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Joint working proven to enhance patient care

Speaking at the inaugural CNP conference in Manchester, Tracey Coleby discusses the benefits of proactive service

Speaking at the inaugural CNP conference in Manchester, Tracey Coleby discusses the benefits of proactive service


Tracey Coleby. Picture: Neil O'Connor

Collaborative working between breast cancer nurses and community teams is crucial to identify patients with advancing disease at an earlier stage, nurses at the Cancer Nursing Practice conference were informed.

Macmillan breast palliative care lead Tracey Coleby said a focus on a proactive service was necessary to ensure that nurses weren’t dealing with consequences only when things get worse.

She discussed a collaborative, integrated project at Manchester’s Christie Hospital, which identified 400 patients in one multidisciplinary team (MDT) for patients with advanced cancer last year.

Ms Coleby informed delegates that regular patient review was necessary: ‘Patients were only being referred at crisis point yet there were a lot of patients who had need. I wanted to try and give the breast cancer team a better understanding of what we do and get them involved with patients at an earlier stage.’

The breast cancer team, including three consultants, approached Macmillan to fund an integrated project. After 21 months, it has streamlined services for patients with advanced disease and has allowed breast care nurses, community teams and breast disease groups to identify more patients. It has also ensured discussions on best management and trials or experimental trials patients could participate in.

Patient value

Ms Coleby said that patients benefitted from the team being more aware of patients with advancing secondary breast cancer: ‘Patients value coming to one clinic and being seen by the MDT team; they think it’s great we all know about them.’

The value in joint working has also allowed breast care nurses to work alongside oncology rather than work as two isolated groups, leading to increased knowledge, more confidence and enhanced decision-making across the teams, Ms Coleby added.

This multidisciplinary approach led to fewer crisis interventions or hospital admissions, increased support and community teams kept fully updated.

Crucially, there are more opportunities to have open and honest discussions: ‘Crisis admission is a thing of the past and patients are now put more firmly in control and in the picture, earlier on in the disease care.’

For the Christie, this has led to a cost-effective service, reduction in hospital admission, inappropriate patient appointments and hospital deaths as well as fewer patients dying on active treatment, Ms Coleby explained.

Meanwhile, the benefits to the community team include earlier involvement, increased awareness of patients with advancing disease, awareness of treatment plans, and advanced care planning wishes. 

What attendees of the CNP conference had to say
  Anna Bagulay chemotherapy nurse, GenesisCare

‘Today was very informative. Coming from the NHS to working in a private cancer treatment, it’s beneficial to hear everything that goes on in the NHS that we should be doing in the private sector as well. I’m going to take home the survivorship stuff with me as it’s very interesting.

'We’re actually trying to set up our own survivorship support group at the centre and have it based with other hospitals around us so they can use the centre as a support group for all patients to go to. The session I found most enjoyable was the phase 1 clinical trials. Going into the private sector, we don’t do the clinical trials so it’s interesting to know you can go on courses, which can benefit patients, because obviously down the line it may be an option.’

Matthew Dicksen, coleorectal nurse at Leicester Royal Infirmary

'I’m new to cancer care having previously worked in an intensive therapy unit so I saw this as an opportunity to catch up with colleagues working in this massive area.

'It’s easy to get too focused on what you are doing, so this is great to see what else is going on.

'I’ve been most impressed by how much support is out there for patients going through this life-changing jouney.’


Read more on the CNP conference 

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