FACET - European Journal of Cancer Care June 2002

FACET - European Journal of Cancer CareJune 2002

slides available at: www.blackwell-science.com/ecc

Policies and Practice: developing a vision for the future

L. BARNISH1, RGN, ONC CERT, BSC (HONS), MSC

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*Click on “View”; “Notes Page” for explanatory notes

Introduction

• How can policies influence clinical practice?

• How can policies be used in the ongoing development of cancer services?

• How can a vision be developed for cancer services?



Policies and Practice: developing a vision for the future (continued)

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Example 1. A model for the consultation

phaseDraft ‘standards’

reviewedby Lead Cancer Nurse

Changes to service could be made slowly with a view to

improving the services rather than in a rush to pass peer

review process

Content of standards discussed with Clinical Nurse Specialist’s

Standards become

familiar to clinical staff

Standards were used during usual

development of services

Difficulties in meeting standards

noticed early

All staff comments were included

when comments to the draft were

sent to the Department of Health




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Outcomes at the consultation

phase• Implementation of the

changes was difficult

• Reading documents in isolation is of limited value, clinical staff need to be involved in discussions at hospital level

• Clinical staff have vital contributions to make at all levels:– Instigating policy

objectives– Informing the design

and content– Ensuring local

implementation.




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Example 2. The use of policy

documents

• Some policy documents relate specifically to areas of clinical practice e.g. Clinical Outcomes Guidance (UK)

• A multiprofessional perspective on the local implementation is essential if comprehensive holistic local services are to be provided.

• This input is required at the early stages of implementation when service redesign and funding is being agreed.




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So how is all this relevant?

Senior clinical professionals have a responsibility to strive to improve services for patients.

This can be made easier by:

• Using political levers

• By supporting the development of junior staff – and their involvement in the local interpretation and implementation of policy




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Some points to consider

• Do you have a vision for your service?

• Can it be clearly articulated to others?

• Is it written down?

• Who else knows about it?

• How does it fit with your organisation’s goals?

• How long into the future does it reach?




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Developing the vision for your

service

• What local influences do you have to consider when developing a vision for the service to your patients?

• What are the individuals’ ideas in your team?




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What are the influences for this

vision?

• Patients’ feedback and comments

• Local networking with colleagues

• Perceptions of service shortfalls

• Your own ideas and personal interests

• Recent educational initiatives




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Is your vision driven

by what you believe

your patients should

receive or is it

restricted by what

you believe to be

possible?




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Factors that may restrict the vision

• Consider the factors that are restricting your vision

• Are difficulties perceived, tested, real?

• What assumptions have been made?

• How creative is the vision

• How restricted is it by existing processes?




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Using policy documents to support and

guide your vision

• Consider your responsibility for being proactive in this process

• Benefits include:

– New ideas– Ensures consistency

and relevance of your ideas

– Added support to your vision

– The access of funds (possibly)

– Your own professional development.




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Making the job more manageable

(and less daunting)

• Use your local people resources

• Visit the web pages regularly

• Read the Cancer Action Team Newsletter (UK)

• Review documents in small discussion groups

Remember: • Revisit your vision regularly

– update it – concentrate on those bits

that are currently trendy – you may find you get more support




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Literature and other information sources

Department of Health (1996-2001) Clinical Outcomes Guidance Documents. Department of Health. London.

Department of Health (2000) The NHS Cancer Plan: a plan for investment, a plan for reform. Department of Health. London.

Department of Health: Expert Advisory Group on Cancer to the Chief Medical Officers of England and Wales (1995) A policy framework for commissioning cancer services. Department of Health. London.

Munroe, A. (2001) The Calman-Hine Report: its causes and consequences. European Journal of Cancer Care. 10(3): 213-219.

National Patients Access Team (2000) Cancer Services Collaborative Twelve Months On. National Health Service Executive. London.

NHS Executive (2000) Cancer Information Strategy. Department of Health. London.

NHS Executive (2001) Manual of Cancer Service Standards. Department of Health. London.

NHS Information Authority with the National Cancer Director (2000) Towards a Cancer Information Strategy. Cancer Information Strategy Team, NHS Information Authority. Winchester.

www.doh.gov.uk/cancer