Guidance on Cancer Services Improving Supportive and Palliative Care for Adults with Cancer The Manual National Institute for Clinical Excellence NHS Improving Supportive and Palliative Care for Adults with Cancer Cancer service guidance supports the implementation of The NHS Cancer Plan for England, 1 and the NHS Plan for Wales Improving Health in Wales. 2 The service guidance programme was initiated in 1995 to follow on from the Calman-Hine Report, A Policy Framework for Commissioning Cancer Services. 3 The focus of the cancer service guidance is to guide the commissioning of services and is therefore different from clinical practice guidelines. Health services in England and Wales have organisational arrangements in place for securing improvements in cancer services and those responsible for their operation should take this guidance into account when planning, commissioning and organising services for cancer patients. The recommendations in the guidance concentrate on aspects of services that are likely to have significant impact on health outcomes. Both the objectives and resource implications of implementing the recommendations are considered. This guidance can be used to identify gaps in local provision and to check the appropriateness of existing services. References 1. Department of Health (2001) The NHS Cancer Plan . Available from: www .doh.gov.uk/cancer/cancerplan.htm 2. National Assembly for Wales (2001) Improving Health in Wales: A Plan for the NHS and its Partners. Available from: www.wales.gov.uk/healthplanonline/health_plan/content/nhsplan-e.pdf 3. A Policy Framework for Commissioning Cancer Services : A Report by the Expert Advisory Group on Cancer to the Chief Medical Officers of England and Wales (1995). Available from: www .doh.gov.uk/cancer/pdfs/calman-hine.pdf National Institute for Clinical Excellence MidCity Place 71 High Holborn London WC1V 6NA Web: www .nice.org.uk ISBN: 1-84257-579-1 Copies of this document can be obtained from the NHS Response Line by telephoning 0870 1555455 and quoting reference N0474. Bilingual information for the public has been published, reference N0476, and a CD with all documentation including the research evidence on which the guidance is based is also available, reference N0475. Published by the National Institute for Clinical Excellence March 2004 © National Institute for Clinical Excellence March 2004. All rights reserved. This material may be freely reproduced for educational and not-for-profit purposes within the NHS. No reproduction by or for commercial organisations is permitted without the express written permission of the Institute. This guidance is written in the following context: This guidance is a part of the Institute’s inherited work programme. It was commissioned by the Department of Health before the Institute was formed in April 1999. The developers have worked with the Institute to ensure that the guidance has been subjected to validation and consultation with stakeholders. The recommendations are based on the research evidence that addresses clinical effectiveness and service delivery. While cost impact has been calculated for the main recommendations, formal cost-effectiveness studies have not been performed. Guidance on Cancer Services Improving Supportive and Palliative Care for Adults with Cancer The Manual [...]... national voluntary organisations • enhanced provision of supportive and palliative care services to meet current unmet needs and to reduce inequalities in service provision and access • improved training for health and social care staff in providing supportive and palliative care • better organisation, co-ordination and integration across Cancer Networks C Definitions of supportive and palliative care. .. communication in health care and increase dissemination of health care information21 Scope I29 B 24 This Guidance is intended to complement the site-specific guidance manuals in the Improving Outcomes series While the site-specific manuals focus on services for patients with particular cancers, this Guidance reflects the common components of supportive and palliative care for all people with cancer and their... responsibility with professionals for their treatment and care, drawing on their own experience F Implementation of recommendations I48 I49 Although the Guidance concerns supportive and palliative care services commissioned and funded by the NHS, voluntary sector organisations have long made – and will continue to make – a considerable contribution They play an important role in service planning and. .. Living with Cancer initiative • Cancer Services Collaborative initiatives focused on improving patients’ care experience and the community palliative care Gold Standards Framework Programme15, 16 • the development of draft National Standards for Specialist Palliative Care for Cancer Services • a Department of Health-funded initiative for education and support for district and community nurses in every Cancer. .. delivering and evaluating services • Information • Face-to-face communication • Psychological support services • Social support services • Spiritual support services • General palliative care services, including care of dying patients • Specialist palliative care services • Rehabilitation services • Complementary therapy services • Services for families and carers, including bereavement care • Research in supportive. .. and palliative care I7 The understanding of supportive and palliative care on which this Guidance is based leans heavily on work by the National Council for Hospice and Specialist Palliative Care Services (NCHSPCS) 17 Supportive care I8 The working definition of supportive care suggested by NCHSPCS is care that: ‘…helps the patient and their family to cope with cancer and treatment of it – from pre-diagnosis,... recommendations on communication skills for health care professionals In addition, it draws on the Commission for Health Improvement/Audit Commission report on cancer services2 and the National Cancer Patient Survey3 in England, both of which clearly identify issues that require urgent review and action I26 Shifting the Balance of Power: the next steps12 and Improving Health in Wales: structural change for. .. patients’ problems, concerns and needs; in information giving; and in communication skills Additional specialist staff will be needed in roles related to information delivery, psychological support, rehabilitation, palliative care and support for families and carers Ⅲ Key Recommendation 19: Cancer Networks should work closely with Workforce Development Confederations (the Workforce Development Steering... strategy for palliative care services in Wales17 • the All-Wales Minimum Standards for specialist palliative care1 8B • a Cancer Information Framework and the establishment of a Cancer Information Framework Project Board to oversee its implementation19 • the User and Carer Involvement Project, supported by Macmillan Cancer Relief and led by the South West Wales Cancer Network on behalf of the three Cancer. .. issues Importantly, both palliative and supportive care are often provided by patients’ family and other carers, and not exclusively by professionals Supportive and palliative care services I18 Supportive and palliative care services should be delivered, as much as possible, where patients and carers want them – in the community (including a patient’s own home, but also care homes and community hospitals), . Guidance on Cancer Services Improving Supportive and Palliative Care for Adults with Cancer The Manual National Institute for Clinical Excellence NHS Improving Supportive and Palliative Care. Definitions of supportive and palliative care 17 - Supportive care 18 - Palliative care 20 - Supportive and palliative care services 21 D. Context, scope and organisation of the Guidance 22 - Context. Care for Adults with Cancer Cancer service guidance supports the implementation of The NHS Cancer Plan for England, 1 and the NHS Plan for Wales Improving Health in Wales. 2 The service guidance