Wednesday 11 th October 2017 1 Agenda 9.30am Registration and - - PowerPoint PPT Presentation
Transforming Cancer Services Team for London Excellent Psychological Care for those affected by Cancer Second Consultation event: Key principles and recommendations for a Pan- London psychological care pathway Wednesday 11 th October 2017 1
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Transforming Cancer Services Team for London
Wednesday 11th October 2017
9.30am Registration and coffee 10.15am Welcome and Introduction Liz Price, Associate Director LWBC, Transforming Cancer Services Team Dr Philippa Hyman, Macmillan Mental Health Clinical Lead, Transforming Cancer Services Team 10.20am The emotional and psychological impact of cancer: A service user’s perspective Dr Philippa Hyman, Macmillan Mental health clinical lead and Clinical Psychologist in conversation with Lauren Mahon, Service user. Living With and Beyond cancer context Liz Price, Associate Director LWBC (TCST) Psychological care pathway context and update Dr Philippa Hyman, Macmillan Mental Health Clinical Lead, Transforming Cancer Services Team 11.20am Psychological care pathway-the service user’s perspective and the referrer’s perspectives Dr Philippa Hyman, Macmillan Mental Health Clinical Lead, TCST 11.45am Facilitated table discussion 1) Does the pathway make sense? 2) How do we improve primary (community) and secondary (acute) care collaboration? 12.30pm- 13.30pm Lunch break 13.30pm Feedback on the pathway 14.00pm STP groups table discussion-What do you have in your area? What’s missing? How could this pathway work in your area? What might the obstacles be? 15.00pm Tea break 15.20pm Feedback from STP areas-how can you take ideas forward in your STP area? What support do you need? 15.50pm Next steps and closing remarks-Liz Price and Philippa Hyman, TCST 16.00pm End
Agenda
Transforming London’s health and care together
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Dr Philippa Hyman, Macmillan Mental Health Clinical Lead and Clinical Psychologist Lauren Mahon, Service User
Transforming London’s health and care together
Liz Price, Associate Director, Transforming Cancer Services Team
Dr Philippa Hyman, Macmillan Mental Health Clinical Lead and Clinical Psychologist
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What living with and beyond cancer means to us
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National drivers
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London’s strategic planning groups for cancer
Camden Hillingdon Harrow Brent Ealing Hounslow Central London Barnet Enfield Haringey Islington Richmond Merton Croydon Wandsworth Kingston Bromley Bexley Greenwich South- wark Lambeth Newham Tower Hamlets City & Hackney Havering Redbridge Waltham Forest Sutton Barking & Dagenham Hammersmith & Fulham West London Commissioning Lewisham Camden 7 *TCST also serves West Essex CCG which borders Enfield, Waltham Forest, Redbridge and Havering
Hertfordshire & West Essex STP
North East STP (WELC) North Central STP North West STP South West STP South East STP North East STP (BHR)
Cancer Vanguard and Alliance geography
North West & South West
Cancer Collaborative: North Central, North East London, West Essex
East London
National quality of life metric (in development)
As part of the Cancer Dashboard, the new quality of life metric will provide, for the first time, an indication of how well people are living after cancer treatment and not just how long they are alive. 5 pilot sites in England, including UCLH CC (UCLH and Barts Health). Pilot and evaluation period runs from Sep 2017 – early 2019. “One of our key ambitions is to put cancer patient experience front and centre. Everyone is unique, with different views and priorities, so it’s vital that they receive personalised support, this new measure will help ensure local NHS can see where things are going well and where improvements can be made.” - NHSE
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September 2017
10 20 30 40 50 60 70 80 90 100 NWL SWL SEL NCL NEL NAT 2015 2016
Q15 before you started you treatments were you also told about any side effects of the treatment that could affect you in the future
It is important that patients have all the information they need to make an informed choice about their treatment and care. The side effects of treatment for certain cancers can be life changing, affecting long term recovery, family relationships, work prospects and future health and wellbeing. The implications for psychological wellbeing are recognised. Patients need to make choices about treatment confident that they know what the likely outcomes will be.
10 20 30 40 50 60 70 80 90 100 NWL SWL SEL NCL NEL NAT 2015 2016
Q22 Did hospital staff give you information about how to get financial help or benefits?
It is important that patients are given this information as soon as a diagnosis is made to enable them to plan for the short and long term. A diagnosis of cancer can have a serious effect on a patients financial wellbeing. Prolonged periods of ill health can result in loss of wages or unemployment. The employment status now of many people is to be on short term, zero hours or hourly rates contracts meaning that any time taken for appointments, treatment or ill health due to the effects of the cancer or the side effects of treatment can seriously affect a person’s finances. This will create a great deal of anxiety for patients and their families and may lead to a patient missing appointments, cancelling treatment sessions or withdrawing from treatment altogether
10 20 30 40 50 60 70 80 90 100 NWL SWL SEL NCL NEL NAT 2015 2016
Q49 Hospital staff gave the family or someone close all the information needed to help care at home?
Without this information relatives lack confidence in caring for the patient. This may cause increased worry and anxiety for both the patient and their family resulting in increased access to GP and hospital services.
10 20 30 40 50 60 70 80 90 100 NWL SWL SEL NCL NEL NAT 2015 2016
Q50 Patient definitely given enough support from health or social services during treatment
Care from community services during treatment will contribute to a patient’s ability to remain at home during their treatment and may contribute to a reduction in the short term side effects of their treatment.
10 20 30 40 50 60 70 80 90 100 NWL SWL SEL NCL NEL NAT 2015 2016
Q53 Practice staff definitely did everything they could to support the patient
If the patient feels unsupported by the practice staff they may be less inclined to see their GP or practice nurse when a problem occurs. This may have a detrimental effect on their recovery.
Detailed Detailed can cancer pr cer prevalenc valence estima e estimates tes 199 1995-201 2015 in L 5 in Lond
Transforming Cancer Services Team Produced by Molly Loughran— molly.loughran@phe.gov.uk in partnership with Public Health England and Macmillan Cancer Support 21 Sept 2017
Background
E.g. modelling service needs, rehab, psychological care
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Aim: To provide a view of prevalent cancer in London (and across England) of all people with cancer and those with subsequent cancers
Project(s) Status Status
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Methods
Outputs
Prevalence estimates cut by three factors per measure:
diagnosis and at 2015, ethnicity (10 yr. prevalence), stage (4 yr. prevalence)
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Methods
2015 (21 year prevalence) were included.
counts, they are counted once per cancer type.
diagnosis in time period.
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Prevalence—top line results
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Prevalence—deprivation by region
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1,000 2,000 3,000 4,000 5,000 East Midlands East of England London North East North West South East South West West Midlands Yorkshire and The Humber Crude rate per 100,000
Region in England
1 - least deprived 2 3 4 5 - most deprived
Deprivation quintile:
Prevalence—time since diagnosis by cancer alliance
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1,000 2,000 3,000 4,000 5,000 Cheshire and Merseyside East Midlands East of England Humber, Coast and Vale Kent and Medway Lancashire and South Cumbria National Cancer Vanguard: Greater Manchester National Cancer Vanguard: North Central and North East London National Cancer Vanguard: North West and South West London North East and Cumbria Peninsula Somerset, Wiltshire, Avon and Gloucestershire South East London South Yorkshire, Bassetlaw, North Derbyshire and Hardwick Surrey and Sussex Thames Valley Wessex West Midlands West Yorkshire
Crude rate per 100,000
0 yr 1 yr 2-4 yrs 5-9 yrs 10-14 yrs 15-21 yrs
Time since diagnosis:
Workbook example by CCG
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Prevalence—by age at 2015
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Cases 0-14 15-24 25-44 45-64 65-69 70-74 75-79 80-84 85+ Total All Ages
London
3,170 3,641 33,646 89,995 27,700 21,767 16,140 8,799 4,680 209,538
National Cancer Vanguard: North Central and North East London
1,247 1,346 12,206 31,442 9,553 7,612 5,723 3,107 1,561 73,797
National Cancer Vanguard: North West and South West London
1,289 1,628 14,225 39,264 12,146 9,533 6,990 3,785 2,122 90,982
South East London
634 667 7,215 19,289 6,001 4,622 3,427 1,907 997 44,759
North Central London
544 594 5,804 14,994 4,619 3,739 2,593 1,459 684 35,030
North East London
703 752 6,402 16,448 4,934 3,873 3,130 1,648 877 38,767
North West London
707 903 7,557 21,121 6,628 5,238 3,846 2,074 1,124 49,198
South East London
634 667 7,215 19,289 6,001 4,622 3,427 1,907 997 44,759
South West London
582 725 6,668 18,143 5,518 4,295 3,144 1,711 998 41,784
Prevalence—age at 2015 by CCG and STP
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2000 4000 6000 8000 10000 12000 NHS Barnet NHS Camden NHS Enfield NHS Haringey NHS Islington NHS Barking & Dagenham NHS City and Hackney NHS Havering NHS Newham NHS Redbridge NHS Tower Hamlets NHS Waltham Forest NHS Brent NHS Central London (Westminster) NHS Ealing NHS Hammersmith and Fulham NHS Harrow NHS Hillingdon NHS Hounslow NHS West London NHS Bexley NHS Bromley NHS Greenwich NHS Lambeth NHS Lewisham NHS Southwark NHS Croydon NHS Kingston NHS Merton NHS Richmond NHS Sutton NHS Wandsworth NHS West Essex North Central London STP North East London STP North West London STP South East London STP South West London STP WE
Prevalent Patients CCG-STP 20-39 40-59 60-74 75+ Age group:
Prevalence—Ethnicity by CCG and STP
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1000 2000 3000 4000 5000 6000 7000 8000 9000 NHS Barnet NHS Camden NHS Enfield NHS Haringey NHS Islington NHS Barking & Dagenham NHS City and Hackney NHS Havering NHS Newham NHS Redbridge NHS Tower Hamlets NHS Waltham Forest NHS Brent NHS Central London (Westminster) NHS Ealing NHS Hammersmith and Fulham NHS Harrow NHS Hillingdon NHS Hounslow NHS West London NHS Bexley NHS Bromley NHS Greenwich NHS Lambeth NHS Lewisham NHS Southwark NHS Croydon NHS Kingston NHS Merton NHS Richmond NHS Sutton NHS Wandsworth NHS West Essex North Central London STP North East London STP North West London STP South East London STP South West London STP WE
Prevalent Patients CCG-STP
White Chinese Black Asian Mixed Unknown Other Ethnicity:
Psychological Care Pathway context and update Presentation Outline
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Background Context (1) Commissioning guidance for cancer care in London
commissioning and provision
remains uncoordinated.
diagnosis of cancer through to living with cancer as a long term condition and end of life.
productivity standards have not been agreed for London.
develop a pan London: end to end psychological care pathway and service specification.
psychologist, is leading this project from January – December 2017, three days per week.
through a working group.
preliminary pathway and principles for the specification.
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Background Context (2)
Patient experiences
been directed to stuff earlier I would have accessed it earlier which would have really helped”
there”
with cancer, or women with children or you have the Teenage Cancer Trust. It all felt like a different life stage to me. It didn’t fit for me. I found things out because I’m
for young people.”
Service user experience: Information and Signposting
leave my front door. The anxiety and depression hit me then”
treatment when that’s the time you feel you need more and more reassurance”
go to the GP, when to the hospital, when should I worry. It’s quite scary”
but there’s no point of contact for me”
Service user experiences: Post-treatment support
feel I’m a positive and resilient person and I still feel I need help, so how do people less resilient cope?”
between physical/medical side and the psychological side.”
there was sympathy about cancer but a lack of understanding”
which was so helpful, but after treatment it doesn’t feel like it’s offered”
Service user experiences: Psychological support
financial implications of cancer. There’s no safety net
home, when you’re facing cancer”
they might not know the finer details of fertility.”
after having treatment are being told about fertility”
Service User experiences: Wider impact of cancer
E Holistic Needs Assessment results
E Holistic Needs Assessment results
Collated by Pan- Cancer Vanguard Informatics team Contact - rmpartners.informatics@nhs.net Data provided by Macmillan Cancer Support – sourced from E-HNA tool
Integration of physical health and mental health is essential
The economic argument…
The economic argument…
London prevalence data and modelling example
54% of patients have a psychological issue within 10 years of their diagnosis. We would like to know how many people that equates to in each CCG.
Modelling example
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CCG 0-9 years since dx Multiplier Number of people
NHS Barking & Dagenham
2916
× 54% =
1575
NHS Barnet
7192
× 54% =
3884
NHS Bexley
5497
× 54% =
2968
NHS Brent
5210
× 54% =
2813
NHS Bromley
7663
× 54% =
4138
NHS Camden
3880
× 54% =
2095
NHS Central London (Westminster)
2781
× 54% =
1502
NHS City and Hackney
3860
× 54% =
2084
NHS Croydon
7643
× 54% =
4127
NHS Ealing
5836
× 54% =
3151
NHS Enfield
6073
× 54% =
3279
NHS Greenwich
4333
× 54% =
2340
NHS Hammersmith and Fulham
3143
× 54% =
1697
NHS Haringey
4292
× 54% =
2318
NHS Harrow
4619
× 54% =
2494
NHS Havering
5827
× 54% =
3147
NHS Hillingdon
5101
× 54% =
2755
NHS Hounslow
4406
× 54% =
2379
NHS Islington
3478
× 54% =
1878
NHS Kingston
3348
× 54% =
1808
NHS Lambeth
5135
× 54% =
2773
NHS Lewisham
4821
× 54% =
2603
NHS Merton
4024
× 54% =
2173
NHS Newham
3594
× 54% =
1941
NHS Redbridge
4912
× 54% =
2652
NHS Richmond
4437
× 54% =
2396
NHS Southwark
4600
× 54% =
2484
NHS Sutton
4304
× 54% =
2324
NHS Tower Hamlets
2742
× 54% =
1481
NHS Waltham Forest
4326
× 54% =
2336
NHS Wandsworth
5330
× 54% =
2878
NHS West Essex
7602
× 54% =
4105
NHS West London
3726
× 54% =
2012
Limitation: this will not take into account those who have had a psychological event and have since died.
London prevalence data and modelling example
“In the year following diagnosis, around one in ten patients will experience symptoms such as anxiety and depression severe enough to warrant intervention by specialist psychological/psychiatric services” (NICE, 2004)
Delivery Units Locality CCG Code CCG Name 1 Yr Prevalence (Cases - 2015 Diagnosis) 10% Requiring Intervention UCLH Cancer Collaborative BHR 07L NHS BARKING AND DAGENHAM CCG 486 49 08F NHS HAVERING CCG 982 98 08N NHS REDBRIDGE CCG 873 87 WELC 07T NHS CITY AND HACKNEY CCG 655 66 08M NHS NEWHAM CCG 667 67 08V NHS TOWER HAMLETS CCG 472 47 08W NHS WALTHAM FOREST CCG 709 71 NCL 07M NHS BARNET CCG 1051 105 07R NHS CAMDEN CCG 599 60 07X NHS ENFIELD CCG 980 98 08D NHS HARINGEY CCG 669 67 08H NHS ISLINGTON CCG 550 55 West Essex 07H NHS WEST ESSEX CCG 1175 118 RM Partners NWL 07P NHS BRENT CCG 894 89 09A NHS CENTRAL LONDON (WESTMINSTER) CCG 416 42 07W NHS EALING CCG 878 88 08C NHS HAMMERSMITH AND FULHAM CCG 479 48 08E NHS HARROW CCG 734 73 08G NHS HILLINGDON CCG 825 83 07Y NHS HOUNSLOW CCG 652 65 08Y NHS WEST LONDON CCG 578 58 SWL 07V NHS CROYDON CCG 1251 125 08J NHS KINGSTON CCG 495 50 08R NHS MERTON CCG 602 60 08P NHS RICHMOND CCG 693 69 08T NHS SUTTON CCG 717 72 08X NHS WANDSWORTH CCG 835 84 South East London SEL 07N NHS BEXLEY CCG 922 92 07Q NHS BROMLEY CCG 1267 127 08A NHS GREENWICH CCG 757 76 08K NHS LAMBETH CCG 724 72 08L NHS LEWISHAM CCG 715 72 08Q NHS SOUTHWARK CCG 736 74 STP Localities North London 3849 385 East London 4844 484 North West London 5456 546 South East London 5121 512 South West London 4593 459 Vanguard/Alliance Geographies UCLH Cancer Collaberative 9868 987 RM Partners 10049 1005 South East London 5121 512 TCST Region (includes West Essex) 25038 2504 London Region 23863 2386
Modelling example
987
1005
512
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Transforming London’s health and care together
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Dr Philippa Hyman, Macmillan Mental Health Clinical Lead at TCST
Psycho-oncology services, IAPT waiting times
BME groups, age, severity/complexity of mental health difficulties/harder to reach groups?
Key themes from May 4th event (1)
and updated to include social media support groups.
with LTCs including cancer
communication including CCRs, HNAs and treatment
professionals regarding who coordinates care. Very important for those with rarer cancers or those treated in a number of different hospitals. Key themes (2)
people to make choices?
changing needs and complexity (age, tumour type, point on the pathway)
whole pathway-especially between primary and secondary care
CNS/Practice nurses/GPs (junior and senior staff)
Key principles
progress that cancer is now coded as a LTC for integrated IAPT. Further work needed in training and consultation for working with cancer, inclusion/exclusion criteria and ensuring outcome measures are appropriate.
currently refreshed
will be part of Cancer dashboard) to keep this work high up on the
diagnosis and 62 day standard?
and to ensure effective implementation of recommendations.
Context Update
London
Coastal West Sussex CCG Crawley and Horsham CCG Mid Sussex CCG Windsor, Ascot & Maidenhead CCG Slough CCG Bracknell and Ascot CCG Aylesbury Vale CCG Chiltern CCG Herts Valleys CCG West Essex CCG Cambridgeshire & Peterborough CCG Greater Huddersfield CCG North Kirklees CCG Harrogate & Rural District CCG NEW Devon CCG North East Hampshire & Farnham CCG Wokingham CCG Newbury and District CCG North and West Reading CCG South Reading CCG North Staffordshire CCG Stoke on Trent CCG Blackburn with Darwen CCG East Lancashire CCG Warrington CCG Oxfordshire CCG Swindon CCG Portsmouth CCG Richmond CCG Hillingdon CCG Sunderland CCG Nottingham West CCG Calderdale CCG North Tyneside CCG
Key
IAPT Wave 1 CCGs
Wave 1 Wave 2
London
Brent CCG Harrow CCG Central London CCG West London CCG
Ealing CCG Hounslow CCG South Cheshire CCG Vale Royal CCG Ashford CCG Canterbury & Coastal CCG South Kent Coast CCG Thanet CCG Sheffield CCG Hardwick CCG North Derbyshire CCG Southern Derbyshire CCG Erewash CCG Haringey CCG Islington CCG Thurrock CCG South East Staffordshire & Seisdon CCG Cannock Chase CCG Stafford & Surrounds CCG East Staffs CCG North East Lincolnshire CCG Solihull CCG Dorset CCG Wyre and Fylde CCG Chorley & South Ribble CCG West Lancashire CCG Lancashire North CCG Bath and North East Somerset CCG Wiltshire CCG Coventry & Rugby CCG South Warwickshire CCG Warwickshire North CCG Nottingham City CCG Telford & Wrekin CCG
IAPT Wave 2 CCGs
Key Wave 1 Wave 2
I rely on my own strength I look for support from friends & family I join peer groups & online communities I get information I need, in a way I can understand All staff listen and communicate compassionately I feel reassured by prompt and reliable systems I trust the staff dealing with my care to communicate and share information I need expert help to cope with my treatment and its consequences I’m feeling stuck and cannot move on I feel overwhelmed, hopeless and unsafe
I have a cancer keyworker who knows my situation, will ask about my feelings, give advice & reassurance and coordinate my care
Prompt, reliable administration Patient Information Service Support groups & courses e.g. HOPE 3rd sector support centres Level 1 communication training for staff HWBEs
Psycho-oncology Hospital Liaison Psychiatry Community Mental Health
Holistic Needs Assessment Level 2 training Level 2 supervision Treatment Summ.
L e v e l 1 L e v e l 2 L e v e l 3 / 4
reliable administration Single point of contact (e.g Macmillan Navigators) Level 1 communication skills training embedded 3rd sector support (e.g. Maggie’s ) support groups & courses (e.g. HOPE) accessible patient information & advice H&WB Events Psycho-oncology
(incl. neuropsych, psychosexual)
Hospital Liaison Psychiatry Holistic Needs Assessment CNS/AHPs with Level 2 skills consultation/ joint work Treatment Summary EOT Review
Cancer psychosocial care – Hospital
demonstrate kindness and reliability actively listen to preferences, concerns & priorities, and work with these reassure and challenge sensitively help other professionals ‘be on the same page’ allow processing time where possible respect differences in information preferences reflect on and manage own feelings detailed psychological, cognitive and interpersonal understanding psychotherapeutic/ pharmacological advice & management ‘holistic’ – know the person’s circumstances, history and culture explore particular or unusual needs and concerns explore ambivalence, adherence and avoidance reasonable adjustment
supporting access to tests & treatments
Prompt, reliable administration Patient Information Service Support groups & courses e.g. HOPE 3rd sector support centres Level 1 communication training for staff HWBEs
Psycho-oncology Hospital Liaison Psychiatry Community Mental Health
Holistic Needs Assessment Level 2 training Level 2 supervision Treatment Summ. reliable administration effective information sharing Local information services e.g. CAB 3rd Sector cancer support centres Social prescribing 3rd Sector IAPT Step 3-4 Community Mental Health Community Palliative Care GP Cancer Care Review Cancer Keyworker IAPT Step 1-2 3rd Sector
Cancer psychosocial care – Community
from the
I need someone who will help me understand what’s going on, and guide me through every step I need somewhere that’s welcoming, not clinical, where I can get advice and information I need somewhere where I can meet and talk to other people like me With cancer treatment behind me, I need to learn strategies to cope with my worry I am at home, and feel mentally unwell and unsafe As my cancer is advancing, I need specialists to deal with pain and symptoms without going into hospital I need to talk to my family about dying
P s y c h o s o c i a l C a r e N e e d s
I am so overwhelmed I cannot carry on with the treatment I need I need to deal with the changes to my body and the impact on my family I need to feel I can trust and rely on my GP and primary care team Community Psychological Therapies (IAPT) Community Mental Health Services (CMH) Psycho-oncology Third-sector & other cancer support centres Community Palliative Care Team (CPCT) Cancer keyworker (CNS) GP & Practice Nurse Hospital Liaison Psychiatry I am in hospital, and feel mentally unwell and unsafe
R e s o u r c e s
P r e v e n t i n g d i s t r e s s & p r o m o t i n g a d j u s t m e n t
GP / Practice Nurse Community Psychological Therapy Services (IAPT) Community Mental Health Services (CMH)
All Staff
NICE Level 1
Psycho-oncology
CNS / Hospital cancer keyworker
Cancer Psychosocial Care in the Hospital Cancer Psychosocial Care in the Community
Community Palliative Care Team (CPCT) Primary care cancer keyworker co-ordination Hospital Liaison Psychiatry NICE Level 2 NICE Level 3/4
Third- sector cancer info & support
HNA CCR co-ordination
P r e v e n t i n g d i s t r e s s & p r o m o t i n g a d j u s t m e n t
GP / Practice Nurse Community Psychological Therapy Services (IAPT) NICE Level 1
CNS / Hospital cancer keyworker
Cancer Psychosocial Care in the Hospital Cancer Psychosocial Care in the Community
Community Palliative Care Team (CPCT) Primary care cancer keyworker co-ordination NICE Level 2 NICE Level 3/4
Third- sector cancer info & support
HNA CCR co-ordination Community Mental Health Services (CMH)
All Staff
Psycho-oncology
Hospital Liaison Psychiatry
P r e v e n t i n g d i s t r e s s & p r o m o t i n g a d j u s t m e n t
Community Psychological Therapy Services (IAPT) Community Mental Health Services (CMH)
All Staff
NICE Level 1
CNS / Hospital cancer keyworker
Cancer Psychosocial Care in the Hospital Cancer Psychosocial Care in the Community
Community Palliative Care Team (CPCT) Primary care cancer keyworker co-ordination Hospital Liaison Psychiatry NICE Level 2 NICE Level 3/4
Third- sector cancer info & support
HNA CCR co-ordination GP / Practice Nurse
Psycho-oncology
P r e v e n t i n g d i s t r e s s & p r o m o t i n g a d j u s t m e n t
GP / Practice Nurse Community Psychological Therapy Services (IAPT) Community Mental Health Services (CMH) NICE Level 1
CNS / Hospital cancer keyworker
Cancer Psychosocial Care in the Hospital Cancer Psychosocial Care in the Community
Primary care cancer keyworker co-ordination Hospital Liaison Psychiatry NICE Level 2 NICE Level 3/4
Third- sector cancer info & support
HNA CCR co-ordination
All Staff
Psycho-oncology
Community Palliative Care Team (CPCT)
all staff. Good communication between all staff
(health and social care) which is kept up to date and includes online support
health
and promote adjustment (e.g past losses, mental health history, social isolation)
cancer and its treatment)
P r e v e n t i n g d i s t r e s s & p r o m o t i n g a d j u s t m e n t
P s y c h o s o c i a l C a r e A c t i v i t y
Level 1 Role-Psychosocial care activity includes:
impact is…having on your life?
difficulties interfering with their life and accessing treatment?
All Staff
P s y c h o s o c i a l C a r e A c t i v i t y
Level 2 Role – requires specific training and regular supervision Psychosocial care activity includes:
advice
disability)
C a n c e r Ke y w o r ke r C N S / A H P
P s y c h o s o c i a l C a r e A c t i v i t y
treatments and care thus improving patient outcomes
including :
mild cognitive impairment, helping people with adjustment issues, decision-making, body image difficulties, problems with personal relationships and relationships with professionals
to MDT teams and other professionals across the pathway
CNS)
psycho-sexual interventions
Level 3 / 4 Psych o -
P s y c h o s o c i a l C a r e A c t i v i t y
Cancer specialist nurse, embedded within a cancer MDT, guides and coordinates care incl. support, undertakes holistic needs assessment (HNA), offers first-line psychological support (Level 2) Independent organisations, physical or online, with a focus on cancer: typically, provide information, peer support groups and activities, and (often) psychological care in groups or individually Community-based, primary services, offering self-help resources and structured psychological therapies (group and individual) for mild-moderate mental health problems e.g. anxiety, depression. Community-based, secondary psychiatric services for acute and severe mental illness (e.g. active bipolar disorder or psychosis) and related active risk. Community-based, specialist multidisciplinary teams for the holistic palliative management of advanced and end-stage disease, including supportive and psychological care; often linked to hospices.
P s y c h o s o c i a l R e s o u r c e s
Cancer specialist, embedded within cancer pathways – inpatients and outpatients, patients and carers : coping with treatment, adjustment, decisions, body changes, relationships w professionals GP team coordinates care for the patient with consideration of health, both physical and mental health and social care needs. Community Psychological Therapies (IAPT) Community Mental Health Services (CMH) Psycho-oncology Third-sector & other cancer support centres Community Palliative Care Team (CPCT) Cancer keyworker (CNS) GP & Practice Nurse Hospital Liaison Psych Specialist psychiatric service based within acute hospitals, including A&E and wards, for acute and severe mental illness and related active risk
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If you have any further questions or queries, please contact: Dr Philippa Hyman Clinical Psychologist and Macmillan Mental Health Clinical Lead Philippa.hyman@nhs.net England.TCSTLondon@nhs.net This is a consultation event. Your feedback is vital to this process
And finally…..