Living with and beyond cancer
Personalised Care & Support for Cancer Patients (formerly known as Living With & Beyond Cancer)
The NHS Long Term Plan mandates that by 2021, where appropriate, every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. This will empower people to manage their care, the impact of their cancer, and maximise the potential of digital and community-based support. Every patient with cancer will get a full assessment of their needs, an individual care plan and information and support for their wider health and wellbeing. All patients, including those with secondary cancers, will have access to the right expertise and support, including a Clinical Nurse Specialist or other support workers
This new model of care serves to improve the care of patients after their cancer treatment has finished; we learned from patient feedback that more support was needed at this time, so we have made a number of changes and are working on others. Cancer Support Workers are now in place in hospitals to work alongside clinical teams and provide extra support for patients and staff. They contact patients following a diagnosis of cancer and work with patients identifying where assistance is needed; they are available 5 days a week and have extensive knowledge of the wider support for patients. In addition to this, they run regular half-day Health & Wellbeing Events in the community which provide a huge amount of information and support for patients recovering from treatment. These cover subjects such as psychological support, fatigue, nutrition, exercise and adjusting to what is often referred to as “a new normal”.
A Treatment Summary is a document (or record) completed by health care professionals, after a significant phase of a patient’s cancer treatment. It describes the treatment, potential side effects, and signs and symptoms of recurrence. It is designed to be shared with the person living with cancer and their GP.
The Treatment Summary aims to inform the GP and other primary care professionals of actions that need to be taken and who to contact with any questions or concerns. The person affected by cancer also receives a copy to improve their understanding and to know if there is anything to look out for during their recovery.
It provides the GP with an up-to-date and clear understanding of the patient’s treatment. This can include information that is essential for updating their records and for conducting a Cancer Care Review. The Treatment Summary can also be shared with other health professionals and used to evidence the patient’s treatment, for example when claiming travel insurance. A copy of the Treatment Summary is retained in the patient’s case notes, so medical staff can access the patient’s information easily if they are admitted back to hospital after their primary treatment is complete.
This is a discussion between a patient and their GP or practice nurse about their cancer journey. It helps the person affected by cancer understand what information and support is available to them in their local area, open up about their cancer experience and enable supported self-management.
When delivering a Cancer Care Review some patients may be accompanied by a carer and, with permission from the patient, they can act as an advocate when discussing their care. A carer can often help turn any recommendations into manageable solutions for the person they care for.
Remote monitoring is a term used to describe how the specialist can schedule and monitor surveillance tests for patients who have completed treatment for cancer, without the need for a face-to-face outpatient appointment to convey the result.