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Better Cancer Care
in Scotland
Lynn Adams
Nurse Consultant NHS Grampian
Mhairi F Simpson
Nurse Consultant NHS Lanarkshire
• 30,000 per year
2006-10
• 35,000 per year
2016-2020
Challenges
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Growing elderly population
Earlier detection of cancer
Rise in the incidence of some cancers
Declining mortality
Financial pressures
Inequalities
• Most deprived areas report incidence rates of
almost 40% higher that the least deprived
areas.
• Mortality rates for all cancers combined are
approximately 75% higher in the most
deprived areas compared to the least
deprived areas.
• Only a few cancers have higher incidence
rates than those living in least deprived areas
(female breast; prostate cancer & malignant
melanoma of the skin).
Inequalities
• There is some evidence that socioeconomic inequalities in survival are
widening over time
• May indicate
- lower awareness of cancer symptoms
- the benefits of screening and healthy
lifestyle choices
Better Cancer Care:
an action plan
• Prevention
• Early detection of
cancer
• Genetic & molecular
testing for cancer
• Referral & diagnosis
• Treatment
• Living with cancer
• Improving quality of
care for patients
• Delivery
Prevention
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Reduce smoking
Diet, obesity
Expand access to physical activity
Tackle alcohol misuse
Improve public awareness of sun
exposure
Early detection of cancer
• Increase uptake of screening services
cervical, bowel
• Implement two x-ray views at each
breast screening
Genetic & molecular testing
• Develop capacity and capability for
cancer genetic services
• Scottish Genetics Education Network
Referral & diagnosis
• Improve public awareness of common
cancer symptoms
• Increase electronic referrals
Treatment
• Capacity and demand – surgery
• Sentinel Node Biopsy
• New drugs
Living with Cancer
• Survivorship
• Cancer costs
• Self Management
Improving quality of cancer care
for patients
• Quality Improvement
• Extend 62 day target
• Introduce new 31 day target
Delivery
• Scottish Cancer Taskforce
– Advisory Groups
• Agreed annual work programme
• Clinical leadership
– Nurse & AHP Directors
– Lead / Consultant Nurses
• Address workforce challenges
– Nursing; AHP; Healthcare Support Worker
• eHealth and telehealth
Key Advisory Groups
• National Quality Group
• Living with Cancer Group
– “Big Conversation Event”
• Chemotherapy Advisory Group
– Patient Information
• Radiotherapy
• E-Health
Scottish Government Initiatives
• Patient Focus Public Involvement
• Equalities
• Better Together: Scotland’s Patient
Experience Programme
– Better Together Cancer Pilots in 3 networks
• Long Term Collaboratives
• Long Term Conditions Alliance Scotland
– Gaun Yersel
• Healthy Working Lives
Cancer Experience
• The cancer experience can be described
as a roller coaster of emotional and
physical highs and lows, with unexpected
twists and turns.
• To understand the difficulties this group of
people experience can only enhance the
care we give.
• “Life is a bus journey…you are the
driver…the professional gets on and
off.”
• Better Cancer Care NOSCAN road show
• The patient journey / pathway is ‘like a
washing machine – you are in a spin &
information comes at you from all
directions”
Participant in Supported Self Care in Cancer Consultation Event
Cancer Challenges & Opportunities
• Cancer incidence is increasing as people are
living longer
• More people are alive who have survived
cancer
• Scientific understanding of cancer is
improving greatly
• New opportunities for early diagnosis
• New treatments in pipeline
• New service models – easily accessible;
improve outcomes for people
Remote and Rural Cancer Care
• Strengthening healthcare in remote and
rural areas of Scotland
• Educating healthcare professionals for
practice in local hospitals
• Delivering care close to patients’
homes
Remote and Rural Cancer Care
• Development of chemotherapy services
in NHS Orkney
• Development of nurse led cancer
clinics in community hospitals in
NHS Grampian
Current context of nursing
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Complex & diverse population
Ageing population
Health inequalities continue
Peoples’ expectations are changing
Technology advancing
Costs are rising
Challenges for nursing
• The context of care – where care takes
place
• Delivering care across the pathway
• New models of service delivery
• Addressing emerging patient & family
issues
Thank-you