Better Connections and Navigation: - PowerPoint Presentation

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Better Connections and Navigation:Macmillan Cancer Navigator Service at Imperial College NHS Trust Slide2

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What is the Cancer Navigator Service?

Macmillan Cancer Navigators is an enhanced phone based service for cancer patients, their family/carers and primary care services

The Navigators triage all calls from cancer patients, and using a PRAG system are authorised to action calls or to refer to more appropriate person primarily CNSSlide4

Evidence of NeedPoor patient experience – as highlighted by successive National Cancer Patient Survey results, particularly the ability of patients to contact their CNS

CNS time inappropriately taken up with routine admin/non specialist tasks reducing the time and attention available for clinical work and innovationSlide5

The context

Cancer Navigators were developed as part of a Whole System Redesign partnership between Imperial College NHS Healthcare Trust and Macmillan Cancer SupportOther programme work-streams include:CNS developmentSchwartz Rounds

VBSLiving With and Beyond Cancer Slide6

expected outcomes

To improve patient experience by:Ensuring that patients receive a timely response to their queries and have a positive seamless experience of accessing cancer services, support and informationFreeing up CNS time to focus on appropriate patient support, clinical care and innovation Slide7

Design and Induction

To create competent staff and raise the VALUE of the teamOrientation and training is essential for each Navigator:-

Attendance/observation of MDTS & relevant departments & services - to enhance understanding of role & functionRadiology diagnostics & treatment areas ensures visualisation of service & increased understanding of service & treatment to reassure patientsAbility to book/check appointments -ensures speedy response to patientsInstigation of PRAG rated triage assessment sheetsDesigned to speciality needs with CNS teams

Key manager / leader initiatives

Establishment of regular team meeting

1 to 1s for each team member Monthly ‘Supervision Sessions’ whole team to attend Promotion of service CNS to inform patients about the service remitNavigator information leaflet Slide8

Process-mapping: 62 day pathwaySlide9

Evidence of ImpactImprovement in score of National Cancer Patient Experience Survey- most notably a 23% increase in the ability of patients to easily contact their CNS

Multiple CNS led innovations including:PREPARE programme in OG- an innovative prehab programme leading to nurse of the year award for lead CNS 2016Introduction of HIPEC: a specialised treatment for colorectal patients- one of only 5 centres in UK

Redesigned Urology Pathway including multiple CNS led clinics and development of Open Access Follow UpDevelopment of telephone clinics across tumour sitesSlide10

Learning

Renewal is central to successOngoing communication between navigators and CNS teams particularly is essential e.g. each attending the others team meetingsTeam Leader necessary to manage the day to day activitiesBanding is such that there is likely to be a regular staff turnover as staff seek professional advancement or perhaps face-face roles

Clinical supervision is criticalReview of what does/doesn’t fall in the role remit is importantSlide11

Possible Future DevelopmentsIntegrating the Navigator role with Tracker and OAFU roles to ensure renewal of

skills