Insights and Oportunities by Kieran Brookes

INSIGHTS AND OPORTUNITIES

INSIGHT: TRAVELLING Patients could potentially have to travel from all over North Yorkshire.Travelling to a hospital from somewere in an area 3400 sq miles is difficult, bus services are infrequent and journeys increase stress levels before chemo. Most routes require changes of buses and times are infrequent,journeys are long and roads are narrow. Being alone on a bus can increase anxiety levels in patients and put them in the wrong frame of mind. Aswell as this the journeys can be very costly. After conducting research into commuting to the hospital i found that the commute can be very costly and take long periods of time to travel small distances. In one instance a 24mile journey can take up to 2 1/2 hours on a bus with one change.

â&#x20AC;&#x153;The travelling is the main worry,it gives me so much time to myself were i get worked up about the treatment and it is far too expensive.â&#x20AC;?

OPPORTUNITY Could the services be brought direct to the patients or at least more localised ? Travelling less would mean a more normal life for the patient , this potentially reducing stress levels and making the treatment more succesful. Main roads are of a poor quality which again makes travel expensive and time consuming. Bringing the services closer to the patients or carrying out chemotherapy at homes would be much more succesful for e.g mobile units , self administering ?

INSIGHT: VERY LARGE CATCHMENT AREA North Yorkshire is the largest ceremonial county within the UK with a population of around 1,072,600 people. It covers an area of 8,608 km meaning that overall there is an average population density of only 125 people per square kilometer. Overall this isnâ&#x20AC;&#x2122;t a very high population density at all which is down to the vast landscape and farmlands that cover the county. This means that the population is stretched out over such a large place in rural areas which donâ&#x20AC;&#x2122;t have the best access to the nearest hospitals.

OPPORTUNITY This can be a good incentive for patients to use the service People living out in these rural areas may have trouble reaching the nearest hospital to receive treatment and when they can they may have to spend a lot of time and money reaching these areas, time and money that may be spent on things for themselves. Spending this extra time and money on themselves may provide some kind of distractions away from what they are currently going through.

OPPORTUNITY As the county is so big and the workforce will be spread about the whole region, could there be a possibility of NHS nurses qualified to treat cancer patients from each area being able to do a shift on the chemo bus if it goes into there area. A nurse local to that specific area could be able to interact better with the patient as they have something in common with the patient straight away. They may be able to help the patient feel more relaxed because they understand the local area and the people around there. This may also help moral of some staff who have long commutes to work each day.

INSIGHT CANCER RATES RISING Cancer rates in North Yorkshire are rising 30 % year on year. This increasing demand is puting stress on the local hospitals and stretching funding and resources.This increasing the spend of the NHS and potentially reducing the quality of treatment and care each person receives.

OPPORTUNITY With the rising cancer rates in the area, this puts pressure onto the hospitals and stretches resources in the region.To combat this problkem the treatments coud be caried out in local gp practices or in mobile units possibly located in car parks or local community centres.This could reduce issues with capacity and also provide a more local convenient service.

INSIGHT: CHECK UP With patients living hours away I is hard for doctors and other medical staff to reach them if they have a problem with the after effects of the chemotherpy.

OPPORTUNITY: The hospital staff need to ensure that not only does the mobile unit travel out to the patients but also the staff to the patients, and not only in emergancy cases. Nurses who work in the mobile unit may be local and in this case can make house calls, making more of a personal connection with the patient.

INSIGHT: PATIENTS TOO ILL TO TRAVEL Cancer takes a lot out of the patient and sometimes if they live too far away from the nearest hospital they may not feel up to travelling, even if the treatment is essential.

OPPORTUNITY This is a great way to justify the use of a mobile chemotherapy treatment bus as the patient wonâ&#x20AC;&#x2122;t have to travel a large distance across the county if theyâ&#x20AC;&#x2122;re not feeling up to it. They may feel more motivated to go and receive the treatment

INSIGHT: PATIENTS FEEL VERY UNWELL FOR A WEEK AFTER The drugs involved in chemotherapy take a great toll on the body, and patients have described feeling very unwell for up to a week after treatment. During this week, patients are able to phone the hospital, however seeing a doctor face to face is much more difficult for those targeted in this project. Having to travel multiple hours to hospital is not an option for many, especially if they are feeling unwell from treatment.

OPPORTUNITY: AFTERCARE SERVICE There is an opportunity here to provide an aftercare service to the patients during the week after treatment. Instead of the patients having to travel to hospital, the chemotherapy bus could bring care to the patient. If we could provide an aftercare service as part of the bus service, maybe 3 or 4 days later, the patients would feel much more reassured in the knowledge that there is support arriving on a regular basis. This service could be extended to cancer patients who do not use the bus for chemotherapy, but still feel like aftercare would benefit them.

INSIGHT: PEOPLE DON’T WANT A ‘CANCER BUS’ TURNING UP AT THEIR HOUSE It was apparent that patients of chemotherapy did not want the fact that they were receiving treatment to be broadcast to the world in the form of a cancer bus. They were not ashamed of the treatment, rather they did not want to be stereotyped/stigmatised/ labelled as cancer patients.

OPPORTUNITY: MAKE THE SERVICE OPEN AND APPROACHABLE The service provided needs to challenge perceptions of cancer and the potential stigmas surrounding it. The bus should be friendly and inviting and create an atmosphere of calm. The bus could possibly also act as an information point to the public, answering any queries the public have.

OPPORTUNITY: SIMPLE BRANDING, PUBLIC LOCATIONS We feel that simple graphics on the outside of the bus would be most fitting for the purpose. We do not want the patients to feel like theyâ&#x20AC;&#x2122;re starring on an episode of Embarrassing Bodies. We want the patient to feel like they are simply turning up for a hospital appointment, for example. The bus could be parked in supermarket parking lots, coach parking areas, near village greens, etc.

INSIGHT: PATIENTS LIKE ROUTINE From our visit to York hospital, we found that the patients enjoy a predictable routine to their chemotherapy treatments. For example, a patient may like to have their treatment on a Tuesday, as that is when a member of their family is available to support them. This routine means that the patient can plan the rest of their week without worry.

OPPORTUNITY: TIMETABLED SCHEDULE A timetabled bus arriving at the same time and location each week, or 3-week cycle, could provide a level of comfort in the knowledge that the bus is certain to turn up. On the patientsâ&#x20AC;&#x2122; level, a timetable could provide reassurance that the service is thinking specifically of them.

INSIGHT: Record Keeping Doctors and nurses often need to ask the patient themselves for updates from their previous visits. This is partially due to them dealing with hundreds of different patients every day, and also not having enough time to familiarise themselves with the patient before the time of the appointment. This can put pressure on the patients to keep records of their visits to the hospital. â&#x20AC;&#x153;I get asked the same questions about my medical history every visit to the hospital which becomes tiresome and dishearteningâ&#x20AC;?

OPPORTUNITY: Patients â&#x20AC;&#x2DC;Own Spaceâ&#x20AC;&#x2122; A way in which the staff can easily access patients medical history without bothering the patient each visit. A way which doctors and nurses who have not had any contact with the patient can get some background information on them before the appointment.

INSIGHT: Data Data throughout the full NHS system is stored on paper, a very old fashioned way of record keeping. This makes it very difficult to pass on information to other members of staff, and also find information about patients. â&#x20AC;&#x153;Feels very out of touch with the rest of the worldâ&#x20AC;?

OPPORTUNITY: Upgraded System The current record system creates a lot of clutter for the NHS, this would simply not fit in a mobile chemotherapy unit. There needs to be an updated system which is simple to use, efficient and easily accessible for all staff; alongside secure enough that records will not be hacked into.

OPPORTUNITY: Easy Contact Between Staff A quick and simple way to send information to different members of staff - this would allow the NHS staff to keep better records of certain patients, so all staff are aware of any problems and breakthroughs during treatment. This would update the system to the modern world, where every piece of information about a patient can be sent instantly.

INSIGHT: Updates Some patients either do not feel up for chemotherapy treatment or they can not be administered it due to them feeling too weak or ill. These drugs are then administered to other patients if a person is unable to come in for their treatment.

OPPORTUNITY: Updates With appointments and patients constantly changing as a result of this there would be a good opportunity to create a easy way to keep the mobile unit updated.

NHS DATA LOGISTICS INSIGHTS NORTHUMBRIA KIERAN BROOKES 2015