Health: Cancer

Baroness Emerton Excerpts

Thursday 11th November 2010 Lords Chamber

[Baroness Emerton]

I, too, congratulate my noble friend Lady Finlay on raising this debate and on so eruditely setting out the complexity of the integrated care plans for patients suffering from cancer. It is important to ensure a seamless service to patients who, together with their families, as the noble Baroness, Lady Pitkeathley, said, are filled with trepidation by the word cancer.

I shall highlight the importance of specialist cancer nurses. A recent report from the Royal College of Nursing entitled Changing lives, saving money states that evidence to date demonstrates that specialist nurses play a vital part in a range of ways in assisting patients through a complex pathway by delivering high-quality specialist care. They frequently help avoid unnecessary admission or readmission to hospital. They reduce post-operative hospital stays, thereby freeing up consultant appointments for other patients. They provide treatment at the point of need, so reducing patient drop-out rates. They assist in the education of health and social care professionals, provide direct specialist advice to patients’ families and ensure rapid referral if necessary to other medical treatment, so reducing waiting times.

A survey conducted by health advocacy groups nationally demonstrated that patients consistently rate the specialist nurse higher than any other healthcare professional in understanding patients’ needs. Specialist nurses provide a lifeline to many patients and families, the patient having gone through incredible physical and mental upheaval. While the good news is that survival rates have increased, patients will continue to need to access expert care and support. It is also proven that specialist nurses’ expertise keeps patients safe and exposes them to less risk.

The noble Viscount, Lord Bridgeman, mentioned the recent announcement in the comprehensive spending review that the right to one-to-one nursing care for patients, having been promised, is to be rescinded. I have heard that further consideration is being given to this decision. Will the Minister confirm that? Evidence points to unequal access to cancer specialist nurses across the country, and it is also reported that one-third of them are supported by the Macmillan Cancer Support.

Commissioners need to address as a priority whether there are enough specialist nurses to meet patients’ needs. Local management needs to ensure that the skills and expertise of specialist nurses are not deployed to fill gaps in ward or department staffing, as this is a waste not only for patients but also in economic terms. Another study shows that if provision could be made for administrative support for specialist nurses it would save 6.6 hours per week per specialist nurse. Specialist nurses are highly qualified and educated mostly to masters level and are too precious to be deviated from their dedicated programmes which would result in a loss of care to patients.

It is a known fact that patients prefer to be cared for at home where at all possible. Obviously early diagnosis is vital in order that treatment starts immediately; the majority of patients starting with surgery. With the least invasive approach, the length of stay in hospital is reduced and then the requirement is for expertise in the home by specialist nurses and experienced nurses in post-operative care. The Marie Curie and Macmillan nurses provide a very good service.

The noble Viscount, Lord Bridgeman, also spoke about the Healthcare at Home service as a leading provider of home care to cancer patients. The service has developed over the past 15 years and continues to grow, and now includes the administration of highly cytotoxic chemotherapy regimes to patients at home by highly skilled experienced nurses. The service delivers 24/7, 365 days a year and has improved efficiency and safety by investing in bespoke industrial leading infrastructure and new technology. It continues to develop outcome measures.

The service works in partnership with the Department of Health. The important thing is that the patients who have received Healthcare at Home are still maintained by their clinical teams, who retain ultimate responsibility for patients and with whom Healthcare at Home maintains close contact. Evidence so far shows improved outcomes, as has already been mentioned by Dr Foster Intelligence, and that a considerable amount of money has been saved.

Innovations as described by Healthcare at Home certainly cannot be ignored in taking forward the ways to increase the quality and quantity of life for cancer sufferers. I mentioned the good news of improved survival rates and much work is being developed in Living with Cancer. Emphasis on this work needs to continue with education to patients and the public as mentioned by the noble Lord, Lord Clement-Jones. This is an important point for all patients, their families and their friends. Healthcare professionals are taken up with the actual delivery of care, but there needs to be healthcare provision by experts in setting out the information that is so necessary for the understanding of the general public as well as patients and their friends.