We can not meet the psychological well being wants of most cancers sufferers with out breaking down silos | HSJ Companions

This text was authored by All.Can UK, a multi-stakeholder initiative involving affected person teams and business consultants, and has been absolutely funded by the All.Can UK funding companions: Bristol Myers Squibb (major sponsor) and MSD (supporting sponsor). Collectively, the All.Can UK membership outlined the main focus of the article. Bristol Myers Squibb and MSD don’t intend to encourage the use, or advocate the promotion, of their merchandise by this text and it doesn’t embody dialogue of particular remedies or merchandise. The viewers for the article is predominantly comprised of commissioners, healthcare suppliers, these concerned in commissioning and people working in healthcare within the non-public sector.

A most cancers analysis and subsequent therapy might be devastating and debilitating for the wellbeing of the particular person concerned. In England, there are at the very least 130,000 folks dwelling with ‘treatable however not curable most cancers’.[i] These sufferers usually tend to expertise fear, concern or nervousness resulting from their situation.[ii]

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While sufferers wouldn’t be given chemotherapy with out anti-sickness medicine to deal with the speedy bodily impacts, many individuals will undergo analysis, therapy and dwelling with and past most cancers with out receiving any accompanying psychosocial assist.[ii]

Recognition of the necessity to enhance the psychological wellbeing of individuals affected by most cancers, in addition to that of their households and carers, has been rising lately – with most cancers and psychological well being each included as strategic priorities for NHS England.[ii]

This was emphasised within the NHS long-term plan, revealed in 2019, which set out the significance of enhancing entry to personalised care for each particular person recognized with most cancers, together with entry to psychosocial assist.[iii]

Nonetheless, the commissioning of those companies has not developed to maintain tempo with this ambition and vital hurdles stay in making certain routine entry to companies that assist the psychosocial wellbeing of individuals dwelling with and past most cancers.

A key barrier cited inside a latest All.Can UK and HSJ roundtable was the ‘conceptual separation’ that exists between bodily and psychological well being.[iv]

Completely different budgets, cost programs and contracting preparations for most cancers and psychological assist companies imply that there’s typically an absence of any constant method to commissioning of assist companies.[v]

This in flip results in regional variation within the assist on provide, with some geographical areas having no or restricted entry to psycho-oncology provision.[v]

Kelly, a most cancers affected person dwelling in Bedfordshire, skilled these challenges first-hand. She says:

“I used to be given my Stage 4 analysis by a scientific nurse specialist (CNS) with no advisor current. Once I requested for psychological assist at this assembly, she mentioned I wasn’t entitled to it as I lived in a special county to the hospital. I mentioned it was crucial that I obtained assist and she or he mentioned she would look into it. Two weeks later, I lastly noticed a advisor. Once I mentioned I nonetheless didn’t have any psychological assist, he mentioned they’d a lady who “sits over there” (pointing to the top of the hall), however that I couldn’t communicate together with her as I reside in Bedfordshire and the hospital is in Hertfordshire.

I bought very upset and mentioned it was crucial I communicate with somebody to assist me course of my devastating analysis. I ultimately bought assist after 5 weeks of calling my GP instantly and speaking with my district nurse. It was provided through a charity although, not the NHS.

I later modified hospitals and one of many first questions my new advisor requested was what psychological assist I wanted. It appears loopy that the NHS would spend 1000’s of kilos on my bodily therapy in a single place however that I couldn’t get psychological assist on the similar time when processing a analysis of incurable most cancers”.

That is Kelly’s expertise, however she shouldn’t be alone. A report revealed by All.Can UK in December 2020 discovered that of these surveyed, half of sufferers who required psychosocial assist following their analysis had not been capable of entry any companies to assist with their wants.[vi]

Rethinking how companies are commissioned would assist to deal with these boundaries by enabling the system to start to take a extra holistic ‘complete particular person, complete system, complete pathway’ method.[ii]

This implies breaking down silos to make sure that the varied wants of the affected person are being met in a co-ordinated means, with all points of the system working collectively and new processes and programs put in place to facilitate correctly built-in care.

Ceinwen Giles, chief government of Shine Most cancers Help and a member of the All.Can UK Working Group, explains additional:

“Presently, entry to psychological assist is a messy patchwork of commissioned companies, the non-public sector and charities.

Should you reside outdoors of a significant metropolis, it may be particularly troublesome to entry assist because the charities that usually fill the gaps is not going to be lively there.

One subject is that we don’t have a framework for what beauty like – what ought to all oncology companies provide sufferers? What’s the minimal that ought to be supplied?

That is one thing that we have to specify in order that we are able to start to construct companies which assist each the bodily and psychological wants of sufferers.”

One organisation already taking motion to encourage higher joined-up commissioning is the Remodeling Most cancers Companies Workforce (TCST) for London, a part of the Wholesome London Partnership.[vii]

In 2018, TCST – working along with Macmillan – produced a doc with complete suggestions, together with each a pathway and repair specification, to enhance the commissioning of psychological assist companies for folks affected by most cancers throughout London.[v]

A few of the sensible measures outlined on this doc embody making certain that every one hospitals answerable for diagnosing and treating most cancers have entry to a psycho-oncology staff, requiring native well being programs to take a ‘complete system’ method to figuring out and offering a complete community of psychosocial assist which is known by professionals, sufferers and their carers and households, and establishing a platform the place professionals working throughout bodily and psychological well being companies can collaborate and share experience to enhance outcomes for sufferers.[v]

The steering is predominantly involved with driving a constant greatest observe method to psychosocial care provision throughout the entire pathway: from analysis, by acute therapy, dwelling with and past most cancers and finish of life care.[v]

Nonetheless, it additionally emphasises the necessity to establish gaps in psychosocial assist and highlights the very important function that info provision and sign-posting, for instance to 3rd sector organisations and on-line assist, can have in enabling folks to entry assist early.[v]

All.Can UK are working to assist this by growing a software to map the psychosocial assist companies supplied by its affected person group members, making it simpler for NHS employees to signpost most cancers sufferers to psychosocial assist companies from day one in every of their analysis.

This yr, All.Can UK can even be working to display the worth of third sector service provision of psychosocial care that helps the NHS in driving higher most cancers affected person outcomes. Via this work, the group can even search to create steering for provision of a clearer path for psychological well being and most cancers commissioning inside built-in care programs.

In the end, if we’re to attain the NHS’s ambition of enhancing entry to personalised care, we should break down commissioning silos, with the versatile, person-centred, non-stigmatising, constant assist the third sector offers being recognised as a vital piece of the puzzle.


[i] Macmillan (2021). ‘Treatable however not curable most cancers’. Out there at: https://www.macmillan.org.uk/about-us/treatable-but-not-curable-cancer. [Accessed: February 2022].

[ii] Remodeling Most cancers Companies Workforce (2020). ‘Commissioning steering for Most cancers Psychological Help’. Out there at: Refreshed-February-2020-Steering-doc-Psychological-support-for-people-affected-by-cancer-.pdf (healthylondon.org). [Accessed: February 2022].

[iii] NHS England (2019). ‘NHS Lengthy Time period Plan’. Out there at: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf. [Accessed: February 2022].

[iv] Well being Service Journal (2022). ‘Roundtable: Assembly the psychological well being wants of most cancers sufferers’. Out there at: https://guides.hsj.co.uk/5992.information. [Accessed: February 2022].

[v] Remodeling Most cancers Companies Workforce (2018). ‘The psychological affect of most cancers: commissioning suggestions, pathway and repair specs on psychosocial assist for adults affected by most cancers’. Out there at: https://www.healthylondon.org/wp-content/uploads/2018/05/Psychological-support-for-people-affected-by-cancer-Might-2018.pdf. [Accessed: February 2022].

[vi] All.Can UK (2020). ‘All.Can UK: Inserting the psychological wellbeing of individuals with most cancers on equal footing to bodily well being’. Out there at: https://www.all-can.org/national-initiatives/uk/#panel-pub-res. [Accessed: February 2022].

[vii] Wholesome London Partnership (2020). ‘Psychosocial Help’. Out there at: https://www.healthylondon.org/useful resource/psychosocial-support/. [Accessed: February 2022].

Doc quantity: ONC-GB-2200181

Date of preparation: March 2022

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