The National Health Service Cancer Plan - Assignment Example

The National Health Service (NHS) Cancer Plan (2000) Introduction: The National Health Service is responsible for the healthcare system in the United Kingdom and is responsible for the benefits that the citizens derive from the system. The benefits that are derived from the healthcare system are immediate benefits, as well as future benefits. These benefits take the form of health promotion, diagnosis and treatment. There are two basic elements in the determination of benefits derived by the citizens. These two factors are the incidence or prevalence of the health problem and the effectiveness of the currently available interventions to deal with the health problem. In the United Kingdom the annual incidence of cancer is 200,000 and the mortality rate as a result of cancer is 120,000. The high mortality rate makes cancer the second highest killer, after heart diseases. Thus cancer is a serious health issue in the United Kingdom. Keeping this in view the National Health Service made an assessment of the currently available interventions to deal with the health problem of cancer and has come out with its recommendations termed the National Health Service (NHS) cancer Plan 2000, with the objective of increasing the effectiveness of the interventions to deal with cancer, so that the citizens derive the maximum benefits from the healthcare system (The NHS Cancer Plan). Overview of the National Health Service (NHS) Cancer Plan (2000): The Cancer Plan 2000 commends the interventions to deal with cancer in the healthcare system and recognizes the contributions from voluntary organisations, the community as a whole and the families of those afflicted with cancer. At the same time it acknowledges that cancer care in the country still needs to be enhanced in the country to required levels to make proper interventions available to benefit the entire population of the country. In keeping with this the Cancer Plan 2000 envisages the linking of prevention, diagnosis, treatment, care and research into one total strategy to effectively tackle the health problem of Cancer. The Cancer Plan 2000 has selected four aims, whereby the effectiveness of cancer care in the country is enhanced. These aims are: “to save more lives to ensure people with cancer the right professional support and care as well as the best treatments to tackle the inequalities in health that mean unskilled workers are twice as likely to die from cancer as professionals to build for the future through investment in the cancer workforce, through strong research and through preparation for the genetics revolution, so that the NHS never falls behind in cancer care again” To achieve these aims the Cancer Plan 2000 makes three commitments from the side of the NHS. These include enhanced reduction in smoking rates by 2010 with particular emphasis on the gap between socio-economic groups, reduced waiting times for diagnosis and treatment for all cancers and an investment of fifty million pounds by 2004 in hospices and specialist palliative care services to make these services more accessible across the length and breadth of the country. Through these commitments the Cancer Plan 2000 attempts to meet the challenges posed with regard to enhancing the level of cancer care in the country. These challenges are better prevention, action on health inequalities, earlier detection, faster diagnosis and treatment, consistent high quality of services, improved quality of life through better care. By targeting these challenges that impact on the delivery of effective cancer to the entire population of the country, the Cancer Plan 2000 in a staggered manner attempts to raise the levels of cancer care in the country to match the levels witnessed in other countries with advanced cancer care facilities (The NHS Cancer Plan). Impact of the Cancer Plan 2000 on the Role of Nurses in Cancer Care: Nursing professionals play an important role in cancer care and therefore the Cancer Plan 2000 is of significance to the role that nursing professionals will continue to play in cancer care. The challenges of better prevention, action on health inequalities, earlier detection, faster diagnosis and treatment, consistent high quality of services, and improved quality of life through better care provide the pathway of understanding the manner in which the Cancer Plan 2000 has impacted on the role of nurses in care and a guide to the future role of nursing professionals in cancer care. Better Prevention: The result of greater funding availability as a result of the Cancer Plan 2000 has caused an increase in the training facilities available for nursing to be better equipped in their participation in cancer prevention programs. The cancer care related content of the educational training received by nursing professionals has seen an increase too. A continuing impediment to cancer preventions programs from the perspective of the nursing community is the lack of adequate facilities to assist in the cancer preventions programs. An easing of this is expected as better facilities gradually filter to every part of the country in an effort to do away with healthcare inequalities being felt in more remote areas of the country. The recognition that preventing cancer reduces the heavy load in the treatment and care of every case of cancer detected on the healthcare system involved in cancer care (Loescher, 2004). Smoking has been recognised as the primary cause of lung cancer, and smoking prevention programs have been among the earliest prevention programs in the fight against cancer. The changing scenario for nursing professionals in smoking prevention programs provides insight into the role of nurses in cancer prevention programs on the whole. The impact of increased impact of enhanced knowledge and skills of cancer care and its prevention has seen increased participation of nursing professionals in cancer prevention programs in the United Kingdom (Mullally, 2001). In the United Kingdom nurse practitioner led prevention programs are encouraged for two reasons. In the first place there is evidence to show that nurse practitioner led prevention programs show improved results and it is not necessary for prevention programs to be led by physicians. Therefore nurse led prevention programs are efficient. The second reason for encouraging nurse practitioner led prevention programs is that it is more cost efficient than physician led prevention programs. In short enhanced participation of nursing professionals in prevention programs makes it more feasible to have nurse practitioner led prevention programs, which is efficient and cost effective (Raftery, et al, 2005). However for continued efficiency of nurse practitioner led prevention programs it is essential that at the nursing education stage appropriate knowledge and skills in cancer prevention are provided and subsequent means to upgrade knowledge and skills in cancer prevention. In the United Kingdom a comprehensive smoking prevention program has been initiated by the Government through the NHS Stop Smoking Service. This service is available throughout the country and provides counselling and support to smokers desirous of wanting to quit smoking. Nicotine Replacement Therapy and bupropion are used to assist in the quitting of smoking. The financial support committed by the NHS to this effort over the period of three years from 2003-2006 is a total sum of one hundred and thirty-eight million pounds. In the subsequent two years up to 2008 a further one hundred and twelve million pounds is being allocated to the Primary care Trusts to further this effort to prevent smoking. The spearheads for this effort are nursing professional and pharmacists, who have been provided with adequate training and act as stop smoking advisors (NHS Stop Smoking Services & Nicotine Replacement Therapy). Earlier Detection: Early detection of cancer helps in better prognosis. For early detection of cancer on of the significant factors is the involvement of the individual. Breast and cervical cancer take more lives in women than any other form of cancer and breast and cervical cancer screening has been on of the earliest means of reducing the impact of mortality sue to cancer in women. Yet quite often the success in screening for breast and cervical cancer has been negatively impacted by failure of women to follow the recommended screening guidelines provided by the nursing professionals. Nurse practitioners have been in the forefront of screening for breast and cervical cancer in women. The holistic perspectives and advanced practice skills of nurse practitioners enable them to intervene on behalf of their female clients at all levels required in their healthcare. These facets enable nursing practitioners to assess the health of female care seekers and the system that is most suitable to these care seekers (Patnick, 2000). Moving on further these strengths of the nursing practitioners strengthen the efficiency of screening programs. In view of the Cancer Plan 2000 to provide for early detection of cancer to increase the efficiency of cancer care, these capabilities of the nursing professionals translate into monitoring of screening facilities , promotion of screening efficiency by educating the care seekers on proper attention to precursors of cancer development within their bodies. An additional facet that is likely to come to the forefront in the near future is the ability of the nursing practitioners, with the confidence that the women health seekers have in them, to enhance their advocacy in increasing the efficiency of the screening programs with particular emphasis on breast and cervical cancer (Champion and Rawl, 2005). Women above the age of fifty and women below the age of fifty with a genetic history of breast cancer are the essential target group for screening for breast cancer. It has been shown that it is not the frequency of screening that aids in detection of cancer, but rather identification of the high risk population and screening this population that is instrumental in the larger detection of cancer. It is here that the role of the nursing professionals comes to the fore by their ability to identify high risk target groups for screening. (The frequency of breast cancer screening: results from the UKCCCR Randomised Trial. United Kingdom Co-ordinating Committee on Cancer Research). This ability of nursing professionals is likely to see an enhanced role for nursing professionals in the future for screening protocols for other cancers including colorectal-cancer (Steele, 2004). Faster Treatment: The impetus given to greater availability of cancer care for faster treatment of cancer patients in the United Kingdom, has brought about a significant increase in the number of clinical nurse specialists (CNS) working in cancer care in the United Kingdom. This has brought about some confusion among the nursing professionals involved in cancer care in the country. The site-specific cancer CNSs were developed as a means for providing a nursing lead after the appropriate training in the care of a particular type of cancer. Care for cancer is a long journey and involving not just multi-disciplinary teams, but with the advent of CNSs multifunctional nursing professionals also. This has the potential to cause fragmentation and confusion in the nursing care unless key issues like role clarity are provided and disseminated among the nursing professionals involved in cancer care. Then clinical nurse specialist would lose viability unless their role is made clear to the patients and the multidisciplinary team involved in the care of the patient (Hill, 2000). The clinical nurse specialists have been able to improve cancer care provided by nursing professionals at the community nursing level. This was made possible by providing the providing community staff nurse with opportunities to develop skills in a particular type of cancer like colorectal cancer. The aim was to provide adequate knowledge and skills to the community staff nurses on a particular type of cancer to empower generalist and community nurses in the care and treatment of particular types of cancers. It is becoming more common to see such knowledge and skills being imparted to community nurses through work-based programs in to provide for faster treatment at community levels without having to depend on the larger hospitals (Adams, Dufton, Lamb & Taylor, 2003). A lacuna that is felt in the role of nursing in the treatment of cancer is the role that it plays in the teenage and young age group. This is because there aren’t enough specialist nursing professionals to provide the care and treatment that this age group desires. The lack of specialist nursing professionals for this age group is because of the lack of availability of training facilities for nursing professionals. This situation may have arisen from the belief that this age group is not representative of high risk for cancer and the focus has been on older age groups. The emphasis of faster treatment for all cancer patients behoves the necessity for additional training facilities for nursing professionals to address the cancer care requirements of this age group (Lack Of Specialist Training For Nurses Is Failing Adolescent Cancer Patients, UK). Consistent High Quality of Services: In an attempt to provide high quality of nursing care to cancer patients an increased drive for evidence-based practice is being witnessed in the United Kingdom. This drive for evidence-based practice enables nursing professionals in cancer care to determine who they are, what they need to do and the effect of their actions on patient outcomes. One of the drawbacks seen is that though evidence-based practice is vast, it often lacks the depth that is required. The challenge that cancer nursing in the United Kingdom faces is on a continuous basis to evaluate what it does, keeping the effective interventions, striving to develop new ones and refining those that interventions that are in need of refinement to ensure quality in their practice and thereby ensure better patient outcomes (Richardson, Miller & Potter, 2002). An increase in specialist nursing care for cancer patients is being witnessed. Specialist nursing care is the result of increased input in knowledge and skills to nursing professionals in the cancer care. Macmillan specialist palliative care nurse are a set of such specialist nurses that take care of patients in the advanced stages of cancer. Assessment of the quality of service delivered by Macmillan specialist palliative care nurses have shown it to be of high order and having a positive impact on patient outcomes (Corner, et al, 2003). Improved Quality of Life Through Better Care: Palliative care is the complete care of the patient, whose disease has not responded positively to the curative treatment employed. The objective in palliative care is providing the best possible quality of life to not just the patient but also to their families. (Higginson, 1997). Palliative care differs in philosophy from curative treatment care, in that it focuses significantly on the consequences of the disease, instead of any specific curative regimen. Palliative care approaches are more holistic, pragmatic and multidisciplinary, which is being witnessed more frequently in the care of cancer patients. In the care of cancer patients palliative care complements oncological and antiviral treatments. (Finlay, 2001). The National Institute of Clinical Excellence (NICE), in its guidance on supportive and palliative care clearly provides the distinction between the, which acts as the guidelines for present day nursing care of cancer patients. According to this guidance of NICE, “supportive care means helping patients and their families cope with cancer and its treatment. Palliative care means alleviating pain and discomfort when it is not possible to cure the cancer (New guidance will improve supportive and palliative care services for adults with cancer). The Cancer Plan 2000 has seen the establishment of cancer care networks to enhance the efficiency of cancer care. Palliative care providers have in a similar manner set up palliative care networks, which assist nursing professionals increase the quality and efficiency of the palliative care provided to their cancer patients. (Travis &Hunt, 2001). Future Trends in the Role of Nursing Professionals on Cancer Care: The continuing trend of developments in the field of medical science and technology means that there will be new methods of diagnosing and treating cancer. There is already an increasing trend in the role that nursing professionals play in the treatment and there will be no slowing down in this trend. This means that there will be extra demands placed on the knowledge and skill requirements of nursing professionals (Cooper & Depledge, 2004). The increased emphasis on removing health inequalities in the Cancer Plan 2000 means that there will be greater emphasis of cancer care at the primary level. Nursing professionals are already showing competence in the Primary Care Cancer Lead Clinician role. These roles of the nursing professionals will in all probability only increase, leading to a more significant role for nursing professionals in cancer care (Leese, et al, 2006). Supportive and palliative care of cancer patients calls for skills in communication. With greater emphasis on the quality of cancer care provided, nursing professionals with their key role in cancer care will need to enhance their communication skills. There is a trend for increased training facilities for nursing professionals to improve their communication skills and there will be the onus on nursing professionals to make use of these facilities in the drive for enhanced quality in cancer care (McEvoy & Mullan, 2003). Globalization and the large transmigration of populations being witnessed in the modern world will throw a significant for nursing professionals in the days ahead in cancer care, if it is already not being experienced currently. The nursing professionals will be exposed more and more to cancer patients that originate from other geographic locations. These patients are quite likely to have languages, cultures and religions far different from the prevalent language, culture and religions native to the United Kingdom. In providing quality cancer care to these patients the nursing professionals will have develop an understanding of different languages, cultures and religions (Schmit, 2005). Literary References Adams, T., Dufton, R., Lamb, C. & Taylor, M. (2003). Empowering community nurses in cancer care, British journal of community nursing, 8(12), 539-543. Champion and Rawl (2005). Secondary prevention of cancer. Seminars in oncology nursing, 21(4), 252-259. Cooper, C. & Depledge, J. (2004). Cytotoxic chemotherapy: what do community nurses need to know? British journal of community nursing, 9(1), 26-32. Corner, et al. (2003). Exploring nursing outcomes for patients with advanced cancer following intervention by Macmillan specialist palliative care nurses. Journal of advanced nursing, 41(6), 561-574. Finlay, I. (2001). UK strategies for palliative care. Journal of the Royal Society of Medicine, 94(9), 437-441. Higginson, I. (1997). Palliative and Terminal Care. In A Stevens & J. Raftery (Eds.) HEALTHCARE ASSESSMENT NEEDS. (pp. 1-4). Oxon: Radcliffe Medical Press Ltd. Hill, A. (2000). The impact of expanding the numbers of clinical nurse specialists in cancer care: a United Kingdom case study. European journal of oncology nursing, 4(4), 219-226. Lack Of Specialist Training For Nurses Is Failing Adolescent Cancer Patients, UK. 2006. Retrieved January 15 2007, from Nursing News, MEDICAL NEWS TODAY, Web site: http://www.medicalnewstoday.com/medicalnews.php?newsid=40590 Leese, et al. (2006). A new role for nurses as Primary Care Cancer Lead Clinicians in Primary Care Trusts in England. Journal of nursing management, 14(6), 462-471. Loescher, L. (2004). Nursing roles in cancer prevention position statements. Seminars in oncology nursing, 20(2), 111-120. McEvoy, M. & Mullan, A. (2003). The essence of cancer care: the impact of training on nurses ability to communicate effectively. Nursing, 40(6), 731-738. Mullally, S. (2001). Future clinical role of nurses in the United Kingdom. Postgraduate Medical Journal, 77, 337-339. New guidance will improve supportive and palliative care services for adults with cancer. 2004. Retrieved January 15 2007, from National Institute for Clinical Excellence. Web site: http://www.nice.org.uk/download.aspx?o=110309. NHS Stop Smoking Services & Nicotine Replacement Therapy. Retrieved January 15 2007, from Department of Health. Web site: http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Tobacco/TobaccoGeneralInformation/TobaccoGeneralArticle/fs/en?CONTENT_ID=4002192&chk=5Xx9q6 Patnick, J. (2000). Breast and cervical screening for women in the United Kingdom. Hong Kong medical journal, 6(4), 409-411. Raftery, et al (2005). Cost-effective roles for nurse practitioners in secondary prevention. BMJ, 330, E357-E358. Richardson, A., Miller, M. & Potter, H. (2002). Developing, delivering, and evaluating cancer nursing services: searching for a United Kingdom evidence base for practice. Cancer Nursing, 25(5), 4o4-415. Schmit, K. (2005). Nursing Implications for Treating "Kanser" in Filipino Patients. Journal of Hospice and Palliative Nursing, 7(6), 345-353. Steele, R. J. C. (2004). Results of the first round of a demonstration pilot for screening of colorectal cancer in the United Kingdom. BMJ online, Retrieved January 15 2007, from bmj.com Web site: http://www.bmj.com/cgi/reprint/bmj.38153.491887.7Cv1.pdf The frequency of breast cancer screening: results from the UKCCCR Randomised Trial. United Kingdom Co-ordinating Committee on Cancer Research. (2002). European journal of cancer, 38(11), 1458-1464. The NHS Cancer Plan. A plan for investment. A plan for reform. September 2000. Travis, S. & Hunt, P. (2001). Supportive and palliative care networks: a new model for integrated care. International journal of palliative nursing, 7(10), 501-504. Read More