Cancer strategy: consultation analysis

Question 10

Under High quality care, we want to think about actions outside of direct treatment that affect the care given to those affected by cancer. We are considering:

• Workforce (thinking, for example, about requirements and modelling for oncology and other workforce, including specialist nurses; leadership)
• Service delivery (thinking about national, regional and local services; flexible use of workforce; role of cancer network; strategic alliances and working across health boards, for example)
• Inequalities (thinking about how to make sure everyone is included, and targeting those who may be at a disadvantage)
• Accessibility (breaking down barriers such as geographical, cultural or language)
• Integrated support services between NHS and Third Sector

Do you agree with these areas of focus?

There was a high level of support for the proposed areas of focus among respondents: 97% of respondents agreed with the areas of focus, while 3% did not agree. Respondents were also asked to provide any comments on their response, and the key themes raised in responses are covered below. There were two open-format questions on the areas of focus for high quality care:

• 166 responses to the first question ("In your experience, what aims or actions would you like to see under any of these areas? Please focus your response on quality of care."): 86 from individuals and 80 from organisations.
• 94 responses to the second question ("Please explain your answer and provide any additional suggestions."): 35 from individuals and 59 from organisations.

Service management

The most common theme regarded management of services. Respondents highlighted issues such as collaboration across different parties, shorter waiting times in health settings, accessibility of services and care, better infrastructure, diversity among services, consistency of care, forward planning, centralisation of services, enhanced leadership and capability, the inclusion of palliative care, and the integration of the third sector.

"Yes but we also need care in the community which is non existent just now. Hospitals are working hard and seeing people. GPs are impossible to even get a telephone call with. All receptionist wish to do is refer you to other services and not allow you to speak to a doctor." (Individual response)

"increase the cancer workforce starting now, particularly in the biggest priority areas eg radiotherapy." (Individual response)

Workforce management

The second more frequently highlighted theme was about the management of the workforce. Respondents mentioned the necessity for an upskilled and flexible workforce that receives decent pay, more recruitments, workforce assessments, daily access for patients and their carers to a CNS, and the development of a workforce action plan.

"[…] This Strategy should set out the steps to build the cancer workforce of the future by addressing current shortages, retaining expertise, and investing in innovative workforce planning models so that everyone with cancer has the dedicated support of a team of professionals to help meet their needs and navigate around the system." (Organisation response)

"Quality of care is reliant on the right healthcare professional with the right skills being available at the right time. [...]" (Organisation response)

Engagement, support and inequalities

The next most discussed theme encompassed engagement, support and inequalities. Many respondents discussed the need for patients to have access to information that can help them make informed decisions. Education of the public using health-promoting messaging was called for as well as encouragement of community engagement. Some respondents specifically spoke about the role of cancer networks citing functions such as ensuring consistent and holistic management of cancer services as well as measuring quality in terms of outcomes instead of time-related measures and holding services accountable.

"Making screening and education about cancer vaccines available to all. [...]" (Individual response)

Responses touching upon support mainly focused on offering psychological support to patients, adequately resourcing services, and enhancing innovation. Respondents addressing the topic of inequalities mainly did so with reference to the quality of care currently being determined by geographic location as well as other reasons that can hinder patients' access to treatment such as older age.

"Concentrate on the most deprived say 20 % of people." (Individual response)

Treatment, diagnosis and innovation

The last theme was about treatment, diagnosis and innovation. Respondents provided suggestions on different or alternative treatments and models for care. Furthermore, responses favoured early interventions for high-risk populations.

"Massage for supporting patients who have a diagnosis of cancer. Massage can help manage symptoms of pain, fatigue, nausea and brain fog" (Organisation response)

Responses focussing on innovation mainly did so by addressing topics relevant to research and technology. For example, some respondents suggested that data be updated and published regularly, and that research findings are integrated to support high-quality care.

No further suggestions

A few responders agreed without adding significant suggestions.

"Try and keep good strategies going" (Individual response)