The Teenage and Young Adults Cancer Services (TYA) is a new and innovative service funded by the Teenage Cancer Trust. The IOG for Children and Young People with Cancer set out recommendations on how healthcare services for children and young people with cancer should be organised. Based on these guidelines a novel approach to multidisciplinary working with Teenagers and Young Adults (TYA) with cancer was developed in the South West region: a virtual Multi-Disciplinary advisory Team (MDaT). Using a new online collaboration tool the team members are able to contribute remotely, making geographical patient treatment and support easier.
Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?
The TYA team's innovative agenda for working with young cancer sufferers has highlighted new learning needs for the team whose plans include delivering the service throughout the communities between Gloucester and Cornwall. In particular TYA identified that due to the nature of the new service there are skills and competencies required to realise the true benefits associated with effective use of the new technology and interaction with patients of the service. Liaising with patients using an on-line tool has identified that the team must develop a skill set in order to realise the benefits of the project. Most importantly however, and since the service aims to engage with vulnerable patient groups, there is a need for a more in-depth understanding of the Information Governance agenda which has been identified as critical for ensuring that the service complies with its responsibilities to confidentiality, security and maintaining dignity for users of the service. In order to help support the TYA achieve successful project outcomes, the service approached Ideal; a training company recognised by the NHS with specialist experience of training in the field of health care change, project management within a background in healthcare informatics. TYA and Ideal are committed to working in partnership in order to support the successful deployment of the on-line tool by equipping the team with the right skills and knowledge to work safely and effectively. The TYA Service comprises a multi disciplinary professional team of health care clinicians, led by a senior nurse and other members including social workers, a psychologist, nurse specialists and administrators. The service is funded by the Teenage Cancer Trust and is hosted by the United Hospitals Bristol NHS Foundation Trust. The TYA team tasked with rolling out the on-line tool must be able to interact with patients securely, encouraging a feeling of trust, confidence, dignity and sensitivity. The TYA identified that this process would require detailed discussion with Ideal which would design a learning programme capable of tackling the needs of the workforce. In order to ensure these needs could be met appropriately, TYA and Ideal worked together to construct the training programme combining blended learning to support the needs of the staff. Discussions to support needs assessment covered all facets of the project providing a map of the skills and competencies that would need to be covered, thus empowering the TYA workforce to make informed decisions about the roll out the project, maximising benefits that would follow. Ideal and the TYA explored the use of the tool in a 'conversation in order to focus on learning outcomes enabling the TYA team to gain a clear understanding of how the training design would help the team in the 'real-life' community. Since the project crosses the wide and rural demographic between Gloucester and Cornwall a small pilot was agreed on the basis of starting small while enabling further understanding about how a scaled up model of training would be utilised to share lessons learned.
The nature of the new TYA project meant that a partnership approach to the project could encourage a firm and open relationship enabling widening discussion for careful planning and proactively managing the risks identified with the project. Specific learning outcomes were identified by issuing delegates with pre course assessments. Ideal and the TYA also agreed that richer, more detailed information could be gained through individual discussions and documenting any further gaps identified. This approach provided a basis for the development of the training plan and timeline for delivery. The results of the discussion and pre-assessment questionnaires highlighted the need for a programme to address project principles, change and information governance. In particular the needs analysis also raised awareness of previous information sharing incidents such as 'Baby Peter' and 'Climbie' and therefore the service was determined to learn lessons ensuring the multi disciplinary staff within the TYA understand their responsibilities for sharing information to support patients using the service receive the right care at the right time. The discussion also helped identify further need for awareness of the latest technologies to help provide secure contact with patients on-line such as encryption. As a result of the detailed discussion and needs assessment, Ideal developed the learning programme later signed off by both the Cancer Services and Ideal before planning a date convenient for the busy care service to attend the bespoke training designed to meet their needs. Ideal incorporated an assessment leading to CIS UCQ assistant practitioner award recognised by the professional body the Royal College of Nursing and awarded by a National Awarding Body. This approach was agreed by the TYA as being a useful contribution to staff development, who as nurses and other health care clinicians are required to gain CPD credits to maintain important professional registration.
The project which uses an on-line collaboration tool to provide discussion and support to teenagers and young people with cancer is radical and breaks new ground. Initiating the project required careful pre-course assessment and discussion to ensure service requirements were accurately reflected in the design and development of new learning materials. Despite research and development into previous and current projects, including a review of case studies and discussions with subject matter experts, the project required careful development of new learning materials to support the TYA. Joint working, including discussions and in depth exploration into the project helped shape the design and development of the bespoke training materials to be a useful resource to staff within the TYA to roll out the on-line meeting tool. The TYA service identified that project and change management would both be essential learning requirements including a better understanding of the models for change which was suggested a particular area of interest. The training materials designed as result of the discussion and needs assessment included pre-reading, scenarios and case studies to ensure the service could use up-to-date and evidence based information to inform practices deployed in the 'real world'. Both the service and supplier agreed that a blended approach to training would be best suited to the learners during the pilot which would make it possible to explore a scaled up model to include other services.
The TYA service is the first of its kind, and therefore it was considered by the service it was a vital step to ensure that training needs were correctly identified for the planned pilot which would later be capable of defining a model for the future provision for online patient support. Making the right preparations to ensure the service has a positive impact for the patient is fundamental, and since the TYA thrives on charitable funds the service must demonstrate clear benefits in order to achieve a sustainable position.
A compelling argument to ensure the programme was piloted successfully and rigorously reviewed is the challenge that is the benefits to service users, and avoiding previous mistakes which could be suggested in the past, to have resulted from large-scale IT enabled change projects and issues of security and confidentiality. There are also additional drivers which stem from the possible organisational and individual consequences including individual penalties such as legal action, hefty fines or even imprisonment. The work of the TYA will result in positive experiences for patients who would otherwise have to travel for miles to the historic service being hosted in a hospital or clinic, thus enabling a model for the future. As a model, the TYA is deemed a trailblazing service and an example to other services, patients and service users creating a firm foundation on which to build effective answers to remote treatment and care when and where it is needed, made sustainable by effective partnerships.
Director of Education Quality and Accreditation
Is the example industry-sponsored in any way?