Community nursing
4.15 Many patients with advanced cancer would prefer to die at home, but in practice only about one quarter of cancer patients do so.
Too often a combination of a lack of support in the home, ageing carers who cannot continue with the burden of care and inadequate community services combine to prevent this wish being achieved. Details of new actions to improve specialist palliative care services in the community are set out in Chapter 7.
4.16 The government will invest £2 million to provide additional training and support in the general principles and practice of palliative care for district nurses and other community based nurses. The National Cancer Director will work with Marie Curie Cancer Care and Macmillan Cancer Relief to develop and evaluate these new training initiatives, which will raise the quality of care in the community benefiting a wide range of patients with advanced cancer and other incurable illnesses.
Marie Curie Nursing Service
'They (Marie Curie Nurses) are often the thing that makes 50% of the day when nobody is around manageable.'
District nurse
'Had I not had that help (from Marie Curie Nurses), I think we would have just been overwhelmed by the problems of 24 hour care.'
Carer of a cancer patient
4.17 Macmillan Cancer Relief and other key players are currently reviewing the provision of out of hours palliative care services. The Department of Health will build on this work with Macmillan Cancer Relief, Marie Curie Cancer Care and the National Council for Hospice and Specialist Palliative Care Services to develop guidelines and models of good practice.
St Benedict's Hospice
St Benedicts' Hospice in Sunderland is a palliative care beacon which provides support to all patients within the health authority with advanced progressive disease who wish to remain at home. The service is funded by Sunderland Health Authority. Two registered nurses are on duty every night providing pain management, symptom control and support to patients and carers. Quality improvements include planned visits undertaken within 30 minutes of appointment times and crisis visits within 45 minutes. The service has facilitated better links with local GPs.
4.18 The importance of primary care in cancer services and the need for effective links between sectors was highlighted in the Calman/ Hine Report. The actions set out in this Cancer Plan will ensure the necessary developments become a reality.
Action and Milestones
2000
- Primary Care Groups and Trusts represented on cancer network management groups
2001
- Electronic referral guidelines pilots begin
- Primary Care Groups and Trusts appoint cancer lead clinicians
- Review of out of hours palliative care services completed
- New support and training in palliative care for community nurses
2003
- New primary care clinical datasets
