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CANCER IN SCOTLAND: ACTION FOR CHANGE
05. IMPROVING CANCER TREATMENT AND CARE
"Patients and their carers must be involved as equal partners in decisions about care and treatment and must be provided with the information they need when they need it."
What has been invested Scotland-wide in improving cancer treatment and care |
2001-02 | 2002-03 |
2.1 million | 3.6 million |
3.5 million of this investment represents at least 21 consultants, 34 clinical nurse specialists, 17 nurses, 5 radiographers, 4 pharmacists and 25 other support staff such as Allied Health Professionals (AHPs), psychologists, technicians and administrative staff. 0.9 million is being spent on ultrasound, laboratory and pharmacy equipment. Examples of initiatives are: Improved communications systems between the Beatson Oncology Centre and outreach clinics across the West of Scotland. An integrated breast unit in Highland will enable the service to meet CSBS standards and provide co-ordinated multidisciplinary care for patients.
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Information Management and Technology (IM&T)
The Scottish Executive "Strategy for Information" sets out national and local targets for the development of IM&T.
A Cancer IM&T Sub Group of the Scottish Cancer Group is developing an action plan to deliver the key priorities for cancer services:
Core patient record created and available at point of care to actively support multidisciplinary care and provide information for outcome monitoring and audit.
Referral and discharge clinical communication between primary, secondary and tertiary care sectors.
Systems to support chemotherapy prescribing, imaging and other specialist processes.
The action plan links closely into existing national initiatives such as SCI (Scottish Care Information) and ECCI (Electronic Clinical Communication Implementation). The Sub Group undertook an analysis of the available information and IT systems which support each stage of the patient's journey and produced a Guide to support NHS Trusts in choosing appropriate IT systems.
Patient Information
During the final quarter of 2002 the Patient Information Sub Group of the Scottish Cancer Group will bring forward their recommendations aimed at securing improved access to information needed by patients and their families/carers.
Improving Quality
The CSBS reports on breast, colorectal, lung and ovarian cancers provide a baseline picture of services at the time of the assessment. Many of the improvements funded by the cancer investment are aimed at improving cancer services to meet CSBS standards.
Investments to meet CSBS standards |
In Lothian, additional clinical nurse specialists, medical oncologists and consultant in palliative care to meet the CSBS standards in relation to multidisciplinary teams for colorectal cancer. More radiography staff in Tayside to reduce the waiting time for radiotherapy treatment in line with the CSBS standards. Redesign of services in Glasgow with additional radiology, radiography and nursing staff to provide imaging support for breast clinics. This will improve access to services and reduce waiting times to meet CSBS standards.
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RCAGs regularly review services in their area and seek to address any shortcomings identified as well as share examples of success and good practice across Scotland.
Managed Clinical Networks (MCNs)
Breast, lung, colorectal and gynaecological MCNs are well developed in most areas. Some have developed more rapidly than others and work continues to ensure the core principles set out in Scottish Executive Health Department guidance are met. In all three networks MCNs for head and neck, skin, haematology and other tumour specific networks are being developed. Networks are crucial to deliver an integrated service capable of achieving the 2005 overarching waiting times target and continuing service quality improvements.
The report of the Scottish Audit of Gastric and Oesophageal Cancer was published in May 2002 and issued to NHS Boards, Trusts and RCAGs who are considering the findings and recommendations so that, where required, the key messages for patient care are translated into positive action.
Beatson Oncology Centre, Glasgow
Cancer in Scotland is a national strategy and as such did not target individual operational issues of NHS services. However, in the last year the Beatson Oncology Centre in Glasgow has been the subject of such intense public, patient, media and Parliamentary interest that any report on Scottish cancer services would be incomplete without mention of it.
Following on from the resignation of four consultants over the period November 2001 to February 2002, the issues faced by the Beatson have been well aired and will not be reiterated here. What is important to record is a summary of the actions which have been taken and continue to be vigorously pursued to ensure that effective and safe services for patients continue to be delivered.
More than 1 million of the West of Scotland cancer investment is being used at the Beatson, in addition to the 2 million targeted specifically to help recruitment and improve its services. This money has largely been used to purchase new and replacement equipment, upgrade wards and other facilities and to increase the staff establishment. More than 50 additional staff are now employed at the Beatson as a direct result of this investment. More information is provided elsewhere in this report and full listings are available from the
Cancer in Scotland website.
There is no doubt that the consultant, nursing, radiography and other posts filled over the past 10 months have significantly improved the position - for staff and, importantly, for patients. The environmental improvements made to the facilities and the recent opening of the 24-bed chemotherapy facility at the Gartnavel campus are very much welcomed by patients.
Although a great deal has been achieved since the appointment of Dr Adam Bryson as Interim Medical Director last December, much more remains to be done. Even although it is an internationally recognised shortage speciality, two replacement Clinical Oncologists have been appointed and as this report goes to press applications for the new West of Scotland Medical Director post are being considered. Recruitment to the Chair of Clinical Oncology is expected to be rapidly processed by the University of Glasgow and an interview date for a new consultant post in medical oncology has been set for mid October. It is hoped that appointments will be made to all of these posts.
Dr Bryson and colleagues are working in partnership with West of Scotland NHS Boards to progress plans for delivery of services across the region to meet current and future patient needs.
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