Quality statement 5: Holistic needs assessment

Quality statement

People with lung cancer are offered a holistic needs assessment at each key stage of care that informs their care plan and the need for referral to specialist services.

Quality measure

Structure: Evidence of local arrangements and written clinical protocols to ensure that people with lung cancer are offered a holistic needs assessment at each key stage of care that informs their care plan and the need for referral to specialist services.

Process:

a) Proportion of people with lung cancer who have a care plan based on a holistic needs assessment undertaken at diagnosis.

Numerator – the number of people in the denominator who have a care plan based on a holistic needs assessment undertaken at diagnosis.

Denominator – the number of people with lung cancer.

b) Proportion of people with lung cancer who have a care plan based on a holistic needs assessment undertaken at diagnosis and other key stages of care.

Numerator – the number of people in the denominator who have a care plan based on a holistic needs assessment undertaken at diagnosis and other key stages of care.

Denominator – the number of people with lung cancer.

c) Proportion of people with lung cancer who receive specialist services as a result of a care plan based on a holistic needs assessment.

Numerator – the number of people in the denominator who receive specialist services as a result of a care plan based on a holistic needs assessment.

Denominator – the number of people with lung cancer.

Outcome:

a) Patient satisfaction with support offered.

b) Patient satisfaction with support received.

What the quality statement means for each audience

Service providers ensure that services are in place for people with lung cancer to be offered a holistic needs assessment at each key stage of care that informs their care plan and the need for referral to specialist services.

Healthcare professionals offer people with lung cancer a holistic needs assessment at each key stage of care that informs their care plan and the need for referral to specialist services.

Commissioners ensure they commission services for people with lung cancer to be offered a holistic needs assessment at each key stage of care that informs their care plan and the need for referral to specialist services.

People with lung cancer are offered an assessment of all their needs at each stage of care, the results of which are used to form part of their care plan and indicate whether referral to a specialist service is necessary.

Source guidance

Improving supportive and palliative care for adults with cancer (2004) NICE guideline CSG4, recommendations KR2, KR13, KR14 (key recommendations) and 8.10

Data source

Structure: Local data collection.

Process: a), b) and c) Local data collection.

Outcome:

a) Local data collection. The Department of Health National Cancer Patient Experience Survey report 2010 (data can be disaggregated for lung cancer) contained information on the proportion of patients who were given information about support and self‑help groups for people with cancer, and the proportion of patients that received information from hospital staff about how to get financial help or benefits.

b) Local data collection.

Definitions

A holistic needs assessment should consider all aspects of a person's needs, including physical, social, psychological and spiritual. Assessments should encompass all aspects of supportive and palliative care, including the preferences of patients and carers with respect to:

  • written and other forms of information

  • face‑to‑face communication

  • involvement in decision‑making

  • control of physical symptoms

  • psychological support

  • social support

  • spiritual support

  • rehabilitation

  • complementary therapies

  • self‑management and peer support

  • family support

  • bereavement support

  • involvement in the design and delivery of services

  • financial support

  • smoking cessation advice and support.

Key stages of care include diagnosis, starting treatment, during treatment, at the end of treatment, at relapse and when death is approaching.

People referred for specialist services should receive them within a timeframe that does not cause avoidable physical, social, psychological or spiritual distress and should not exceed 2 weeks.

Specialist services include respiratory medicine, clinical and medical oncology, surgery, palliative care, lung cancer clinical nurse specialists, smoking cessation, psychological support services and other non‑core services where there are clinical indications (for example cardiology).