People’s experience of cancer services and pathways in Doncaster

Healthwatch Doncaster commenced this engagement - which involved gathering the views of local people in relation to their cancer journeys - in May 2020 with an end date of October 2020. Healthwatch were keen to gather extensive narrative to understand:

1. How patients’ journeys were affected by the Covid-19 pandemic
2. Patients’ experience of receiving consultations digitally or via phone
3. What went well?
4. What did not go well?

Patients were recruited with the support of specialist nurse practitioners and local groups and they could choose to use either phone or the digital platform Zoom to complete the interview, or, for those uncomfortable with both, they could submit their experience as a written story. The resulting fourteen stories were led by the respondents themselves with no focus on specific subjects or topics.

Findings: The report covers five sections with each of them split into themes.

1. The start of the journey
   1. Recognition of symptoms and instigating advice
   2. Receiving the diagnosis and treatment
   3. GP Help and support

2. Treatment and ongoing care
   1. Accessing information and services
   2. Fighting your own corner
   3. Effective communication and relationship building
   4. Fear of the unknown
   5. In Patient services
   6. Day patient services and other services of support
   7. Community and Home care services
3. Impact on emotional wellbeing
   1. Impact on the patient
   2. Impact on family and friends
   3. Psychological safety
4. Impact of Covid-19
   1. Attending hospital
   2. Impact on restriction of the support networks
   3. Digital care versus face-to-face care
5. Timing: Participants regularly mentioned timing. Spontaneous accounts of their journeys included specific points where they felt timing was significant and had either a positive or negative impact on their experience.
6. Miscellaneous
   1. Firefly Cancer Awareness and Support
   2. Yorkshire Ambulance Service
   3. Discharge planning
   4. Respect forms and DNACPRs
   5. Hair loss and wig provision
   6. Use of the word palliative
   7. Screening programmes

Recommendations

The evidence indicates that the journey and experience of people diagnosed with and receiving treatment for cancer would be enhanced if person centred care and care planning was improved.

1: Enhancing communication, involving patients and use of Care Plans. Throughout the report lived experiences related to communication were shared and discussed.

2: Continued offer of digital consultations. All the patients under review were offered digital consultations and were happy with them

3: More effective planning for End-of-Life Care and robust discharge plans and use of Respect forms

4: Offer of emotional and financial support throughout the patient’s journey at pivotal points evidenced within the Care Plan. Considerable feedback was heard in relation to the emotional needs of patients and their families.

5: Person centred approach to wig provision Participant’s struggled, as many people do, with their hair loss and subsequently the provision of a wig.

6: Weekend provision at the Jasmine Suite. Patients mentioned the positive feelings associated with consistency and familiarity and how this creates a sense of belonging and wellbeing.