CANCER IMPROVEMENT SERVICES

Opening times

Monday- Friday 08:30hrs - 16:30hrs

Contact

My name is Elizabeth McGowan, the CSIM (cancer service improvement manager) here at Noble’s Hospital. Part of the role is involvement in coordinating and facilitating the development of The Manx National Cancer Plan for the Isle of Man, launched in (2012). As part of this role in the Hospital, I have been fortunate to be involved in many new developments such as setting up and becoming system administrator for the Somerset Cancer Registry (SCR) to monitor and track patients through their cancer journey to ensure that they are meeting the Cancer Waiting Times Targets - The SCR will enable me to track our own cancer patients receiving on going treatment in cancer specialist tertiary centres in England.

Another crucial part of the role is the responsibility for ensuring all cancer patients meet the cancer targets, especially patients on transfer back to the Isle of Man. This will reduce risk / anxiety for the patient and family. Evidence suggests that tracking of patients allows a more streamlined service.

The Isle of Man is able to compare data and standards with other European and U.K services, thus allowing the Isle of Man Health Service to become more objective in benchmarking, to develop high standards in cancer care and treatment. The effectiveness of the Cancer Register will be measured by the Cancer Services Improvement Manager by conducting a tangible quantitative approach, measuring outcomes against the Cancer Waiting Times / Nice Guidelines.

The key role of the Cancer Services Improvement (CSIM) is to improve the experience and outcome of care for all patients suspected or diagnosed cancer by reinforcing delivery of a high quality standard of cancer care.

What the initiative is about?

The initiative is really about developing and redesigning the overall cancer service to prioritise the experience and outcomes for cancer patients. Our team prioritises each patient’s care and treatment efficiently and effectively, through procedure planning, so the entire process is less stressful for the patient. The Cancer plan also encompasses facilitation of cancer developments across the Isle of Man the cancer waiting times targets facilitated by CSIM (Fig1.) Is reinforced as a strong linchpin thus ensuring patients are seen within the recommended waiting times targets as set out in the proposed Isle of Man Cancer Strategy.

Fig1. Isle of Man Cancer Waiting Times Targets

Why is it important?

Having been a ward sister and a part of the front line service for 23 years, I feel it is crucial to put patients at the forefront of care to develop early detection of cancer through early referral and screening, diagnosis. This will indirectly reduce morbidity and mortality amongst our island residents. The current system enables us to collect reliable data to use for research purposes and benchmark against best standards, comparable with other trusts and hospitals across Europe. It is also aiding to reduce unnecessary delays and provide personalised consistent care. Facilitate provision of care in the best place by the best team. The Cancer Services Improvement Manager is a key champion or voice for the Cancer Patient and his/ her significant others. The role is also essential in that evidence based practice is at the heart of cancer care on the Isle of Man.

How it has contributed to patient safety & improved quality care?

A key component of the (CSIM) role contributes to reduction in significant delays in care and treatment. Suspected cancer patients are “fast tracked” through the system, therefore ensuring immediate intervention / treatment of the patient. This commences from referral from G.P to consultants so patients are assessed in clinic within 14 days of referral. (FIG, 1.) This systematic approach may infuse confidence in the patient Diagnostic tests are also prioritised. This new structure monitors the process to minimise all risks associated with the delivery of patient care with particular reference to Clinical Risk Management and any relevant Health and Safety legislation. The CSIM will act as a key role model and communicator between all disciplines involved in the patient’s pathway. The Cancer Services Improvement Manager will influence significant change and developments for cancer care across the Isle of Man. This is an exciting and inherently positive development within the health services and patients alike across the Isle of Man.

As the service is put into practise throughout the hospital I have links with tertiary cancer manager throughout the hospital and am also closely involved with these areas:

Palliative Care Clinical Nurse Specialists

Tel: +44 (0) 1624 647475

Opening hours: Monday – Friday 09.00am-17.00pm

The Palliative Care Clinical Nurse Specialist Team is based at Hospice Isle of Man and consists of six dedicated senior nurses. We visit people in their own home, care homes and also in Noble’s and Ramsey District Cottage Hospital’s. We work closely with your doctors and other health professionals in the community and in the hospitals.

Our aim is to improve the quality of life for people affected by cancer and other life limiting illnesses by meeting their physical, emotional, social and spiritual needs. This applies primarily to patients but also includes their families and carers.

Our role is to provide advice on pain management and other symptoms; such as sickness, constipation, reduced appetite and tiredness. We also provide advice, information, education and support to patients, families, carers and other professionals.

The team mirrors the approach taken by Hospice Isle of Man in being multi-disciplinary (we can seek help from dieticians, physiotherapists, occupational therapists, social workers and more) with the underlying principle being; to respect and respond to the individual wishes of patients, families and carers.

Breast Care nursing Services

Tel: +44 (0) 1624 650194 or Hospital switchboard: +44 (0) 1624 650000 and ask for pager 102 or 131

Opening hours: Monday - Friday 08.00am – 17.00pm

Contacting us:

For a large proportion of our time we are in clinics, on the ward or out of the hospital making visits so we have an answer phone which is on 24hours a day. If you leave a message we will get back to you normally by the next working day. Please be aware we are not an emergency service.

Here at Noble’s Hospital we have two Breast Care Specialist Nurses:

• Dianne Karran
• Sue Ardern

Both qualified registered nurses with a specialist qualification in breast care and are experienced in the care of breast cancer and other related breast conditions.

Urology Nurse Specialist Service at Noble’s Hospital

The Urology Nurse Specialist Service at Nobles Hospital consists of two Specialist Nurses

• Marie Maguire-Kerwick
• Jackie Nickson

We are senior registered nurses who have received additional specialist training and education in order to help people who experience problems with their urinary system. This includes cancers or suspected cancers of the prostate, kidney, bladder, penis and testicles. We also help people who are experiencing urinary symptoms which are non cancer related.

We are available to provide support, information and advice to patients and their families (with patient consent). Once given the diagnosis of cancer it is normal to experience a wide range of emotions, these can be over whelming and unsettling. Our role is to offer you further support and information on any of the following:

• Your diagnosis
• Your symptoms
• Any aspect of your investigation or treatment
• How your diagnosis may effect you or your family
• Resuming your normal activities after treatment
• Information about support groups and where to access further information

You may contact us any stage during your investigations, treatment or recovery. If you are having urology treatment of island you may also contact us to access our service. Any information or support we provide will be given in confidence and can be given either in clinic, on the ward, by phone, e-mail or post.

Contacting us:

Your Doctor or Nurse can refer you – or if you prefer you may contact us directly. Our telephone number is – 650235 or contact us via the hospital switchboard on 650000 and ask for pager 241.

Alternately you can e-mail us with any question you may have at – marie.maguire-kerwick@gov.im or jackie.nickson@gov.im

For a large proportion of our time we are in clinics, therefore we have an answer machine. If you leave a message we will get back to you normally by the next working day. Please be aware we are not an emergency service.

We are available Monday Tuesday Thursday 9am – 5.00pm, Wednesday 9-1 and Friday 1-5

The Urology Nurse Specialist Service is reviewed at regular intervals and is amended as necessary to ensure the service remains beneficial to you. Your views on this service are always welcomed and valued.

Oncology Nursing Service

Nobles Oncology Nursing Service consists of a full-time Macmillan Clinical Nurse Specialist Oncology & Rare Tumours (CNS) and three part-time Chemotherapy Sisters. The service is led and managed by the CNS. The teams offers a variety of services but its main purpose is to provide a nurse-led chemotherapy service to Island residents.

Macmillan CNS

Many patients are naturally very anxious and frightened when they hear they have to embark on a course of chemotherapy as part of their cancer treatment. The CNS will be involved and able to provide information and support about your cancer and the treatment you may need often right from the point of diagnosis. This support also extends to family members and carers, however no information about your condition will be given or discussed with anyone without your consent.

Expert advice and help in managing chemotherapy side effects is available. The CNS also spends time in the Oncology Day Care Unit administering chemotherapy and working with the other members of the team.

Chemotherapy Sisters

Chemotherapy is administered Monday - Friday in the Oncology Day Care Unit (ward 7A) by three very experienced, highly skilled nurses. Many different kinds of cancer are treated with chemotherapy and alongside the CNS, they are also able to provide specialist advice and support to help manage any side effects you may experience. They are responsible for organising your appointments for treatment and will advise on when to have blood tests if necessary. They will also interpret blood results as part of a general health assessment when you attend for treatment. This is to ensure that you are fit enough to receive your chemotherapy. Should you have other problems not necessarily connected to the chemotherapy, they can make a referral to another expert if appropriate, for example, dietician, social worker for financial advice or counselling services.

The Oncology Nursing Service is available Monday – Friday

Oncology Day Care Suite – 650063

Macmillan CNS – 650162 (answerphone available)

Bleep – 650000 and ask for bleep 149

Please remember that the service is heavily patient focussed and someone may not be available to take your call immediately. If your call is not urgent, leave a message and you will receive a response within 24 hours. If you are unwell and unable to speak to the chemotherapy nurses you should contact your GP or attend Accident & Emergency