John Taylor Hospice
Establishing a community based Prostate Cancer Nurse Specialist to provide integrated and seamless care between secondary and primary care.
Meet John Taylor Hospice
John Taylor Hospice (JTH) is a Community Interest Company which provides expert end of life care to individuals and their families across Birmingham and the West Midlands. The hospice provides a wide variety of support to individuals including: tailored 24/7 support for in-patients; home care; day care; counselling and wellbeing services; pain management; complementary therapies; occupational therapist support; access to a patient and family support worker; physiotherapists and dietitians.
The hospice also runs a programme called Benjamin’s Brothers, which began in 2014 and works to raise awareness of prostate cancer particularly among the African Caribbean community.
The big idea
At present, there are around 68,000 African Caribbean men and their families within Birmingham who are currently not engaged and have a poor understanding of their risks of prostate cancer.
This is despite this group having a higher prevalence of prostate cancer and suffering from a particularly aggressive form.
Through raising awareness the project hopes to encourage earlier testing and diagnosis, and allow more men to receive earlier support and treatment for prostate cancer. Our project has been developed to support the aims of the Benjamin’s Brothers project.
Finding out what works
A Prostate Cancer UK funded project was developed to facilitate collaborative working within the Birmingham area addressing identified gaps in services, which include comprehensive support and care pathways for diagnosed prostate cancer patients in the community.
The initiative was developed with key members of the Black and African Caribbean community through the Benjamin’s Brothers project at John Taylor Hospice, a concept set up with the local community, including religious and community leaders, carers and prostate cancer survivors.
Clinical support is being set up from consultant oncologists from University Hospitals Birmingham, as well as a variety of professionals across Birmingham Cross City Clinical Commissioning Group (CCG).
One of the initiatives of this service provides men and their families with a point of contact within this setting, offering advice and support via community clinics, telephone follow-up or home visits.
There is a high black & minority ethnic (BME) population in this area. As statistics show that black men have a higher risk of getting prostate cancer than men of other ethnicities (Prostate Cancer UK, 2013), it’s really important that this demographic know about this project and are able to access support and advice.
The role can signpost them to the appropriate services and act as a liaison between the multidisciplinary team across secondary, tertiary and primary care settings with an aim of early re-referral and treatment where required.
- Early engagement with relevant stakeholders at post planning stage is key to ensuring that rapid implementation takes place by post holder.
- It is important to get to know service providers and fully involve them in project development work.
- We have found that a major theme for men with prostate cancer is difficulty accessing information at appropriate times.
- From initial work undertaken we were able to identify new areas of improvement for our own service provision.
- The project has demonstrated that a prostate cancer nurse specialist based in a community setting can help provide a seamless service between primary and secondary care and improve the level of care and treatment that patients receive.
- There is an increasing demand on secondary care follow-up clinics for men being treated for prostate cancer, which in turn places an increased burden on capacity for these appointments.
- By examining the current patient pathways from pre-diagnosis through to post-treatment and by provision of the measures described above, it is hoped this is an issue that can be addressed, thereby freeing up consultants to see newly diagnosed patients and patients with more complex disease and treatment options.
289 people have been seen in total either in groups, workshops or surgeries.
The findings from the Patient Satisfaction survey given in the community setting found patients' responses compared favourably to responses received from patients seen by a CNS in a nurse-led clinic service in the secondary care setting for the following three outcomes:
- Men feel more satisfied with the care they receive
- Men have improved quality of life
- Men have improved awareness of prostate cancer symptoms and feel more informed about their condition
Healthcare professionals who have received advice and training from the postholder feel more supported and informed about prostate cancer and the support available to men.
Supporting men and their families in the community closer to their homes offers many benefits including:
- Improved access to advice and support that will equip men and their families with the knowledge & understanding to self-manage their health
- Providing men and their families with a point of contact within the community setting who can signpost them to the appropriate services and act as a liaison between the multifaceted multidisciplinary team across secondary, tertiary & primary care settings
- By providing support and education to the GPs who monitor these men in the community setting we will enable men to have better access to advice and support
- This initiative offers us a new way of working and improves the dissemination of information and support through these communities.