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'So many people peddle myths about cures and misdiagnose things on the internet'

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Martin Ledwick’s job in information giving proves you don’t need to see a patient to be able to help them.

Martin Ledwick leads a team of nine nurses who answer over 10,000 queries a year from patients who have cancer - and never meet any of them. As Cancer Research UK’s head information nurse, his contact with patients is by email, via the web and on the telephone.

“You’d think you’d miss the face-to-face contact of nursing, but you don’t,” he says. “As soon as I put on headphones to work on the Cancerbackup helpline in 1995, it was an ‘Aha!’ moment. I knew it was for me.”

Mr Ledwick trained in 1985 and, after working in urology, went into cancer nursing in 1987. From 1995 until 2005 he worked for the charity Cancerbackup, helping to set up a second call centre, and developing quality standards and nursing competencies in information giving as well as a user involvement forum. Since 2005, he has been head of Cancer Research UK’s team of information nurses. He has qualifications in cancer nursing, care of the dying and a Master’s degree in health promotion.

“I was always interested in looking after cancer patients. As they tend to be in treatment over a period of time you really had the chance to see things through with them,” he said.

His current role may differ from nursing in cancer wards, but he says the various ways his team can provide support and give information make it exciting. The most popular support method for those with questions is the helpline.

“It is interesting working on the helpline,” says Mr Ledwick. “It’s fascinating to see what you get asked, and hugely satisfying to feel that sense of relief from someone at the other end of the phone. The phone anonymises the question so callers feel they can ask anything - things they might be too embarrassed to ask face to face, for example about sexual problems.”

The helpline still attracts a third of the 10,403 public enquiries the team received last year, but the charity is looking at new ways to give information and support. A third of its enquiries are by email, which lets a nurse consider a response and make it personal for the enquirer.

“With so much information being provided, it’s important to be accurate. So much of my job is spent producing and checking quality standards and developing communication skills for nurses to ensure we get it right,” says Mr Ledwick.

The team also works via other digital channels such as the NetDoctor website, on which there is an “Ask a nurse” feature, and Yahoo! Answers, which allows people to post a question on the message board or comment and vote on the best answer. The nurse team felt there was an important opportunity to provide evidence-based answers to questions related to cancer and are supplying answers to posts each day.

The charity’s most recent innovation is Cancer Chat, an online chat forum. On the first Thursday of every month between 2.00pm and 3.30pm, its nurses are online to respond personally to clinical, practical or emotional aspects of cancer affecting the public, patients and their relatives or carers. 

“These methods are fairly new,” says Mr Ledwick. “We may only get 25–30 questions a week on NetDoctor and five on Yahoo! Answers, but more people will access them than one email or a call to one specific person.

“We must get into digital approaches,” he says. “So many people peddle myths about cures and misdiagnose things on the internet, scaring people. They are on there, so we have to be.”

Mr Ledwick also answers queries from the media and ensures journalists are writing accurate stories about cancer.

“I love the job, it suits me,” he says. “But going into information nursing is not the soft option - it’s hard. You have to have high standards, be accountable and be serious about giving a good-quality answer.”

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  • I have had too recent negative experiences with telemed call centres run by a large medical insurance company. there are some common medical conditions they have not heard of and are incapable of giving any advice on. in such a case they establish the part of the anatomy the condition is concerned with and then fire a long list of predetermined questions at the enquirer, many of which are totally irrelevant. I assume solutions to the problems are then found by applying algorithms to the answers given as, judging by their responses, no sort of professional or skilled cognition seems to take place although the operators claim to be qualified nurses.

    At the end of this lengthy and detailed questioning process which may have little relevance to a particular condition, the only solutions they seem capable of are whether the patient should consult a GP or not which I could have decided for myself. The object of the exercise does not seem to provide any sort of advice of reassurance, and is a totally impersonal experience, although the concept and purpose of such centres is to reduce the number of unnecessary visits to a GP. In the end consulted one mainly for reassurance and I ended up having an x-ray I didn't strictly need and a prescription for a prophylactic treatment in case the condition worsened over the weekend when medical assistance would not be available.

    The first time I phoned in was a problem with BP and the useful advice I got was to purchase a monitor which was unaffordable for me at the time, as well as being unnecessary given the circumstances. This produced an angry reaction from the operator when I said I did not feel that this was a suitable answer to my questions.

    If I raise a query or ask for their advice, it appears that I am expected to take it without discussion!

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