One of those categories is for the Ingrid Fuchs Cancer Nursing Award which seeks to recognise those who have improved the quality of care that patients with cancer receive during diagnosis, treatment and beyond through innovations that are either nurse led or where nurses played a significant leadership role in steering the initiative as part of a multidisciplinary team.
Newcastle’s team has been shortlisted for their commitment to providing their patients with the highest standards of care, driving a bold and innovative approach to introducing a Seven Day Systemic Anti Cancer Therapies (SACT) Service.
Since introducing this courageous new, greatly inclusive approach they have witnessed:
- a noticeable reduction in waiting times for patients to commence SACT from 4 weeks to an average of 2 weeks
- increasingly positive feedback from patients on the flexibility of appointments
- no day case patients being treated on inpatient wards as additional patients due to lack of capacity in the day unit
- positive feedback from inpatient nursing colleagues on their experience as a result
- reduction in staff turnover and improved morale and retention
David McClinton, Matron at the Northern Centre for Cancer Care (NCCC) says, “This is a remarkable achievement which has benefits for both patients and staff.
“We offer a different dimension to how we deliver chemotherapy and supportive therapies which has led to a significant decrease in our waiting times to initiate treatment. Feedback from patients has been extremely positive.”
The driver for change
The delivery of cancer care constantly evolves with the introduction of new forms of treatment to improve patient outcomes which is exciting and positive news. Yet, cancer remains a devastating disease and patients need both skilled clinical care and intensive support while receiving treatment and – increasingly – in managing the long-term effects of the disease after treatment.
Nurses are the linchpin of the cancer care team, managing complex new treatment regimens, coordinating care and ensuring patients receive timely diagnosis and treatment.
As the volume of patients receiving the latest systemic anti-cancer therapies (SACT) or in need of post treatment care has increased at NCCC, capacity to meet their needs to highest standards had become simply unmanageable with a Monday to Friday service.
Increasing pressures on staff due to delays in starting treatments, and more patients than staff, was resulting in the potential for compromised patient care alongside inevitable staff burnout and increased turnover rate.
The team decided it was time the way they delivered the service evolved too and proposed expanding to a seven day service including bank holidays.
Two stage approach
Senior Sister Ashleigh Hughes explains, “We knew this would be a major endeavour and so consulted with our staff from the outset discussing how we could implement the new service, looking at all potential barriers and exploring solutions.
“Once everyone was clear on our intended approach, we took a two step approach: firstly we recruited additional new nurses who we trained in the delivery of all aspects of cancer services including SACT.
“Secondly we opened the unit over a staggered time frame, initially opening shorter hours with limited workload and gradually expanding to the full seven day service from 8:00am to 7:00pm.
“Such a big change to working arrangements for staff, and for patents to attend for their treatment on a weekend or bank holiday, as well as external factors such as organising patient transport support, did present us with challenges.
“However, since the introduction of the seven day service we have achieved a higher level of patient satisfaction than ever before because we can offer a much wider availability of appointments, particularly for those who work or have children.”
Ashleigh adds, “Patients have told us that they feel they have more time with their nurse which makes them feel safer and better attended to. In addition, we have seen a great improvement in staff morale and a reduction in staff turnover with staff choosing to stay on our unit.
In fact, we currently have a 0% staff vacancy rate in the department and since our latest recruitment we now have five nurses waiting for roles to become available on the unit – a fantastic result.
Ashleigh Hughes Senior Sister for Ward 36 at the Northern Centre for Cancer Care
The inspiration for service improvement
When asked what inspired her to introduce such a major service improvement, Ashleigh says, “The inspiration came from a lengthy career in cancer services which has always seen the day unit limited in capacity, unfortunately resulting in patients being treated on inpatient wards giving those staff additional work.
“I saw how the effects of this could compromise patient safety and cause unnecessary distress to patients who were at risk of being deferred, delayed or moved on their day of treatment.
“Yet I also saw the potential for improvement and relished the opportunity to implement the seven day service ensuring its effectiveness so that the wider directorate could benefit. As a result, all day case patients are now treated on the day unit and not on wards as additional patients, and our waiting times for patients to commence SACT has noticeably reduced from 4 weeks to an average of 2 weeks.”
Ashleigh added, “I also implemented a new emergency triage phone as part of the seven day plan, reducing the pressure on the inpatient areas where staff previously managed this alert helpline out of hours.”
The Northern Centre for Cancer Care is the only unit in the North East open permanently seven days per week with staff working later into the evening on the largest SACT day unit, in a regional centre with the capability to treat all cancer types that our peripheral units attached to other hospitals are unable to treat – such as complex haematology and bone marrow transplant, radiotherapy regimes and sarcoma regimes.
Additionally NCCC is the only unit in the region that opens as standard on bank holidays and work core hours on these days. To date the unit has closed for the past two years on Christmas Day, Boxing Day and New Years Day only. However year on year this is reviewed and if there is a clinical need the team would open on Boxing Day and New Years Day.
Sharing expertise
Ashleigh is frequently contacted from peripheral units in the area for guidance, support and sharing of knowledge as to how the team implemented the 7 day service.
She also regularly links in with UKONS where generic questions are posted to members asking for specific advice and she has been in contact about how successful Newcastle’s service expansion has been and how others could implement a similar service.
Ashleigh says: “It has been incredibly satisfying witnessing our day unit’s working week transform from 5 to 7 days and it’s so rewarding to consistently receive fantastic feedback from our patients, especially those who prefer to come in at the weekend so as not to affect their work life or child care – all because we can offer much more flexibility according to their personal circumstances.”
“It’s also been hugely satisfying to be able to improve staff morale and see staff turnover vastly reduced. As a manager it’s great to see very little vacancies and staff wanting to come to work here from out of the area.”
Nursing Times Awards 2023
These awards bring together the nursing community to shine a light on the brightest talent in the profession and recognise those of you making nursing innovative, patient-focused and inclusive.
There are 23 categories covering a wide range of nursing specialities, all open to entries from individuals and teams, or nominations from those who wish to highlight a nurse or team who they believe deserves recognition.
The awards ceremony will take place in London on Wednesday 25 October 2023 – we wish all of our Finalists the very best of luck.
