analysis of patient experience of cancer care pathway within merseyside & cheshire produced by...
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Analysis of Patient Experience of Cancer Care Pathway within Merseyside & Cheshire
Produced by Merseyside and Cheshire Cancer NetworkPresented: November 2008
Patient Survey Report
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2004 - National Audit Office carried out a national survey of cancer patients
2005 - Results were published, together with recommendations for the Cancer Networks
Recommendations Regular good quality surveys of patient experience should be
undertaken at local level to help drive up the quality of patient care
A template would be developed by the NAO and adapted by the networks. This would avoid duplication and the need for ethical approval
Within the Merseyside and Cheshire network, the Lead Nurse and Patient Involvement Groups agreed to look at the NAO survey and devise a shorter version
Survey was adapted and piloted in Aintree and St Helens & Knowsley, from this the finalised version was rolled out
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Background
Background For a variety of reason not all Hospital Trusts were able to participate. Those who did were:
Countess of Chester Liverpool Heart and Chest Hospital Liverpool Women’s North Cheshire Southport and Ormskirk St Helens & Knowsley
The main tumour sites covered were: Breast, Lung, Colorectal, Haematology, Upper GI, Urology and Gynaecology
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Between August 2007 and March 2008
The first 25 patients diagnosed from April 1st 2007 from each tumour group, who were known to be alive, and who had been given a cancer diagnosis, were approached
Cancer Services, the Service Improvement Facilitator and CNS’s were responsible for undertaking the survey
Network was responsible for providing the survey and analysing the data
MethodologyS
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338 completed questionnaires received by the Merseyside & Cheshire Cancer Network for analysis
34% (n116) were St Helens & Knowsley
14/30 were from the Gynaecology Oncology Department
The Survey S
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The Survey had 28 questions looking at Diagnosis, Patient Information, the Nurse Specialist, Decision Making and Support Groups
Worst Experience
Best Experience
What changes would you make?
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Network %
88Trust%
Gynae%
How were you given your diagnosis?(in person)
96 96 93
Where were you told of your diagnosis?(in clinic)
84 83 71
How did you find the environment? (pleasant)
59 47 60
If diagnosis given on the ward, was it in a private location ?
60 50 33
Did you understand the explanation of the diagnosis you were given?
72 68 71
Who was present when given your diagnosis? (family support)
56 55 50
Who gave you your diagnosis?(doctor)
88 84 78
Did you feel able to ask questions about your diagnosis?
88 89 93
Diagnosis
Information S
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5958
909295
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94 92
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NETWORK TRUST GYNAE
Receive Useful Understand Easy to read
%
Next StageS
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Network Trust Gynae
Understand next stage Copy clinic letter offeredIf no would they want it
%
Network Trust Gynae
Did you see a nurse specialist?
83 86 100
If Yes did you know who your nurse specialist was?
93 92 100
Did you feel you received enough support?
80 89 93
Nurse SpecialistS
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Network Trust Gynae
Before diagnosis was given 24 22 27
When diagnosis was given 59 57 50
After your diagnosis was given
68 69 100
During treatment 50 57 58
Never 1 0 1
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On what occasions did you have contact with your Nurse Specialist?
Network Trust Gynae
Listen to concerns 80 76 75
Advice with symptom control
75 74 79
Emotional Support 53 53 64
Contact with community nurses
33 31 43
Contact with other professionals
26 25 50
If you were seen by a nurse specialist, in what ways did you find them supportive?
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Network Trust Gynae
Did you feel you were involved in the decision making process?
79 82 86
Were you informed of possible side effects?
81 84 93
Did you feel you received emotional support?
64 67 79
Were people working together to provide the best care?
61 60 64
Were you told about support groups?
49 33 79
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Toilets on H4 not clean, staff did their best
Support groups solely for your own needs in your local area
Not given my clexane - family had to complain about my leg pain (pt had DVT)
Delays in keeping the GP informed - test results not passed on
Manner given diagnosis unacceptable - no relative present, not very private environment
We should be asked if we want a family member or friend to be present before the diagnosis is discussed, private environment handled sensitively
What changes would you make? S
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Ensure patients are told in person & in private Ensure that clear and concise information about who they
can have with them is given Consistent provision of patient information, summarising all
that was discussed in the consultation All patients offered a copy of their clinic letter All patients involved in decision making process All patients offered emotional support Information on support groups Complete co-ordinated services
Network Recommendations S
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All tumour sites are to develop an action plan on three areas of the survey which will be presented to the trust cancer committee and fed back to the network
Trust Recommendations S
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Copy of clinic letter 43% patients offered a copy of their letter50% of patients would have like this to have been offered
Nurse Specialist present at diagnosisAlthough 100% of patients did have contact with the CNS, 50% patients did not have a nurse specialist present when given their diagnosis
Breaking bad news21% of patients had no one with them other than the Dr when given their diagnosis. Only 57% had a family member or friend present
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Gynaecology Oncology Action Plan
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