Putting people at the heart of health and social care is the right thing to do

by Fiona McKenzie, London Cancer Fiona McKenzie is Patient Insight and Involvement Lead at London Cancer, a partnership of NHS, academic, charity and cancer specialists dedicated to providing expert, compassionate care for every patient, every time. She explains how the partnership focuses strongly on treating patients as individuals. Fiona McKenzie image blog



Creating a health and social care system that organises itself around the needs of the people it serves, enabling them to be at the heart of conversations, decision making and care planning, seems both common sense and the right thing to do.
That said, turning person-centred care from rhetoric to reality is one of the greatest cultural challenges for health and social care organisations in the UK today. So it is wonderful to be supporting Marie Curie's About Me campaign in shifting the focus away from diseases and conditions and back to the person. I work for London Cancer, the integrated cancer system for north and east London and west Essex, where this focus has been our way of working since we were formed following a review of services in 2010. We are a partnership of 11 NHS hospital trusts, and collaborate with a wider affiliation of Clinical Commissioning Groups (CCGs) and other NHS healthcare organisations, to improve cancer patient outcomes and experience. We do this by redesigning the whole pathway of care to provide expert, compassionate care for every patient, every time.


Patient priorities


In partnership with cancer patients, carers and healthcare professionals from across the sector, as well as local and national charities, London Cancer held conversations with boards and patient involvement groups. We asked about how we would organise pathways around patients, using the questions ‘What does great care look like?’ and ‘How would you know?’ This conversation also focused on what the measures of achievement and progress might look like. From these conversations we developed a list of top 10 things that matter most to patients, around which we organised our priorities and focused effort and attention. One of these top 10 things was earlier diagnosis with patients saying good listening and rapid action by GPs when a patient presents with possible cancer symptoms. Therefore London Cancer prioritised earlier diagnosis as one of our three overarching objectives and it remains a core focus for our work.  We are working collaboratively with our acute and primary care partners to shorten the patient pathway to diagnosis.


More efficient systems


For example, Dr Ed Seward has developed a new service at Whipps Cross Hospital in East London that opens up the referral pathway for patients with lower gastrointestinal symptoms beyond the strict criteria for urgent referral of suspected colorectal cancer. GPs and patients receive a diagnosis more efficiently through a ‘straight to test’ model whereby a trained specialist nurse assesses patients by telephone. This enables most patients to go directly to the appropriate endoscopic investigation, according to symptoms and age, rather than attending clinic first. Clear benefits for patients have already been seen from the first 125 cases, including: faster diagnosis, a reduction in missed appointments and unnecessary clinic visits and cost savings across the whole pathway, which could be redeployed for more early diagnosis. We have continued to work in partnership with patients and carers to consider the full pathway of patient care, from diagnosis to living with and beyond cancer and, for some patients, end-of-life care. All colleagues – chief executives, medical directors, clinical leaders, cancer managers, nurses, GPs and other health professionals – are focused on addressing patients’ needs, enabling us to genuinely put patients at the heart of everything that we do. For more information, and to share your experiences, please see our About Me web pages.