FACET - European Journal of Cancer Care June 2002

1. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future L. BARNISH1, RGN, ONC CERT, BSC (HONS), MSC • 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? Slide One *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

2. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) Example 1. A model for the consultation phase Draft ‘standards’ reviewed by Lead Cancer Nurse Slide Two 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 All staff comments were included when comments to the draft were sent to the Department of Health Standards become familiar to clinical staff Difficulties in meeting standards noticed early Standards were used during usual development of services *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

3. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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. Slide Three *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

4. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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. Slide Four *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

5. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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 Slide Five *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

6. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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? Slide Six *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

7. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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? Slide Seven *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

8. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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 Slide Eight *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

9. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) Is your vision driven by what you believe your patients should receive or is it restricted by what you believe to be possible? Slide Nine *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

10. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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? Slide Ten *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

11. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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. Slide Eleven *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

12. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) • 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 Slide Twelve *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc

13. FACET - European Journal of Cancer Care June 2002 Policies and Practice: developing a vision for the future (continued) Literature and other information sources Department of Health (1996-2001) ClinicalOutcomes 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 Slide Thirteen *Click on “View”; “Notes Page” for explanatory notes slides available at: www.blackwell-science.com/ecc