Norfolk Primary Care Trust was to establish the key concerns of the PCO for which she works.



To enable her to do this, the trust supported a brainstorming session to discuss the key issues around cancer and palliative care services in their area. This provided a springboard for developing an action plan for the next three years.



An assessment of the current situation and the development of an action plan is a key component of the role of cancer leads. The Macmillan Support Programme has been developed specifically to support cancer lead clinicians in these and other aspects of their work.



The programme
The Macmillan Support Programme has identified the areas of expertise essential for primary care cancer leads, to enable them to work effectively and efficiently.



By building on existing skills and knowledge the programme offers advice on gaining clinical and organisational knowledge of the disease and the services available.



It also advises leads on how they can make an impact on their PCO and on the cancer network, as well as on how they can have an input into the development of future resource materials for other leads.



Through this, Ms Hardicker feels her experience can really be made to count.



The Working Brief welcome pack
The welcome pack supplied to the cancer leads provides them with clear direction on how to build a picture of the local situation and gives guidance on establishing key contacts and identifying areas that will need early intervention.



Individual learning needs are addressed and Macmillan will provide leads with the necessary contacts they might need to fulfil their personal development plans. Group learning sessions are planned and supported by Macmillan, allowing cancer leads to identify common concerns and to share and develop the skills they need to impact positively in their roles.



Ms Hardicker feels that, due to the varied backgrounds of the cancer leads, peer support is a vital component of the three-year support programme.



Ongoing support
Macmillan provides Ms Hardicker and her peers with ongoing and general support in a variety of ways. The telephone helpline provides them with links to their peers and colleagues, and also offers information and support, updating leads on initiatives.



A website will provide information about support programme resources and also provides leads with a discussion forum to share their experiences. The Working Brief topic-based resource materials and toolkits will be developed over time in response to the needs identified by the cancer leads as they develop their roles.



Establishing the role
There was some initial uncertainty about the role of the primary cancer lead clinician within Ms Hardicker’s PCO. This has now been addressed through a series of briefing sessions at professional meetings. Colleagues have been encouraged to become involved in identifying problem areas and to participate in the planning stages.



Ms Hardicker is actively encouraging the set-up of cancer registers to track a patient’s cancer journey through both primary and secondary care. By improving the documentation and collating information, she hopes to close the gap between primary and secondary care. Her aim is to encourage nurses and clinicians from all areas to work more closely together to improve services for cancer patients and their families.
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