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7. PUTTING PATIENTS AT THE CENTRE
Earlier diagnosis and new treatments have enabled people with cancer to survive longer than ever before. We therefore need to develop new methods of care which enable people to lead healthy, normal lives while at the same time ensuring that they receive the appropriate follow up by the right staff in the right place. We also need to ensure that services are sensitive to the particular issues experienced by older people given our ageing population and the higher incidence of cancer and multiple long term conditions amongst older age groups.
Supported Self Management
As many more people are surviving cancer, some of whom may also be living with one or more other long term conditions, it is becoming increasingly important to consider what support and services are required to help people to maximise their independence, including their rehabilitation. A good example of how we have started to make inroads across these important areas is through the development of a model of supported self management. This is being developed across all stages of the 'patient journey' for cancer and the key elements of the model include better information, questions and prompts on how to 'navigate the system', knowing who to contact and what skills are necessary to be able to 'self manage'. From discussions held with patients, carers and healthcare professionals, it is clear that supported self management is about encouraging and supporting people to be as active as they can be, recognising that this may fluctuate for people throughout their pathway of care. Supported self management is about what can be added to the existing services, not instead of existing services and about working together in a supportive way throughout the whole patient journey of care. There are already many existing examples of good practice in supported self management occurring in parts of Scotland.
In thinking about what NHSScotland needs to do to further develop and deliver supported self management, patients, carers and healthcare professionals identified shared key themes. These include:
- the importance of clear and open communication between patients, carers and healthcare professions
- supported education and training to give people the confidence and skills to feel ready to take more responsibility for their health
- education and training for staff; creating a system of information flexible to person's need; and focusing on the patient experience and developing possibilities for intervention across the pathway.
From 2008, Better Together, NHSScotland's Patient Experience Programme will empower patients, carers and healthcare staff across Scotland to work together to improve our services for the benefit of patients. Preliminary work within the programme is being focussed on improving the experiences of people with cancer and the programme provides us with a huge opportunity to tap into the experiences of our patients and use them to drive improvements in the services we offer.
One of the areas that will be tackled is access to advice and support. To achieve this, the Independent Advice and Support Service was launched by the Minister for Public Health in September 2007. Funded by NHS Boards in a strategic partnership with a consortia of local Citizens Advice Bureaux, the service will provide information about a wide range of issues, including advice about access to benefits and support services.
Safety
Patient safety is paramount at all times. The Scottish Patient Safety Alliance ( SPSA), launched in 2007 and co-ordinated by NHSQIS, will aim to reduce healthcare associated infection, adverse surgical incidents, adverse drug events, improve critical care outcomes, organisation and leadership on safety. Better Health, Better Care confirmed that Scottish Government will support the SPSA to deliver significant improvements to safety in all major NHS hospitals in Scotland.
Issues to Consider
- How can we further improve the experience of patients with cancer?
- How can we further improve the information that is available to support patients, their families and carers? What information gaps exist at present for public/patients and how are these best addressed?
- How can we work more effectively with the third sector in meeting these objectives?
- How could the model of self care management be implemented across the pathway of care?
- What approaches need to be considered to deliver the services required to meet the survivorship needs of patients living with cancer and patients living with cancer as well as other long term conditions?
- How can we further improve rehabilitation for people with cancer and how can their needs be better supported?
- How do we ensure better integration and continuity of care?
- Have you had any recent personal experiences that might help shape and inform future actions across Scotland?
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