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Improving the survivorship pathway: Holistic Needs Assessment (HNA) addressing the concerns of people living with and beyond cancer

Natalie Doyle Nurse Consultant, Living With & Beyond Cancer at The Royal Marsden NHS Foundation Trust, and Survivorship Pathway Group Chair, The London Cancer Alliance spoke at today’s Cancer Survivorship conference on: 

•Identifying the concerns of people living with and beyond cancer 
•Practical implementation of Holistic Needs Assessment (HNA)
•The London Cancer Alliance (LCA) experience

Natalie began her presentation by giving the background to the introduction of Holistic Needs Assessment (HNA):
–    Importance of holistic understanding of patients (NICE Improving Supportive and Palliative Care for Adults with Cancer, 2004)
–    Cancer Reform Strategy (2007) 
–    All Party Parliamentary Group report on inequalities in cancer (2009)
–    Improving Outcomes Strategy for Cancer (2011)
–    Guidance on holistic assessment needs of people with cancer published (2007)
–    Holistic Needs Assessment for people with cancer: A practical guide for healthcare professionals (NCAT, 2011) 
–    National Cancer Survivorship Initiative Vision (2010)
–    Model of Care (London Health Programmes, 2010)
–    Living with and beyond Cancer; Taking action to improve outcomes (2013)

Natalie explained that by creating a partnership with the individual, the focus of care remains on supporting self-management after a cancer diagnosis. 

Natalie said; “one of the key components of the recovery package is the holistic needs assessment (HNA) which is carried out at two key points in the care pathway – around diagnosis and at the end of treatment - and also, at any other point on the pathway  if the individual’s health and social needs change. This ensures that care is proactive and support services are planned and accessed appropriately. The patient receives a copy of the care plan to enable self management; further copies are stored in the medical records and can be sent to the GP.

In London we have developed a pan London tool which comprises a distress thermometer and a concerns checklist. The assessment identifies the individual needs of the person affected by cancer and contributes to a consultation. The consultation can then be focused on the needs identified, a care plan can be developed and appropriate referrals can be made to services that support patients, such as lymphoedema management, psychological support and services dealing with the consequences of treatment.  

The assessment can be used to inform the treatment summary.”

Natalie's full presentation is available for download at the end of this page.

LCA survivorship metrics, guidelines and tools

The Recovery Package

Cancer Nursing Partnership

Macmillan Cancer Care Ten top Tips booklet

The United Kingdom Oncology Nursing Society (UKONS)

Natalie Doyle MSc RGN – Nurse Consultant for Living With & Beyond Cancer, The Royal Marsden NHS Foundation Trust

Natalie has a long and established nursing career in the care of people following a diagnosis of cancer. She leads on the practical implementation of Holistic Needs Assessment and health and wellbeing initiatives across the Royal Marsden and South and West London, as chair of the London Cancer Alliance (LCA) Survivorship Pathway Group. Natalie has been involved in various aspects of the National Cancer Survivorship Initiative (NCSI) in England since its inception in 2008, including being a member of Macmillan’s Consequences of Cancer Treatment Collaborative (CCaT). 

Currently Past President of UKONS (United Kingdom Oncology Nursing Society), Natalie is a founder member of the Living With & Beyond Cancer Forum and co-chairs the Cancer Nursing Partnership (CNP), a collaboration of national nursing organisations representing over 22,000 nurses, currently working to implement delivery of the survivorship Recovery Package. 

Following on from her concept analysis of cancer survivorship, Natalie is studying the experience of men surviving five years after a diagnosis of prostate cancer for a Professional Doctorate in Nursing.

Future events of interest:

Patient Experience Insight: Demonstrating Responsiveness to Feedback
Wednesday 4 February 
Colmore Gate, Birmingham

Download: natalie-doyle-hallam-december-2014_872.pdf

5 December 2014


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