Evaluation of cancer care development facilitators in supporting ambulance and urgent care services with cancer and end of life patients

The South Western Ambulance Service NHS Foundation Trust (SWASFT) provides emergency and urgent care to the largest area of any ambulance trust in England, covering 10,000 square miles, equivalent to 20 per cent of mainland England. In the UK, an estimated 2.3 million people were living with a cancer diagnosis in 2015, and 3 million people are predicted to be living with or beyond cancer by 2030.

There will inevitably be an increase in ambulance services attending cancer patients. The five year cancer strategy for England highlights a number of priorities with expected benefits, including ‘better integration of health and social care such that all aspects of patients’ care are addressed, particularly at key transition points’ and ‘a radical improvement in experience and quality of life for the majority of patients, including at the end of life’. The ambulance service plays a key role in these areas.

SWASFT and Macmillan Cancer Support are working together to improve cancer and end of life care in the South West. They have identified gaps in providing the right care, in the right place, at the right time. As a result, Macmillan has funded three cancer care development facilitators in SWASFT, along with a project manager. Each facilitator covers a geographical patch, responding to local needs, but with common objectives.

The objectives of the role are:

  1. Building the team: Empowering and educating staff, developing a competent workforce
  2. Service improvement – systems: Identifying opportunities for improving the patient journey
  3. Service improvement – clinical: Supporting the development of clinical guidelines and specific pathways/directory of services

Project aims

NIHR CLAHRC West is carrying out an independent evaluation of the facilitator roles and achievements. This project will examine the value of the cancer care development facilitator role’s capacity to deliver enhanced patient care and service improvement.

There are two levels of CLAHRC West input. We will:

  1. Provide an evaluation of the roles. Qualitative face-to-face interviews with SWASFT and Macmillan staff and a quantitative documentary analysis will capture experiences and impacts of the role
  2. Contribute to the design and analysis of any quantitative work to identify gaps in the service

Anticipated impacts

This project will help SWASFT and Macmillan understand the effect that the cancer care development facilitator roles have had on patient care and inform decisions about any continuation of the existing roles or roll-out of additional roles. It will also help them identify gaps in the service, helping patients get the right care, at the right time, in the right place.