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
Business | NAFW
| Name of respondent:Nici Evans |
| Are you responding on behalf of an organisation/group?Yes |
| If so please give the name All Wales Cancer and Palliative Care Nurse Education Forum (members are all lecturers providing cancer and palliative care
education in all the Universities in Wales) |
| Address: c/o Macmillan Education Unit Denbigh HouseCollege
of MedicineHeath ParkCardiffCF14 4XN |
| Telephone number:02920 743539 |
| 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 publishedN/A |
| I am not content for my evidence to be publishedN/A |
Business | NAFW
| 1 |
How can information technology be used more effectively to track and facilitate the patient’s journey? |
| Response |
It is also important to view this question from an educational perspective as we prepare health professionals to support patients through the cancer journey. There are several ways that information technology can support this process by preparing health professionals
to deliver high quality care which facilitates the patient’s experience. For
example, the University of Glamorgan have adopted a definition of blended learning which is designed to use information technology to enhance learning and teaching. Utilising blended learning could enable students and health professionals to better understand
the patients journey and thus respond more appropriately to their needs. To
facilitate information technology being used more effectively totrack and facilitate the patients journey there needs to be a commitmentto
IT training for all staff in the NHS and voluntary sector. ECDLshould be a basic requirement and staff should be supported in obtaining basic IT qualifications.
To provide a seamless journey for the patient between the NHS and voluntary (hospice / palliative care providers ) use of telemedicine and tele-education should be encouraged. The NHS already have a very good videoconferencing network through Health Solutions
Wales however systems in the voluntary sector need to be compatible with this to enable joint MDT case conferences, education and support particularly to remote areas where there may be a lack of "specialist " services. The use of telemedicine
units in patients homes can support the primary care team and the patients family and carer enabling them to remain at home with specialist support. The use of e-learning and video streaming education sessions will enable staff to access up to date education
and information at their own convenience from a videoconferencing unit or their own pc. However this is again reliant upon network capacity, budgetary constraints and ensuring all systems are compatible. The
use of skills labs can assist in teaching and assessing skills that may be encountered infrequently by students and practitioners in their work place. Collaboration between universities with skills labs on site and cancer/ palliative care providers could provide
a safe environment for staff to refine and enhance their skills. |
| 2) |
How effectively is research and good practice being integrated with service delivery? What can be done and by whom to improve this? |
| Response |
There are pockets where research and good practice are integrated. However, the very fact that Cancer and Palliative Care Lecturers in Wales were not invited to give evidence to the committee is a clear indicator and example of how divorced education (and therefore
practice based research) is from clinical practice. Research does not exclusively sit with big, funded projects……..research based education for health professionals at the coal face is equally as important and it is this level that is constantly
forgotten. There continues to be a gaping divide which is fed by the constant focus on pre-registration training and lack of resources for post-graduate education. The barriers appear to be lack of leadership, lack of collaboration, everyone working in isolation,
no education strategy and no apparent commitment from anyone in a senior enough position to co-ordinate the pulling together of practice and research, education. |
| 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 |
We agree that the process of commissioning services is too complex - there are no formal links with the University staff who are delivering the education which therefore allows for everyone to work independently thus causing a greater divide. Direct talking
and communication between commissioners, service managers and teaching staff would be a good start. We
believe that Cancer Networks should be more influential and have more power to commission both clinical services and education. |
| 4 |
What evidence is there of the value of screening and immunisation? |
| 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 |
Barriers Lack of resources (time and money - staff cannot be released from clinical duties to attend education or training). A radical change of culture to work based learning in the clinical area would be one way
to overcome this issuePoor
infrastructure - current infrastructures within NHS Trusts do not facilitate learning.Education and training is NOT a priority.
When the pressure is on…..this is the first part of the service to be cut.Overcoming
these barriers requires a major philosophical shift in thinking and belief systems. The current practice of paying lip service to education has clearly NOT worked. It is time to really invest and consider how we bring about major organisational and cultural
changes. |
| 6 |
How can the NHS and the voluntary sector work together more effectively to deliver services? |
| Response |
By understanding one another’s role and by focusing on day to day working. This problem is however very deep rooted in some areas and because the Voluntary Sector is not subject to the same governance - this leads to difficulties. Compulsory compliance
to the NHS governance agenda would be a start in drawing everyone together….but this would be very difficult. This
question is answered in point 53/53 in the original transcript. |
Business | NAFW
| 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 |
A central point of collection (which could be co-ordinated by the Cancer Networks if they had adequate resources) would facilitate and enable the identification of education and training needs. For example…..cases of crisis intervention, of when people
are admitted against their will or inappropriately or when people do not die where they choose. This information would feed into service re-configuration and development and highlight deficits in care, knowledge and skills, which could be addressed. |
| 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 |
If the care is good, then drug costs automatically go down. Educate the workforce and see the appropriate use of medication. A good example of this is the appropriate use of the Care of the Dying Pathway. Another
way is to ensure that there is regular review of patients medications by an educated and specialised pharmacist - this would save a great deal of money.Nurse
prescribing for senior advanced practitioners would also be a means of saving money and ensuring that patients receive the right drugs. |
| 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 |
Yes |
| 8(iii) |
Do doctors, pharmacists and other health professionals have adequate access to independent advice and guidance on the prescribing of drugs? |
| Response |
Our belief is that access to independent advice is probably patchy and depends on a number of factors. |
Business | NAFW
| 9 |
Are services centred on the patient, with service users consulted? If not what are the reasons for this and how can patient involvement be improved? |
| Response |
The rush to get patients and service users on board has brought problems as they are often a self-selecting group. Higher Education could be utilised to deliver training for service users. In
addition - Universities can look to involving patients more actively in the classroom and utilise patient narratives thus preparing the future workforce to be more comfortable with the process of patient involvement. |
Thank you for responding. If possible please e-mail your response to jane.westlake@wales.gsi.gov.uk . Alternatively post it to Jane Westlake, Clerk to the Health and Social Services Committee, Room B4.07, National Assembly for Wales, Cardiff Bay Cardiff, CF99
1NA. The closing date for responses is Monday 24 July 2006
