1. Physicians and CIS working together: extending into the Community Catherine Dickens & Antonia Dawson 2006

2. Physicians and CIS working together: extending into the Community This presentation will cover involving physicians in taking CIS into the community: Doctor/GP Practice Library Mobile Vehicle

3. Taking CIS into the Community

4. The need for CIS in the Community People are living longer with cancer (Summerton N 1999 Diagnosing Cancer in Primary Care). Most people would prefer to get treatment and support at home. (Adewyuyi-Dalton R, et al 1998 Psycho-onc. Vol 7(5). Recent survey showed 80% of people with common cancers first present to GP. (Family Practice Journal Date 2004 Vol 19 (6). NHS survey showed 90% respondents wanted better health information (NHS Dec 2003) The need for CIS linked to GP/Community and hospital (Smith C, Dickens C 2005 EJCC)

5. People from the community visiting CIS based in hospital

6. GP based CIS The Hadleigh Doctor’s Practice CIS was set up by a nurse in 1999. “I see her as a link person between carer, GP, hospital, oncologist….she’s accepted by hospital staff as part of their team and she’s also at the heart of our team. She managed to improve communication between the patient and their consultant.” Tim Howard, GP Hadleigh Practice.

7. Library based CIS In 2001 public libraries in England and Wales had 290 million visits The library is run by information professionals It may be easier to offer services to ‘hard to reach groups’. A CIS nurse based in the library can provide support and information. People can visit to get information or borrow books, leaflets in written/audio formats to make informed choices Easier for local people as a part of a wider range of services

8. Library based CIS Health enquiries in public libraries are growing in volume. Libraries are safe, neutral and accessible places open to all. Provide a range of expertise to many local people. A purpose broader than health. Link to GP and space in library. CIS nurse specialist and volunteers. (Artemis Consulting 2004)

9. Library based CIS

10. Mobile CIS

12. 40% men visitors 30% have cancer 40% friends/relatives Want to know about: Cancer diagnosis Prevention Treatment and side effects Diet (Macmillan Mobile Centre Report 2004) Helping people talk with physicians and health care staff with more confidence. Getting local health care staff involved and knowing about CIS Updating health care staff on range of pamphlet and materials available. Time to look at internet.

13. Summary Needs assessment Clear aims & objectives as part of strategic plan Written policies Being part of a recognisable GP management structure Space for CIS Steering management committee Resources – booklets etc Integrated CIS able to refer on Administrative support Budget Phone & computer equipment Induction & ongoing training Staffing primarily a cancer trained nurse. Audit & evaluation for improvement Physician to champion CIS Physicians and CIS working together: extending into the Community

14. Websites www.Breastcancercare.org.uk www.Breakthrough.org.uk www.Cancerbacup.org www.Cancerhelp.org.uk www.cancernorth.nhs.uk/home www.Macmillan.org.uk www.NHSdirect.org www.icisg.org