Evaluation of the UCLH-Macmillan Partnership to deliver improvements in the care, treatment, support, and information to patients with cancer throughout their individual journeys

Abstract

The University College London Hospitals (UCLH) NHS Trust–Macmillan Cancer Support partnership is intended to improve the experiences of carers and of patients with cancer by improving the whole journey, from diagnosis through to palliation, and to embed this in a system that actively engages patients and carers in decision making at each step. Key changes introduced as a result of the partnership include a support and information service, a learning forum for cancer nurses, one-to-one support for patients and an extended and restructured volunteering service. Central to intended improvements was a new building with a dedicated outpatient clinic area, day care and chemotherapy services, day surgery, and on-site diagnostic services to diagnose and treat cancers and haematological disorders. This report is the second output from a three-year evaluation of the partnership. It aimed to assess the working of the partnership and its capacity to support the partners’ plans to move forward. The evaluation team aimed to approach the question of how the partnership was working from the perspectives of staff, volunteers and senior strategic and operational managers. The evaluation also aimed to understand if, even at this early stage, there were perceptible changes in patient experience compared with comparable changes in patient experience elsewhere in the NHS. This phase of the evaluation applied both quantitative and qualitative data collection methods. These were: In-depth interviews with staff and volunteers conducted between May and August 2014 (n=21) An online survey of a wide range of staff involved in the delivery of cancer services conducted between December 2014 and January 2015 (n=88) In-depth interviews with senior strategic and operational managers within the partnership conducted between April and June 2014 (n=16) Analysis of the 2012/13 and 2014 waves of National Cancer Patient Experience Surveys Towards the end of our data collection we supported a learning event to report our findings to members of staff and to elicit their reflections on the findings. These views, along with the other data sources, also informed the final discussion and conclusions. Key findings were that: a) within broadly positive perceptions across the board, there were important variations – with senior staff being more positive and optimistic than frontline staff; b) there was a positive ambition, vision and expectation among leaders, but this was not always communicated to the whole organisation; c) staff wanted to understand what the partnership meant in specific terms for their jobs and careers; d) there was strong support for strengthening learning through partnership working; and e) there was a danger that positive changes might be undercut by growing pressures on staff. On the basis of these findings, the evaluation identifies five recommendations.