Work underway to improve supportive care for adults with cancer
posted by Research Admin on 15 December 2011
An implementation plan for improving supportive care for adults with cancer has now been finalised, and work has begun to put it into practice.
Supportive care is defined as 'the essential services required to meet a person's physical, social, cultural, emotional, nutritional, information, spiritual and practical needs through their experience with cancer'.
The New Zealand Cancer Control Strategy had determined that patients' supportive care needs had to be better addressed, and established the 'Supportive Care Guidance' project in 2010.
Jo Anson, Manager of the Central Cancer Network and Chair of the working group that developed the Guidance implementation plan, says the aim was to outline best practice and provide a strategic direction for supportive care in New Zealand.
'The Guidance was informed by what was available in the international literature as well as information from earlier New Zealand research which had highlighted problems in accessing supportive care services.'
The Guidance implementation plan was developed following a stock take and gap analysis of what and how supportive care services were being delivered and how the Guidance could be put into practice.
Mrs Anson says the implementation plan provides clear, evidence-based objectives and suggests best-practice service approaches and priority actions, including developing a national supportive care framework.
'The initial focus will be on care coordination, psychosocial support and information support.
'Care coordination is about the importance of patients being well informed and their journey being well coordinated. Some cancer services have specific roles to provide that, such as breast care nurses, but coordination is generally not as well supported for patients with some other cancers or those from smaller DHBs.'
She says it's every health professional's responsibility to consider the supportive care needs of patients and their whānau, and to link them with appropriate services to address them.
'It has to be woven into every aspect of a patient's journey. There are a lot of different organisations that can help meet those supportive care needs, but appropriate referrals need to be made.
'Many supportive care services are delivered by non-government organisations, so it's very much about honouring the value they add to supportive care and incorporating and integrating that into the patient journey so that patients link with them early.
'It's every health professional's responsibility to consider the supportive care needs of patients and their whānau, and to link them with appropriate services to address them.'
'They can provide assistance with things like travel, accommodation and volunteer drivers, and develop a lot of patient information resources. However, these organisations often sit outside the standard referral pathways and are not well integrated in some areas, so we'll be trying to improve that across the board.'
Mrs Anson says there's been a lot of effort put into making sure patients know what's happening as they move between services.
'It's common for people to have treatment away from their home base, so it's about making sure they're supported with effective communication.
'Navigator-type positions have been shown to be effective, particularly for Māori, in helping patients through the treatment process. These roles are often iwi-based and not necessarily filled by health professionals. But not all DHBs have them, and we also think there is scope for an improved government sector workforce around supportive care.'
She says current access to psychosocial support varies.
'The supportive care tiered framework will mean all cancer patients will receive a baseline level of service for things like psychological support, but as their needs become more specific, they will have access to other services.
'We also want to provide a more coordinated approach to the development and distribution of patient information because currently there's the potential for a lot of duplication. We will have a co-design approach to this work that ensures patients are involved.
'Once the framework is in place, the focus over the next few years will be making sure those models of good practice are spread as widely as possible, and integrated into everyday practice and other key pieces of work, such as the 'shorter waits for cancer treatment' health target.'
While the Guidance is being implemented for cancer, Mrs Anson says it would also be relevant for other long-term conditions, such as diabetes and heart disease.
This article appeared in the HIIRC Update, December 2011
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