Inspirational Story

How did you get into your role,  and what motivated you to pursue this speciality?

Paediatric cancer services

As an ODP I accidently fell into a role in paediatric cancer services by offering to provide cover for anaesthetic lists outside of the operating theatre environment, in a ward and day hospital setting for paediatric lumbar puncture & bone marrow procedures, this led to providing cover in Radiology in the CT, MRI and interventional radiology services along with paediatric radiotherapy lists and surgery lists in.

I learned about central lines, how to access and flush them and I took this knowledge back to the theatre environment for training and learning opportunities, this peaked my interest in central lines and their care which I used to great effect later in my career.

I built relationships with patients and families as the haematology children attended for treatment for a number of years and the surgical patients I met on diagnosis in the CT/MRI scanners, I saw again for lines inserting in theatres for chemotherapy and then again for surgery.

It’s quite unusual for ODPs to build relationships with patients and families along a complex patient pathway but this is the part of my clinical role I enjoyed most. I loved the multi-disciplinary team working and the different specialty environments, I continued to learn and soak up information like a sponge.

Next step: Management

I worked in paediatric cancer for 22 years and moved into a management role in adult services to clinically manage Brachytherapy theatres which was exclusively adult cancer services. We undertook gynaecology and prostate Brachytherapy as day case procedures, provided a high demand central and PICC line service to Oncology services (mainly haematology) and to the specialist Sickle Cell services and a palliative care pain list within the theatre environment. Having a good understanding of patient pathways and national targets steered service improvement work in this environment.

Again I had a very patient facing role and as a team we had a common goal of giving each patient the very best experience they could have, this could be challenging at times. As a team what we didn’t know or understand when asked, we found out so we were armed with full knowledge of support services for the patients we accommodated for multiple appointments and treatments with us

So thinking about this, for me it’s always been about the patient/professional relationship and the focus on the patient/family experience during their treatment pathway.

Could you provide a brief description of your day-to-day work, including the speciality you focus on?

Personalised Care Programme

I work within the Personalised Care Programme; in the Living With and Beyond Cancer Team in a Cancer Alliance.

We have NHSE directives for the Personalised Care programme which include Personalised Care Interventions such as Holistic Needs Assessments (HNA) and Personalised Care and Support Planning (PCSP) throughout the patient treatment and surveillance pathway into life beyond cancer treatment. Cancer Care Reviews (CCR) are carried out in Primary/Community Care at scheduled intervals in the patient pathway, all these interventions are opportunities for supportive conversations with the patient, to find out their concerns and worries so we can signpost and refer to supportive Health and Wellbeing services

Once treatment is finished and the patient is on a planned surveillance pathway we also have NHSE directives to work towards Personalised Stratified Follow-Up (PSFU) and Supported Self-Management (SSM) in tumour sites, four are mandated by NHSE currently, this is supported by digital remote monitoring systems (DRMS), these regionally standardised pathways allow the patient to attend scheduled surveillance tests and as is their choice they can receive their test results remotely or attend a regular face to face or telephone appointment, this choice of surveillance is patient led

All the above NHSE directives are reportable to NHSE either monthly figures uploaded by each Trust to COSD and the national cancer dashboard or reported quarterly within a direct report from the Cancer Alliance, so I keep an eye on this data as well to ensure uploads and quarterly reporting is correct for the regional Trusts

Current projects

My current work projects are quite extensive so I only have two projects on the go with some local support into the Personalised Care Interventions above as and when required

1) Prehabilitation and Rehabilitation for cancer patients undergoing treatment, this incorporates dietetics advice, physio assessment, physical exercise assessments and increasing physical exercise and nutrition to optimise patients for their treatment pathway. I am working with the acute Trust, local commissioners, council and public health leads to implement this service with significant charitable funding, this will tie into the council and public health heathy communities programme in the locality.

2) Community Model of Support, this is a large and complex, collaborative project with Trust, Commissioners, Community Programme Leads, Community Services, Local Council and Public Health services, VCSE’s, PCN’s, Councils for Voluntary Services, Social and Community prescribers to ensure that patients with non-clinical concerns and support needs have expert local community based support services to link with to provide care closer to home, this leaves time for the Acute/Secondary Care staff to concentrate on the clinical needs of the more complex patients

Both these projects are collaborative across many disciplines and professionals, so I have a very sociable, varied and interesting roll, no two days are the same except for working towards improving patient experience from diagnosis to life beyond cancer.

What are the positives of your role, and what challenges do you face?

Positives

I have had the most rewarding career practising as an ODP (originally an ODA, I am that old) in cancer services, it has led me to the service improvement role I have today within the Cancer Alliance. The knowledge, clinical skills and patient facing practice skills I have from my clinical career support me in my service improvement work today because I understand the pathways, the processes, the clinical experts involved in providing the best outcomes for patients and having always had a patient facing role providing hands on care, so my focus now is implementing quality improvements for patients and occasionally this sometimes improves the roles of the clinical staff as well

Challenges

The challenges I face today are funding and staffing resources within all the varied teams and services I work alongside to effect positive patient experiences within the service improvement projects I am involved in, these challenges are throughout Primary, Acute/Secondary, Commissioning, Council, Public Health and Community services

Do you collaborate with other professionals, particularly AHPs, in your work?

Clinical Role

As most of my clinical career has had me working out of a conventional operating theatre environment, I have always worked alongside multi-disciplinary professional teams and collaborated to ensure the best patient experience we could provide, mindful of the psychological and physical safety of staff in sometimes difficult and challenging circumstances.

In Brachytherapy I worked within a much larger team of expert professionals who come together to work collaboratively for the best outcomes for patients undergoing different tumour site treatment procedures, the knowledge and expertise of which used to leave me in awe of them as individual clinicians and as an expert clinical team.

Service Improvement Role

I now work with AHP’s in my service improvement role, I work with physiotherapists, occupational therapists, speech and language therapists all of them play a huge part in patient experience along the treatment pathways, focusing on patients throughout treatment giving advice, motivation and support to each individual patient as they need it in their different pathway stages