TY - JOUR
T1 - Improving personalised care and support planning for people living with Treatable-but-not-Curable cancer
AU - Le Boutillier, Clair
AU - Jeyasingh-Jacob, Julian
AU - Jones , Lizzie
AU - King, Alex
AU - Archer, Stephanie
AU - Urch, Catherine E
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Funding Information:
We would like to acknowledge RM Partners for funding the project and Vanessa Brown, RM Partners Senior Personalised Cancer Care Project Manager for supporting the initiative. We would like to thank our project key advisors: Di Dunn (ICHT Trust Lead Cancer Nurse), Katie Bedborough (ICHT Macmillan Deputy Trust Lead Cancer Nurse), Anna Bootle (ICHT Assistant Psychologist) and Sinead Cope (Maggie’s West London Centre Head) for their involvement in supporting, developing, and delivering the intervention. We would like to thank the RM Partners patient advisory group and all patients and clinicians who contributed to the planning of the project, those who were involved in the PPIE activities, and those who promoted and provided feedback on the service. Finally, we would especially like to thank the patients who attended the ARC clinic, and their families.
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC.
PY - 2023/9/4
Y1 - 2023/9/4
N2 - People living with treatable-but-not-curable (TbnC) cancer encounter cancer-related needs. While the NHS long-term plan commits to offering a Holistic Needs Assessment (HNA) and care plan to all people diagnosed with cancer, the content, delivery and timing of this intervention differs across practice. Understanding how people make sense of their cancer experience can support personalised care. A conceptual framework based on personal narratives of living with and beyond cancer (across different cancer types and all stages of the disease trajectory), identified three interlinked themes: Adversity, Restoration and Compatibility, resulting in the ARC framework.Our aim was to use the ARC framework to underpin the HNA to improve the experience of personalised care and support planning for people living with TbnC cancer. We used clinical work experience to operationalise the ARC framework and develop the intervention, called the ARC HNA, and service-level structure, called the ARC clinic. We sought expert input on the proposed content and structure from patients and clinicians through involvement and engagement activities. Delivered alongside standard care, the ARC HNA was piloted with patients on the TbnC cancer (myeloma and metastatic breast, prostate or lung) pathway, who were 6-24 months into their treatment. Iterations were made to the content, delivery and timing of the intervention based on user feedback.Fifty-one patients received the intervention. An average of 12 new concerns were identified per patient, and 96% of patients achieved at least one of their goals. Patients valued the space for reflection and follow-up, and clinicians valued the collaborative approach to meeting patients' supportive care needs. Compared with routine initial HNA and care plan completion rates of 13%, ARC clinic achieved 90% with all care plans shared with general practitioners. The ARC clinic adopts a novel and proactive approach to delivering HNAs and care plans in a meaningful and personalised way.
AB - People living with treatable-but-not-curable (TbnC) cancer encounter cancer-related needs. While the NHS long-term plan commits to offering a Holistic Needs Assessment (HNA) and care plan to all people diagnosed with cancer, the content, delivery and timing of this intervention differs across practice. Understanding how people make sense of their cancer experience can support personalised care. A conceptual framework based on personal narratives of living with and beyond cancer (across different cancer types and all stages of the disease trajectory), identified three interlinked themes: Adversity, Restoration and Compatibility, resulting in the ARC framework.Our aim was to use the ARC framework to underpin the HNA to improve the experience of personalised care and support planning for people living with TbnC cancer. We used clinical work experience to operationalise the ARC framework and develop the intervention, called the ARC HNA, and service-level structure, called the ARC clinic. We sought expert input on the proposed content and structure from patients and clinicians through involvement and engagement activities. Delivered alongside standard care, the ARC HNA was piloted with patients on the TbnC cancer (myeloma and metastatic breast, prostate or lung) pathway, who were 6-24 months into their treatment. Iterations were made to the content, delivery and timing of the intervention based on user feedback.Fifty-one patients received the intervention. An average of 12 new concerns were identified per patient, and 96% of patients achieved at least one of their goals. Patients valued the space for reflection and follow-up, and clinicians valued the collaborative approach to meeting patients' supportive care needs. Compared with routine initial HNA and care plan completion rates of 13%, ARC clinic achieved 90% with all care plans shared with general practitioners. The ARC clinic adopts a novel and proactive approach to delivering HNAs and care plans in a meaningful and personalised way.
KW - Personalised care, Oncology, Holistic Needs Assessment, Healthcare Improvement, Clinical Microsystem
UR - http://www.scopus.com/inward/record.url?scp=85169847292&partnerID=8YFLogxK
U2 - 10.1136/bmjoq-2023-002322
DO - 10.1136/bmjoq-2023-002322
M3 - Article
VL - 12
SP - 1
EP - 9
JO - BMJ Open Quality
JF - BMJ Open Quality
IS - 3
M1 - e002322
ER -
