A fine balance
Catherine Oakley says busy health services must avoid focusing on processes at the expense person-centred care
When a cancer taskforce set up by NHS England in January failed to include any nurses in the 17-strong team, the nursing profession reacted with outrage.
After pressure from senior oncology nurses, chief nursing officer for England Jane Cummings intervened, leading to UK Oncology Nursing Society (UKONS) president Catherine Oakley being appointed to the team in March.
Dr Oakley, a chemotherapy nurse consultant at Guy’s and St Thomas’ NHS Foundation Trust in London, has almost 30 years’ experience in cancer care. After qualifying in 1987, her first job was on an oncology ward, where she met cancer nurse specialist Gillian Hutchison, one of the first lead cancer nurses in the UK.
‘Gillian showed me the difference nurses can make to the experience of cancer patients through expert knowledge and therapeutic relationships,’ she says. ‘Patient experience before, during and after cancer diagnosis is as important as early diagnosis, access to clinical trials and access to the best available treatments.’
In January 1993, Dr Oakley joined St George’s Hospital, London, as a chemotherapy clinical nurse specialist, and established one of the first home chemotherapy services in the UK.
After four years as lead nurse and manager for cancer services at the Princess Royal University Hospital in Bromley, she returned to St George’s in 2003 as Macmillan lead cancer nurse, where she was responsible for the trust’s cancer nursing strategy.
A management role in oncology, haematology and palliative care followed, before Dr Oakley moved to Guy’s and St Thomas’ in 2008 to her current post, where she leads the chemotherapy nursing team to provide a ‘world-class service’.
‘My role is 50% clinically based, and the balance of clinical practice, research and strategy keeps me grounded,’ she says. ‘I have the freedom to challenge practice and innovate, and embed nursing research into everyday practice.’
Dr Oakley is working in partnership with patients and staff at the trust on a person-centred nursing model, for which she is the research lead. ‘We have to focus on what’s best for individual patients. There are real opportunities in cancer care to constantly improve nursing care through research,’ she says.
With a degree in cancer nursing from the University of Manchester and a master’s in advancing cancer nursing practice from King’s College London, research has always been an integral part of Dr Oakley’s nursing career.
In February she completed a doctorate on the patient, carer and health professional experience of neutropenic sepsis, which won the 2015 Elsevier Outstanding PhD thesis prize.
‘One of the things my PhD taught me is that busy health services can naturally become focused on processes around clinical care which can take priority over person-centred care,’ she says.
‘We need to develop ongoing relationships with patients and their families which support and equip them to cope with the physical, psychological and social effects of chemotherapy.’
An oral chemotherapy diary developed by Dr Oakley and a colleague has won numerous awards, including Best Practice in Medication Administration at the 2009 Nursing Standard awards.
The diary, which includes a symptom traffic light reporting tool to help patients and families work out what they should report urgently, helps with adherence to oral medication and reduces anxiety.
‘The impact of the diary hit me when we worked with the wife of a patient receiving oral chemotherapy,’ Dr Oakley says. ‘She found the number of tablets her husband had to take overwhelming, and became very upset. She told me that our diary gave her a sense of control and safety.’
Dr Oakley took up her two-year tenure as president of UKONS in November 2014. She says one of the aims of the organisation is to influence and advise on cancer policy, which she does as part of a Cancer Research UK taskforce.
‘The cancer nursing community lobbied for a nurse to be included on the taskforce and I feel proud to be representing my nursing colleagues,’ she says. ‘I worked hard with others on the group to represent cancer nursing, and believe the final strategy document is well-balanced, and patient and carer-focused.’