Winter 2016 edition of the EONS Magazine - catch up with the EONS-10 Congress

Working in partnership to spread innovation in care

Cathy Hughes from the UK describes how nursing leaders there came together to launch a unique collaborative initiative with the aim of spreading cancer care innovations and improving outcomes for people living with and beyond cancer.

The Cancer Nursing Partnership (CNP) is a unique collaboration of nursing organisations representing more than 22,000 nurses, who have come together to focus on improving person-centred care in the UK. The concept was the brainchild of Natalie Doyle, then president of the UK Oncology Nursing Society (UKONS) and nurse consultant at The Royal Marsden NHS Foundation Trust, and Stephen Hindle, the survivorship lead at Macmillan Cancer Support (a UK cancer charity). As Macmillan Cancer Support led the work on cancer survivorship with the Department of Health in England, its professional engagement lead, Stephen Richards, then headed the project supporting the development of the Cancer Nursing Partnership, and provided dedicated project management and administration.

Cathy Hughes

Cathy Hughes

The overall purpose of the project was to explore the opportunity of developing a strategic partnership with key nursing organisations for spreading cancer care innovations. In order to test this model of working, the initial focus of the CNP was to the support the effective delivery of the survivorship Recovery Package, a series of key interventions which, when delivered together, can greatly improve outcomes for people living with and beyond cancer.

The Recovery Package

Cancer survivorship has become a key area for improvement in cancer care, with the recognition of increasing cancer incidence due to ageing populations, obesity and reduced physical activity, and an increase in the number of people living longer with incurable cancer, more people having multiple treatments and many more people living with the consequences of the disease and its treatment. As a result, UK prevalence is likely to double from two million people in 2010 to four million in 2030, continuing to rise by about a million per decade to 5.3 million in 2040.1 Cancer survivors are reported to suffer worse health and wellbeing,2 they also have more common chronic conditions3 and unmet needs post-treatment.4

The Recovery Package was first described by the National Cancer Survivorship Initiative (NSCI) in 2013,5 and was designed to support cancer patients and reduce unnecessary hospital admissions. It consists of different elements, beginning with a holistic assessment of the patient's needs and the creation of a personalised care plan. After treatment, a clear summary of what treatment has been given and what should happen next is created for the general practitioner and the patient. This enables the patient to self-manage with the support of their primary healthcare providers, and secondary care teams as necessary. The package also emphasises the need for a review of the patient's condition in primary care within six months of treatment and the provision of a health and wellbeing intervention/event. 

The recovery package

The Recovery Package

Since the inception of the NCSI, significant efforts have been made to test the efficacy and workability of the components of the Recovery Package.5 Nurses have been involved in its testing and early delivery; however, national uptake remains relatively low, with only about one third of patients reporting having a care plan6 and a significant proportion having little or no access to such interventions. Elements of the package can deliver immediate benefits as well as supporting improvements in care further down the survivorship pathway. Many nurses are now routinely delivering components of the Recovery Package, but others still report being unaware of it or unconvinced of the benefits. Others say they find it difficult to initiate the change locally because of the lack of time, support or resources.

Launching and developing the partnership

Phase 1 of the CNP project began in September 2013, and included identifying key nursing organisations with a significant interest in cancer care, or organisations reaching out to, or supporting, cancer nurses. A facilitated workshop was held to define the partnership and obtain a commitment pledge from each organisation with the identification of a named representative. The group also benefited from senior nursing input from the East of England Strategic Clinical Network. The workshop went on to define the key priorities, which were around reducing duplication of effort, influence and key stakeholders, research and education.

Cathy Hughes addresses the audience at EONS-10

Cathy Hughes addresses the audience at EONS-10

Phase 2 began in January 2014 and saw the partnership formally named and given a distinct identity. Terms of reference were agreed by the representatives and approved by their organisations, and co-chairs, Natalie Doyle and Steve Richards, were appointed by the group. Following on from the definition of the key priorities, a programme of strategic work around delivery of the Recovery Package was agreed and an action plan developed.

The CNP went on to develop tangible tools to help communicate the messages around the Recovery Package, such as a language set/house style around key concepts, a long and short ‘elevator pitch’ for communications, and a presentation slide set for nurses. The CNP was formally launched with media releases and direct communication with CNP partner members, linking to a dedicated CNP web page at http://www.ukons.org/cnp. Each member organisation committed to having a cancer survivorship/ Recovery Package focus at their conference or education events.

Members include the Breast Cancer Care Nursing Network, the British Association of Head and Neck Oncology Nurses (BAHNON), the British Association of Skin Cancer Specialist Nurses (BASCSN), the British Association of Urology Nurses (BAUN), the Consequences of Cancer and its Treatment Collaborative (CCaT), Cancer Research UK, the European Bone Marrow Transplant (United Kingdom) Nurses and Allied Professions Group (EBMT UK NAP), the Lymphoma Association, Macmillan Cancer Support, the National Colorectal Cancer Nursing Network (NCCNN), the National Forum of Gynaecological Oncology Nurses (NFGON), the National Lung Cancer Forum for Nurses (NLCFN), the Royal College of Nursing (RCN) Cancer and Breast Care Forum and the RCN Practice Nurses’ Association and the UK Oncology Nursing Society (UKONS).

In summary:

  • The cancer survivorship agenda and the need to implement the Recovery Package were the catalysts for the creation of the Cancer Nursing Partnership.
  • This unique partnership brings together 14 very different organisations, representing or working with more than 22,000 nurses supporting cancer patients, to improve cancer care.
  • Much has been achieved, and the dissemination of accurate knowledge of the Recovery Package is being accelerated by recognised nursing leaders.