Presentation on theme: "Liverpool Psychology Service for Cancer"— Presentation transcript:
1Liverpool Psychology Service for Cancer Dr Janice AblettConsultant Clinical Psychologist Professional Lead
2The new service is funded by Liverpool PCT in partnership with RLBUHT and the Division of Clinical Psychology at the University of Liverpool, in collaboration with Aintree Hospitals Trust (for Liverpool patients).It builds on existing service provision:Clinical Psychology Fellow in Breast UnitHealth Psychology Fellow in nationally funded Ocular Oncology Service.
3Prevalence of Psychological Need Surveys indicate that one third to one half of cancer patients experience psychological disorders, with 20-25% reaching ‘caseness’ for depression. In palliative care these figures are higher.British Psychological Society (BPS): 15-30% of patients are sufficiently distressed to require professional help at some point during their cancer trajectory.Psychological morbidity in carers – significant numbers of carers experience psychological distress, in turn affecting their ability to cope & provide support.Clinical staff themselves are at risk of psychological morbidity & burnout.
4From diagnosis onwards People experience a range of emotions; shock, fear, anger, sadness , guiltNo two patients with cancer show exactly the same emotional response, even if the physical status is very similar. Response depends on the individual perception of the threat of cancer, which is determined by the characteristics of the person concerned. (Holland, 1989).Cancer is a disease shot through with uncertainty, and it is this uncertainty that makes everything so difficult. (Burton & Watson).
5Psychological Needs in Cancer People with cancer are at high risk of experiencing psychological difficulties such as:AnxietyTrauma related problemAdjustment disordersBody image problemsDepressionANVInterpersonal difficultiesComplex painInsomniaSexual dysfunction
6Psychological needs in cancer Consider referral for those who are:Struggling to adjust over timeWith intense emotional reactions that compromise their mechanisms for coping and self careWho are ‘stuck’ in a way likely to impair future adjustmentWith emotional difficulties that are unlikely to resolve over a reasonable timeWho need specialist psychological support when involved in complex decision making about treatment
7Strategic Context & Drivers The National Cancer Plan (2000)Improving Outcomes Guidance ( )NICE Guidance on Improving Supportive & Palliative Care for Adults with Cancer (2004)MCCN Review of Psychological Services (2007)The National Cancer Peer Review Programme ( )Cancer Reform Strategy; achieving local implementation (2009)National Cancer Survivorship Initiative (NCSI) vision (2010)
8The local picture Liverpool is the Cancer Capital of Europe with a mortality rate of 237 deaths per100,000 and the highest level of cancerincidence in England.Liverpool Primary Care Trust has been identifiedby the National Health Inequalities Programme asbeing one of 13 PCTs in England that contributethe greatest number of deaths by cancer. Liverpool Primary Care Trust, Nov 2009.
9New Service PCT funded posts: Dr Jan Ablett Consultant Clinical Psychologist/Professional LeadDr Helen BeesleyPrincipal Clinical PsychologistSenior Clinical PsychologistappointedDr Joanna Omylinska-ThurstonCounselling PsychologistMrs Susan ClarkPA/SecretaryUniversity posts:Dr Louise ClarkClinical Psychology Fellow, Breast UnitMs Laura Hope-StoneTrainee Health Psychology Fellow, Ocular OncologyMrs Helen UllmerAssistant Psychologist, Breast UnitMCCN:Mr Rob DinwoodieAssistant Clinical Psychologist; Information/leaflet study
10A psychological service focussed on: Alleviating psychological distressImproving well-beingPerson-centred careRespect & dignityNeeds assessment (rather that distress management)Prevention (& identifying vulnerabilities)Improving quality of lifeCost effectiveness
11Liverpool Psychology Service for Cancer: Level 4 – NICE guidance Provide specialist psychological care for patients with severe distress and complex needsDraw on a multi-theoretical base to inform assessments & interventions that are specifically tailored to individual needEnsure that psychological interventions are high quality and evidence basedUse high level research skills for evaluation, innovation, and to further develop the evidence base
12Liverpool Psychology Service for Cancer - cont’d Support/Supervision/Training of others:Psychological interventions provided by staff at Level 3Psychological support provided by staff at Level 2Contribute to development of specific psychological skills in other staff such as breaking bad news, communication skills, working with bereaved relatives.
13Liverpool Psychology Service for Cancer - cont’d We plan a phased process of introduction of the clinical service:To the RoyalTo other hospitals e.g. Heart & Chest, The Womens’To Aintree Hospital – for Liverpool patientsTo Primary Care – Liverpool GPsIn terms of direct & indirect work:Direct clinical service to patientsSupport to other staff providing psychological supportEducation & training to other staff re psychological approaches.
14Liverpool Psychology Service for Cancer - cont’d Undertaking clinically relevant research, in collaboration with Division of Clinical Psychology, that leads to service improvement and innovation:Current research interests include:CommunicationDecision makingPsychological distress: patients’ & health professionals’ perspectivesProvision of high quality information re psychological care, coping and living with cancer.
15Our vision for the service To develop, establish and provide a high quality specialist psycho-oncology service that is innovative, at the forefront of leading evidence based care for the people of Liverpool affected by cancer.