An innovative programme to improve the care and experience of patients with incurable cancer is being rolled out across the country.
‘Enhanced Supportive Care’ was developed by specialists at The Christie NHS Foundation Trust, and will now be used by at least 21 more cancer centres across England, supported by incentives from NHS England.
The initiative encourages care teams to address more fully the needs of cancer patients – in particular, preventing and managing the adverse physical and psychological effects of cancer and its treatment.
Rather than waiting until patients are in crisis, Enhanced Supportive Care ensures that patients with incurable cancer have early access to specialist support where there are pain or symptom problems. This early intervention helps avoid the need for emergency admission to hospital.
There is evidence that good supportive care provided early in a patient’s treatment can improve quality of life in patients with advanced cancer, lengthen their survival and reduce the need for aggressive treatments at the very end of life.
When it was trialled with patients at The Christie, emergency admissions among that group fell by more than a quarter, as patients benefited from early specialist supportive care to more effectively manage the symptoms caused by their cancer and the side effects of treatment.
Dr Richard Berman, who led the development of the programme at The Christie and is now NHS England’s National Clinical Lead for Enhanced Supportive Care, said: “Enhanced Supportive Care is a fresh and modern approach to supporting people through cancer treatment – one that seeks to help patients in a very positive way, ensuring that they have timely access to the right expertise.
“I’m delighted to see colleagues in cancer centres across the country embrace this simple approach which has huge potential to improve the experience of patients, at what is often the most difficult time in their and their loved ones lives.”
Last month NHS England set out its plans to deliver world class cancer services, building on the recommendations of the report by the NHS’s Independent Cancer Taskforce led by Sir Harpal Kumar, CEO of Cancer Research UK.
The Taskforce’s report cited the impact of Enhanced Supportive Care at The Christie, and recommended that further steps be taken to ensure patients’ receive support to manage the effects of cancer and its treatment.
Christine Phillips from Bury benefited from Enhanced Supportive Care to deal with the pain of her illness and treatment when referred to The Christie. She said: “My tumour was extremely painful. I then developed a chest infection which added to the pain from the tumour and the radiotherapy treatment I was having. I was always asking for painkillers but none would give me any relief, it was agonising.
“I was then referred to the supportive care team at The Christie to get my pain relief sorted. I was so relieved. After trialling different combinations I now only take one pill to relieve the pain – the doctor got it just right. I use a syringe driver now and it acts more quickly on relieving the pain – I can now comfortably sit down.
“I was used to being in so much pain, things are now so much easier.”
In addition to the further spread of Enhanced Supportive Care, from next year pilot sites will develop the use of the Holistic Needs Assessment as a means of better joining up different phases of a patient’s care, including ensuring timely access to palliative care.
Guidance supporting hospitals to implement the initiative was published in March, and is based around 6 key principals:
- Early involvement of supportive care services
- Supportive care teams that work together
- A more positive approach to supportive care
- Cutting edge and evidence-based practice in supportive and palliative care
- Technology to improve communication
- Best practice in chemotherapy care
The participating cancer centres will receive incentives for improving patient experience through the national CQUIN scheme in 2016/17 and 2017/18; in 2016/17 over £4m will be available.
To support them in meeting this challenge a national peer group will be formed to help their nominated clinical leads share expertise and experience with each other and with Dr Berman as the National Clinical Lead.
As it develops, the programme will expand to help patients with more forms of cancer, and be used in settings other than cancer centres.