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The future of cancer care

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Dr Shelley Dolan reflects on her nursing career and looks toward oncology’s future

Although Dr Shelley Dolan is now the clinical director at London Cancer Alliance and chief nurse at The Royal Marsden Foundation Trust, she didn’t always have her sights set on healthcare.

“When I left school, I either wanted to be a famous actress or look after people. Looking back, I probably would have been terrible at the first,” she says. So, soon after she finished school, when she walked past a nursing recruitment agency, she decided to pop in.

“After completing my nurse training I undertook many clinical roles across England but all in intensive or coronary care,” Dr Dolan says. “I hugely enjoyed that time as a clinical nurse, progressing from staff nurse to sister to teaching sister and then clinical nurse specialist.”

Dr Dolan later heard of an opening at the intensive care unit of the specialist cancer hospital, The Royal Marsden. Here she “got to work with really lovely staff” - and so began her lifelong interest and commitment to oncology nursing.

“I was struck by the honesty with which clinicians spoke to families about cancer,” she says. In addition, “the teamwork the doctors and nurses had was evident.”

A recipient of the European Oncology Nursing Society’s Lifetime Achievement Award in 2013, Dr Dolan is passionate about the treatment and care of people with cancer.

“Cancer care has become something I hugely enjoy,” she explains. “It’s both an intellectual challenge and personally rewarding to

be in a position to help someone who has been affected by it. It is a huge honour and a privilege.”

The LCA, which was established in 2011 as the integrated cancer system for west and south London, works to reduce variation in cancer care and improve clinical outcomes and patient experience.

According to the NHS, every hour, three more Londoners are diagnosed with cancer, and there are wide variations in the quality of

the treatment and care across the city. In her current position as LCA clinical director, Dr Dolan works collaboratively with clinicians and chief executives across the LCA’s 16 NHS trusts to deliver safe and effective care, improve cancer clinical outcomes and enhance both the quality of experience and the quality of life for patients.

One of the LCA’s primary goals is integrating treatment across the whole pathway of care from screening or diagnosis in primary care right through secondary and tertiary care.

“When we see people in the clinic, they talk about the difficulty of navigating this pathway. That feels distressing and unsafe, and can be an enormous challenge for patients,” Dr Dolan says.

The LCA, through its pathway groups, seeks ways to integrate along the whole pathway to reduce these pressures on individuals who should be more concerned with their health than navigating structural confusion. As Dr Dolan says: “Nurse specialists have always been the glue that holds this system together, but you shouldn’t have to rely on one person. We want there to be no cracks at all.”

The LCA pathway groups are all publishing cancer-specific exemplar pathways and guidelines. This is so that no matter where the patient receives their care, they have the reassurance that all their clinicians are using the same guidelines and that the care is coordinated.

Dr Dolan also said the LCA is recruiting a new research and development director. “The work we could do by harmonising research across our provider organisations is going to take the care of cancer to the next level. We are working to ensure that everything we design is what the patient would benefit from and design for himself or herself.”

Dr Dolan is optimistic about the LCA’s goals. “Transforming cancer services and reducing variation will not be easy. But we are already beginning to see progress,” she says. “We have developed evidence-based, best-practice pathways, clinically agreed protocols and service specifications to improve cancer services within and across our provider organisations. As a nurse and clinical director of the LCA, having the chance to unify and improve cancer care for Londoners is hugely exciting.”

Rachel Stanback

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