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Case Study – Velindre University NHS Trust Cancer Centre

Enhancing Health Care Worker role helps improve waiting times for cancer clinic chemotherapy services, supporting nurses in its mobile cancer unit, improving remote patient care across the South Wales region

A specialist oncology hospital in Cardiff has developed a Senior Health Support Worker role with the help of Skills for Health’s role development consultants, to formalise new working practices, improve chemotherapy services and free up more time for registered staff.

Velindre Cancer Centre, part of the Velindre University NHS Trust initially developed a Health Care Support Worker (HCSW) role within chemotherapy services to support nurses in its mobile cancer care unit, which helps to deliver treatment closer to patients’ homes. The Centre recognised that if the HCSW role would be expanded to include administrative and organisational skills as well as additional clinical and communication skills, it could also be used more widely. It would enable the Band 6 nurses to spend less time preparing chemotherapy clinics and more time working with patients, improving the level of clinical care that they could provide.

One of the motivations behind the introduction of the new, more senior, role was to enable the clinics to run at full capacity by reducing the number of ‘unused seats’. Each ‘seat’ enables a session of treatment, and once it is prepared, it can be used continually throughout the day. While the new Senior Health Care Support Worker role was being developed, it also became apparent that the process of preparing the chemotherapy drugs was inefficient, with duplication between the nurse and pharmacy staff. This process was reviewed and streamlined, bringing in the SHCSW role to liaise with pharmacy staff.

“I was able to open more seats as a result of releasing clinicians into the clinical area. This is significant because one seat can treat up to seven patients a day so that’s 35 more patients a week being treated – which improves our service to our patients and reduces waiting lists.”

Meryl Mormon, Chemotherapy Nurse Manager, Velindre NHS Trust

Outcomes

Having an experienced SHCSW working on the mobile unit enables more patients across South Wales to receive cancer treatment closer to their homes, allowing more patients requiring higher risk, more complicated care to be treated at the cancer centre. Patients and carers benefit from a Senior Health Care Support Worker with advanced knowledge of chemotherapy and processes associated with their treatment. The SHCSW provides the majority of the hands-on care such as washing, changing and feeding. This continuity of care is likely to have a positive impact as the SHCSW can provide familiarity and emotional support for patients and their families. Band 6 nurses are able to spend less time on administration and more time with patients, improving patients’ experience. The nurses also benefit from working with more highly trained SHCSWs efficiency savings – an estimated reduction in ‘unused seats’ worth around £19,200 per annum.

There has been an improvement in patient waiting times, with 92% compliance after the introduction of the role, compared to 67% before. Speed of treatment is a key element of success for cancer, so this may assist in the improvement of clinical outcomes. The reduction in waiting times is also better for patients and their families overall volume of patients going through the hospital has increased, without expanding the number of available ‘seats’. The numbers of cancer patients across South Wales are anticipated to increase, and so the availability of experienced SHCSWs able to work flexibly across different sites will support effective service expansion. The implementation of the Senior Health Care Support Worker role will offer career progression for individuals currently in HCSW roles.

The redesign of the role took place gradually, having initially been implemented without a formal job description. Velindre worked with our workforce and role development team to use their role redesign methodology in order to formalise many of the changes that had been made to the role and to produce a framework against which future postholders can develop recognisable skills. The role development work resulted in an enhanced job description, describing the learning and development requirements and clinical competences required for the role.

“I enjoy more responsibility and I like having new things to do. Learning new skills and seeing my role expand is brilliant – it makes my job more interesting and a challenge and that’s what drives me.”

James Graham, Senior Healthcare Support Worker, Velindre Cancer Centre

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