Request From Lead Cancer Nurses: To put the National Cancer Patient Experience Survey results and actions on the SSG meeting agendas as a permanent recurring item Purpose of the request: To promote pathway service improvements in the way that the Clinical nurse specialists would like to see their services maintained or changed

 Best practice to be discussed and shared  Trust / network level priorities identified for pathway improvements  Action plan required to address identified areas for improvement  Progression of the action plan/service development

 Overall disappointing results for UHBristol  729 patients responded to the survey from the trust (44 respondents for Head & neck)  Total of 70 survey questions Good Practice  Given a choice of types of treatments (100% ↑13 )  Given right amount of info about condition and treatment (95% ↑1)  CNS listened carefully (94% ↑6)  Staff explained completely what would be done during test (93% ↑6)  Seen info about cancer research in hospital (93% ↑12)  Told sensitively they had cancer (88% ↑4)  Did everything to control side effects of radiotherapy (87% ↑2)  Given name of CNS (84% ↑12)  Gave info about support groups (83% ↑14)

CNS /MDT Specific  Written information about the type of cancer (49% ↓4)  Easy to contact CNS (70 % ↓19)  Understandable answers all/most of the time (88% ↓12%)  Told they could get free prescriptions (57 % ↓19)  Told about side effects that could happen in the future (56% ↓14) Ward staff /Inpatient care  Patients got understandable answers to Q’s (64% ↓16)  Confidence and trust in the ward nurses (61% ↓17)  Staff did everything to control Pain (81% ↓13)  Definitely given enough care from Health and Social services. (43% ↓30)  Gave patient enough emotional support. (64% ↓10)  Offered a written assessment and care plan (9% ↓6)

 Head & Neck centralisation March 2013  UHBT/NBT Head & neck ward moves  Survey questionnaire sent out in in Sep-Dec 2013  2 CNS’s in post at the time of the survey  Head & neck patients that require the most CNS support are unlikely to complete survey (Alcohol dependency, socially deprived, illiteracy, poor prognosis)  Survey results do not reflect patient comments (mostly positive)

 Increase in CNS’s (WTE – 2.8).  Admin support 30 hours a week – easier to contact CNS team.  Answer machine, mobile phone, CNS bleeps and available.  CNS cover from 7:30 – 5pm Monday –Friday.  CNS assessment sheet and checklist created for all new diagnosis to highlight support and services available.  New CNS patient leaflet.  Cancer specific related information (including treatment and side effects) available in MDT, oncology support centre and online via trust DMS and Macmillan.  Patient flow board created to help facilitate complex process  Patient’s and families have the opportunity to meet Macmillan support team prior to treatment (Morris room, POAC)

 Ward teaching – Increased trachy study days, Head & neck nursing assistant study day.  CNS attends ward rounds daily – education, training, continuity of care  CNS uniforms  Enhanced recovery  End of treatment summaries  CNS team will facilitate complex discharges (Non cancer patients included)  Close links with support services – SLT, Dietitian, OT, HDT, Physio, Palliative care, hospice, District nurses

 Head & Neck Macmillan/UHBT website  Holistic needs assessments  Nurse led clinics/MSC clinics/wound care clinics  Next steps ICE referrals  Non-medical prescribing and clinical examinations  Tracheostomy/Laryngectomy/Head & Neck teaching  Support groups (Thyroid, surgery)  In-house repeat of survey  Re-design of survey