Janice Preston: Cancer care plans crucial for supporting patients

A survey shows only 1 in 5 had one, and that's not good enough, says Janice Preston

Picture: PA

The results of the ever Scottish Cancer Patient Experience Survey brought good news as well as bad.

Most people – 94 per cent rated their care as very positive. However over half (55 per cent) didn’t get enough health and social care support after treatment ended.

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Most people (87 per cent) said staff treated them with dignity and respect. However half weren’t told financial advice was available to help them cope with reduced income and increased costs.

Those who received a care plan – an outline of all the support they needed – answered every survey question more positively than those who didn’t. Unfortunately only in one five (22 per cent) patients had a care plan.

The results paint a picture of a cancer care system that’s trying very hard to look after the medical needs of patients but failing all too often when it comes to giving them support for their practical, financial and emotional problems. This doesn’t come as a shock to Macmillan or anyone with a passing interest in cancer or the NHS.

The number of people being diagnosed with cancer increases every year. The number of people living with it also increases and currently sits at an estimated 220,000 people in Scotland.

The NHS is trying to do more with less.

A cancer care system set up to cure patients or help them die as peacefully as possible is struggling under the weight of the hundreds of thousands of people who don’t fit neatly in either category. They may be “cured” but have long-term physical or mental health problems.

They may be living with an incurable cancer that doctors believe will shorten their life but treatment will keep at bay for many years.

They might be dying, but might have a year before end of life care becomes appropriate and right now need help to live. The current cancer care system just wasn’t set up to deal with this.

In many ways the problems we’re seeing now are the result of our success. People are living longer and so are more likely to get cancer. Many people who would have died of cancer pretty quickly 20 or even ten years ago are now surviving.

But this brings with it a whole new set of problems.

We are saving many more lives, but this brings with it a responsibility to help patients do more than just survive. We must help them to live.

Thankfully the results of the Scottish Cancer Patient Experience Survey showed very clearly that there is a way we can help people get the wider support they need; the care plan.

Simply asking patients what they need help with, whether it’s money, housing, help at home or emotional support, then helping them get it, makes a huge difference to how patients feel. Macmillan has been championing the care plan for years. Evidence from our services on the ground has shown it can transform lives.

Time and time again our teams report that getting the right support can take a patient’s level of distress from a ten to a two, despite their diagnosis staying the same.

Although it’s disappointing only 22 per cent of those who responded to the Cancer Patient Experience Survey received a care plan, the good news is that the Scottish Government is committed to getting this to 100 per cent.

We are already working together on spreading their use via the £5 million Transforming Care After Treatment programme.

The new cancer strategy published just before the election includes a promise that every single cancer patient in Scotland will be offered Holistic Needs Assessment (HNA) followed by a care plan.

Macmillan’s role now is to use our experience and expertise to support and encourage the Scottish Government and health boards as they begin to put in place their plans to meet this promise.

Macmillan has already worked with Glasgow City Council and NHS Greater Glasgow & Clyde to offer an HNA and care plan to everyone diagnosed with cancer in the city.

We know it can be done. By the time the next Cancer Patient Experience Survey is published, we must be able to say that it has been.

• Janice Preston is head of services in Macmillan, www.macmillan.org.uk