Nid yw’r dudalen ar gael yn y Gymraeg
National Assembly for Wales
Health and Social Services Committee
Review of Cancer Services for the People of Wales
| Name of respondent: Charlotte Beardmore & Kim Sandford |
| Are you responding on behalf of an organisation YES |
| If so please give the name Society and College of Radiographers |
| Address: Society and College of Radiographers 207 Providence Square Mill Street London SE1 2EWSociety of Radiographers Agriculture House Winch Lane Haverfordwest SA61 1RW |
| Telephone number: 01437 767 392 |
| Would you be willing to give oral evidence to the Committee Yes |
| If the evidence you give below is your personal view, rather then that of an organisation, please state whether or not you are willing for your evidence to be published by putting a X in the appropriate box below: |
| I am content for my evidence to be published |
| 1 | How can information technology be used more effectively to track and facilitate the patient’s journey? |
| Response | It enables the length of the pathway to be clearly seen: shows all processes required per pathway: enables further redesign of services to meet patients needs. Provides a baseline template to enable a review of the patient’s journey to be undertaken - endpoint will be to streamline the journey cutting out unnecessary waits and improve the patient journey by timely and appropriate interventions across all cancer pathways for all patients.Provides an information resource so all the team is aware of the stage of the patients journey ie between the community and acute sectors etc. between surgical and non-surgical oncology and within specific areas of service such as radiotherapyEasily track / monitor waiting times for all patients from referralIn Wales further development of Canisc across all cancer services would enhance this |
| 2 | How effectively is research and good practice being integrated with service delivery? What can be done and by whom to improve this? |
| Response | Slow to implement research into routine radiotherapy practice. Staffing levels and resources limit what can be achieved. There is a lack of spare treatment capacity to develop and implement new technologies to their fullest extent. ie Radiotherapy departments not able to utilise their IMRT facility fully for the benefit of certain patients due to lack of staffing and time to develop and implement required processes. |
| 3 | What are your views on the complexity of commissioning services? Is the process hampered by the involvement of the local health boards, cancer networks and Health Commission Wales? How could it simplified? |
| Response | Cancer Networks have an important role in the prioritising of developments across each network and should advise the commissioning process and LHB’s. Working with multiple LHB’s across a region for a regional service like Radiotherapy can be complex and cause delays and difficulties. This process is considerably easier if a lead LHB commissioner for Cancer services is identified. |
| 4 | What evidence is there of the value of screening and immunisation? |
| Response | No Response |
| 5 | What are the barriers to the NHS in Wales keeping abreast of, and responding to, developing technologies and therapies? How might these barriers be overcome? |
| Response | No coherent development of plan/strategy for the radiotherapy services development across Wales -Development of a formal strategy is required to model service need for the next 5,10 and 15 years. The lack of a robust excepted plan for the service results in difficulty securing resources for new equipment and replacement equipment for example Linear Accelerators The lack of a coherent strategy has resulted in inadequate workforce planning to meet current and future service needs, with a lack of therapeutic radiographers, and physics staff to support changing and evolving service needs. Appropriately trained staff - lack of long term investment in staff education and training at postgraduate levels results in less optimal use of their potential skills. Bottlenecks often exist because of scarce medical resources e.g. Consultant Oncologists away from the centre in peripheral clinics; if therapeutic radiographers were trained to work at advanced and consultant levels these bottlenecks could be reduced and services enhanced for patients. This requires focused development and funding of postgraduate programmes within Wales to support service needs. The following documents provide examples of how therapeutic radiographers can be utilised to their full potential across Cancer services.There is a lack of partnership arrangements and agreements with English education providers which is important for areas of Wales where access to education courses within Wales can be difficult due to geography. There is a lack of investment in funding and implementing alternative learning methods - distance learning for development of advanced and consultant practice.DH Radiography Skills Mix: A Report on the four-tier service delivery model, 2003. www.doh.gov.uk/radiography , SCoR Radiographic Staffing:Short Term Guidance 2005 Benchmark for Standard Core Functions within Radiotherapy,SCoR 2005. www.sor.org/public/pdf/rad_staffing.pdf SCoR Positioning Therapeutic Radiographers within Cancer Services: Delivering Patient-Centred Care,SCoR 2006 www.sor.org/public/pdf/pos_therapeutic_rad.pdf |
| 6 | How can the NHS and the voluntary sector work together more effectively to deliver services? |
| Response | No Response |
| 7 | How can the collection and use of data on where the terminally ill spend their last weeks or months be improved better to inform service provision for those people? |
| Response | Improved tracking of palliative patients will highlight areas of low service provision. Inequality of services available in rural areas, patients often referred to acute services due to unavailability of 24hr support and guidance at home. Improve co-ordination of support for patients and help for professionals and GP’s to look after patients in the community |
| 8 | There are a number of issues around prescribing and the cost of drugs: |
| 8(i) | What should be done and by whom to reduce continued prescribing of inappropriate drugs? |
| Response | Electronic prescribing of all drugs is essential to enable meaningful audit and monitoring changes to practice Agreed protocols for chemotherapy across Wales Improved early forecasting of new drugs, their use and implementation consequence on service provision |
| 8(ii) | Should people who are prepared to pay privately for drugs not available to them on the NHS, be able to do so without having to become private patients and having to pay for all their treatment? |
| Response | There may be a case if cost is the only reason it is not available on the NHS, However new treatments and drugs may have other service consequences - mode of delivery which may require additional manpower recourses to deliver. Ethically difficult to support |
| 8(iii) | Do doctors, pharmacists and other health professionals have adequate access to independent advice and guidance on the prescribing of drugs? |
| Response | No Response |
| 9 | Are services centred on the patient, with service users consulted? If not what are the reasons for this and how patient involvement be improved? |
| Response | With regard to radiotherapy services it would be useful to review service arrangements within Wales and to consider as England are what will be the radiotherapy service requirements for 2011 and 2015. Throughout this process it is important to involve service users - to ascertain what their expectations are of the service and to build a service focused around the needs of the patient. There is a good history of patient involvement in service developments at all levels in some areas of cancer services in Wales and further development would be welcome. |
