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How a cancer hub helped ensure patient safety and staff well-being during the COVID-19 pandemic

Nurse lead at a cancer hub explains how innovative ideas helped her trust continue to deliver high-quality care

Nurse Joanna Waller explains how innovative ideas helped her trust continue to deliver high-quality cancer care and ensure staff well-being

Royal Marsden Hospital

When the COVID-19 pandemic hit, I recognised along with other cancer nurses across the UK the impact this virus could have on an immunocompromised patient population. Solutions were needed to continue safely providing cancer treatment to as many patients as possible.

One of the biggest challenges we faced early on at the Royal Marsden NHS Foundation Trust, London, was deciding what protocols to put in place to ensure the hospital sites in Chelsea and Sutton remained COVID-protected. This included training staff in the correct use of personal protective equipment, advanced cleaning protocols and a significant reduction in footfall.

We delivered this through

Nurse Joanna Waller explains how innovative ideas helped her trust continue to deliver high-quality cancer care and ensure staff well-being

Royal Marsden Hospital

When the COVID-19 pandemic hit, I recognised – along with other cancer nurses across the UK – the impact this virus could have on an immunocompromised patient population. Solutions were needed to continue safely providing cancer treatment to as many patients as possible.

One of the biggest challenges we faced early on at the Royal Marsden NHS Foundation Trust, London, was deciding what protocols to put in place to ensure the hospital sites in Chelsea and Sutton remained COVID-protected. This included training staff in the correct use of personal protective equipment, advanced cleaning protocols and a significant reduction in footfall.

We delivered this through virtual consultations, stringent visitor restrictions and strict self-isolation for patients before and during treatment, with COVID-19 screening before admission to the hospital.

Sharing learning and best practice mean the cancer hub model is being replicated elsewhere

I was asked to support the regional response to the pandemic by helping to set up the RM Cancer Hub, hosted by Royal Marsden Partners. The hub was designed to coordinate care at COVID-protected hospitals across the network for the safe treatment of cancer patients.

Through partnering with independent sector providers, the RM Cancer Hub has been essential in ensuring the continuation of care for thousands of patients across several NHS Trusts.

At the time of writing 2,953 patients have undergone urgent surgical or interventional radiology treatment. The success of the RM Cancer Hub has meant that the model has been replicated elsewhere, with the Royal Marsden sharing learning and best practice.

As autumn began, our focus did not falter. I have attended many operational planning meetings with cancer nurses who remain committed to ensuring the hospital remains COVID-protected so they can continue to offer a safe environment for colleagues and patients, and prepare for a second wave of infections.

‘The nursing teams have shown fantastic adaptability to additional and changing daily demands’

Nurse receiving flu vaccination
Picture: Tim George

Every year I encourage staff to have a flu jab to help protect both them and their cancer patients, and in this, of all years, this message is particularly critical. This winter we will face uncertainty regarding how best to care for patients with flu-like symptoms and my trust, like many others, is seeking to develop the capability to test for COVID-19 and other viruses so we can implement the best care plan for each patient.

As the winter months draw in and with children back at school we are anticipating the usual run of colds and coughs. Even in pre-pandemic times this can give rise to issues regarding staff sickness. The national guidance to self-isolate when you or a family member displays any COVID-19 symptoms will be a challenge for many trusts, including the Royal Marsden.

I continue to be impressed by the unwavering resilience shown by the nursing teams. They have shown fantastic adaptability to additional and changing daily demands, be that moving to different care settings or working with different teams to learn to deliver new and highly specialised care and treatment.

Emotional support for staff so they can cope, recharge and deliver outstanding care

The emotional cost of nursing at this time is high. As carers of patients in distress, who are suddenly attending the hospital without the support of friends and family, we give so much of our emotional and physical energy on a daily basis.

We have been fortunate to have had the support of the Royal Marsden Cancer Charity, which set up an emergency appeal shortly after the national lockdown in March and has helped fund staff well-being initiatives and the rapid roll-out of digital solutions.

We have therapists who offer drop-in sessions, evening telephone calls and videoconferencing on reflective practice. All these initiatives provide emotional support to ensure staff have the right coping mechanisms and ability to recharge, all of which enable them to continue to deliver outstanding nursing care.

I have always been proud to be a nurse. My experiences over the past six months have reminded me of all of the reasons why.


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RM Partners

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