NHS lung cancer information and support sessions - A service review: A viable and modern approach in patient support

By John McPhelim & Lynn Irvine, NHS Lanarkshire

Category: Follow-Up and End-of-Life Care

The problem identified

The lung CNSTeam recognised improvements to the structure of the existing lung cancer support sessions where necessary to encourage new patients to attend and also to justify the role of their attendance at the scheduled sessions. It was also recognised by the patient group members that new patients needed to be attracted and gain access to the benefits for the group.
The group was becoming a social support group rather than a collective group of people sharing common interests and experiences on how to cope with the challenges of living with lung cancer. There was also acknowledgement that new patients who attended often did not return on subsequent sessions.

The intervention made to change the problem

Approval was gained from the lead lung CNS, lung cancer team members and the Maggie's Lanarkshire team. We also gained the support on the requirement to redesign the structure of the support sessions, from the patients of the existing group. Consideration to the session topics, the benefits to the current group and experience of the lung CNS on facilitating the sessions were also examined.
Analysis of the regular session evaluation questionnaires were reviewed, and a focus group discussion, including existing group members on how beneficial they felt the sessions were and the value to them as participants.

How it changed my practice

In redesigning the sessions it has enabled equitable access to additional support, maintaining the initial patient and carers' needs analysis supporting evidence based patient centred approach. By streamlining the sessions it has offered support to all patients and carers wherever they are in their cancer journey. These changes now support a sustainable service, with a focus on movement through the support sessions with a supported exit strategy to continued support at Maggie's. It also ensures the lung CNS expertise is utilised in patient education and support.
It was agreed to maintain the existing sessions once a month and rename it as "Living with Lung Cancer sessions" for social support, facilitated by the current group attendees and the input from the Maggie's team when the sessions required support from a skilled facilitator. The structured sessions on various topics would therefore move to the 4th Wednesday of each month, supported by the lung CNS team.
A patient satisfaction questionnaire was developed for administration to attendees at the end of each CNS facilitated session. This was designed to capture information on session topics, to ensure it was meeting patient and carer's needs and expectations. They were also asked to evaluate various aspects of the sessions including; effectiveness, delivery of information and venue.
On completion of the 6 session block analysis is carried out on the supported exit strategy into the "Living with Lung Cancer" meetings and the value of support from one another to cope with the challenges of living with lung cancer. This takes the form of a focus group. By changing practise it has aided the streamlining of the sessions and offers support to all patients and carers wherever they are in their cancer journey.
There has also been some impact on patient care, including:
- An opportunity to meet with other people living with lung cancer
- Develop new skills in self-management and coping day to day
- An opportunity to be supported and to help others
- A chance to share experiences and source information
- Support and advice within the hospital setting
Changing practise has also impacted on colleagues and the trust including:
- Being part of the development and facilitation of a patient focused service that ensures continuous focused support and advice
- Working in collaboration with Maggie's Lanarkshire, as a 1st within NHS Scotland
- Establishing the goal of delivering a viable and modern approach to patient support
- Delivering an evidenced based initiative that is patient focused
These changes will support sustainable services, with a focus on movement through the support sessions with a supported exit strategy. It is a model of good practice that will be showed with transforming care after treatment (TCAT) a Scottish joint initiative. This initiative being based in the Maggie's Centre encourages patients to access the wide range of support and services also available here.

Resource / Cost implications

To achieve this model an additional session was required within the Maggie's Centre monthly activities timetable. This was introduced on the ethos of delivering a supported exit strategy into the Living with Lung Cancer group, and to allow the introduction of new patients to the structured facilitated sessions. There was no resource implication to the lung CNS, as attendance would continue on a rota basis.

References

Implementing patient-centred cancer care: Using experience-based co-design to improve patient experience in breast and lung cancer services;Tsianakas et al;April 2012.

Published: 2017

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