Like many health professionals and care practitioners who deal with patients with cancer, I hadn’t realised how much support a patient needed once their cancer treatment had ended. It wasn’t a need that I recognised, let alone measured or assessed. This meant that, as a professional, I had had limited input in this part of a patient’s journey.
In my professional work, I am mainly involved with the diagnosis, staging and management of patients with cancer. In my clinics, I would meet my patients and focus on making sure that the treatment I carried out was working. I would mainly focus on their physical health and ensure that there was no reoccurrence of cancer.
Because of my limited time with each patient, I would mainly focus on ensuring that their physical needs were being met. For various reasons, I was unaware of their other needs or if they have been met.
My involvement with Macmillan Cancer Support’s Transforming Care After Treat programme began 18 months ago when I become the North of Scotland Cancer Network Clinical Lead. Part of my role required me to join the TCAT programme board.
I was initially curious about the programme and wondered if it was intrusive into patients lives. My professional training and experience had taught me that from the moment of diagnosis onwards, cancer impacts profoundly on a person’s life. It seemed to me that by simply focussing on the care a person received after their cancer treatment had finished, we would be segmenting their journey, and the care a person would receive.
As the programme developed, I began to understand the different needs that patients have after treatment. I could see that whilst there is significant support currently offered to individuals from diagnosis to treatment, the support offered after treatment comes to an end is missing.
Once a patient is discharged and sent out into the world at large, their cancer journey and the impact of the disease on their life continues; be it emotionally, financially, physically or mentally. People are different and the support needed by different individuals varies.
However, it is only when they are assessed by professionals, and in a focussed and sensitive manner, that patients may express that they are having difficulties and sometimes struggling to cope.
I started to take notice and measure people’s needs, using Holistic Needs Assessments and began signposting people onto local support services. I began to see that when a patient’s needs are met, their outlook on life changes substantially. This in turn impacts on their treatment, their general wellbeing and their return to productive everyday life.
I learned about how the programme promoted self-management, and provided people with the tools and skills to become independent and look after themselves, rather than constantly relying on others for help.
I learned how the concept of self-management enabled people to find the right support when the need arises and gave them the skills and tools to self-manage and go on with their everyday life. Whilst there will always be a few individuals for whom self-management is not possible, this element is vital to TCAT’s continued success. It must become the norm for the programme to continue.
My colleagues and I have started to realise that there is a huge contribution we can make to people’s continued and improved wellbeing.
TCAT has now become the norm for for many health care professionals. My hope as the programme continues is that it will become so for an ever-increasing number of health care professionals across the country, helping to improve every patients whole cancer journey.
by Sami Shimi
Sami Shimi is a Senior Lecturer and Consultant at the Department of Surgery Ninewells Hospital & Medical School. He is a member of the TCAT programme board and is the Clinical Lead for the North of Scotland Cancer Network.