VOL: 98, ISSUE: 34, PAGE NO: 35
Gillian Peace, MPhil, BA, SRN, RMN, is clinical information coordinator/key worker, the Cavendish Centre for Cancer Care, Sheffield
The Cavendish Centre for Cancer Care was set up as a charitable trust in 1992. It is a multidisciplinary service that offers support and complementary care to patients with cancer, and their carers and children, through all stages of their illness. The aim is to enable patients to live through their illness with maximum independence and the best possible quality of life.
New patients are offered a comprehensive hour-long consultation conducted by a key worker. Its purpose is to enable the patient and key worker to define the patient's most important needs and concerns, and decide on a plan of action. A therapy is chosen that is most likely to meet the patient's expectations and address his or her concerns. There follows a course of therapy - no more than six sessions - by a therapist experienced in working with people with cancer. The patient's progress is then reviewed by the key worker and a joint decision is made on whether discharge or further treatment is necessary (Case history 1).
The centre's key workers are nurses or doctors with a background in conventional medicine. They are knowledgeable and experienced in cancer care and the complementary therapies on offer, and know the therapists who work at the centre. They also understand the ways in which these therapies can be used as an adjunct to conventional cancer treatment.
We have become more aware of the need to demonstrate that our care provides measurable benefit to patients. Commissioners of care have to make difficult decisions when allocating resources because of competing priorities (Keeley, 1999), while health professionals must select the most beneficial and cost-effective treatment for their patients. We need to provide evidence that what we offer has a legitimate place in patients' overall care. It is not enough to point to patient satisfaction surveys or the absence of complaints. To date, however, there are no agreed methods to evaluate complementary therapies. The task is further complicated by difficulties in evaluating palliative care interventions (McWhinney et al, 1994; Grande and Todd, 2000).
We are currently working to validate a modified version of the MYMOP with its creator, Charlotte Paterson. We hope that it will be relevant in a variety of cancer care settings where complementary therapies are used.