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Recent news

It’s a real privilege to be on the cancer care journey with our patients

In this blog, Laura Spink, a clinical nurse specialist with the Healthcare at Home cancer team, says that spending time with patients is key to the care she offers. Here she talks about why it’s also a part of the job that she really enjoys.

I joined Healthcare at Home 6 years ago as an IV chemotherapy nurse. After 8 years working on an oncology ward, I had wanted to find a position where I could provide the one-to-one care that I believe is needed to bring cancer nursing to its full potential – and that’s exactly what Healthcare at Home offers.

In September 2019 I became a clinical nurse specialist within the team and now work directly with a hospital consultant, Dr Chakarborti, supporting around 80 patients across three hospitals.

I meet with both Dr Chakarborti and individual patients at their initial clinic consultation, where I introduce myself and explain how Healthcare at Home works. I find this a real benefit as it shows patients right from the start how our team works hand-in-hand with the hospital to deliver holistic care.

I also visit each patient before their first treatment to go through exactly what to expect and answer any concerns they may have about chemotherapy, and we usually build up a trusting relationship quite quickly. The local Healthcare at Home chemotherapy nurses then pick up the visits to give the treatment, however patients can still give me a call and I see them in clinic.

The arrival of the coronavirus pandemic inevitably made a difference to how we deliver our service. During the COVID-19 response much of my work has been carried out remotely, through telephone calls and video consultations. Previously I would spend half of my week in the south and the other half in the Derby area, and the new way of working means that I can be more flexible for individuals across both areas all week. It also suits our patients who want to limit the number of visitors to their home.

Healthcare at Home clinical nurse specialists support patients with symptom control and medicines management, for example by advising on the way forward if there are potential clashes between a patient’s regular medications and the systemic anti-cancer therapy. As specialists we’re also there to support the patients and their families but also the chemotherapy nurses when they’re with patients.  Our support helps them immediately deal with any issues such as patients experiencing nausea during their treatment.

We also complete a holistic needs assessments for patients which cover emotional, physical, and financial concerns, to see what extra support can be added. As part of this role, I’ve developed a relationship with local hospices such as Treetops Hospice Care in Derby and the Maggie’s cancer charity, which have been invaluable in offering further support and signposting to other local services. I also link closely with the palliative care team at Derby who offer excellent support and advice on pain relief for patients with complex needs.

As a cancer care team we also look after palliative care patients who aren’t receiving active treatment, to make sure they remain as comfortable as possible. We provide emotional support to both patients and their families and this ongoing connection means we’re well placed to call in help from hospices as soon as it is needed.

We’re also there for the family after a patient has passed away, and that’s a really important part of our job. I’ve been keeping in touch with the wife of a patient who passed away in February, and in May she called me as she was having a bad time. I went to visit her in her garden for a chat, strictly observing the social distancing rules for healthcare workers in place at that time, and she said it really helped her to not be on her own, especially during the time of national lockdown.

I find that the dedicated support that patients and families receive from our teams is one of the things that sets Healthcare at Home apart – as a clinical nurse specialist I manage my own diary so if I need to sit with a patient for a few hours, I can. It’s extremely rewarding and a real privilege to be on the journey with our patients and their loved ones.

Just a couple of nights ago I spoke with a new patient who was amazed and thrilled that he could get care at home, where he would be more comfortable and relaxed together with his wife and children rather than surrounded by strangers.

As a key support to Dr Chakarborti, our service has helped grow his patient cohort and allowed him to focus more where his support is needed while we pick up the day-to-day concerns.

Patients give us a lot of positive feedback, especially around having a dedicated nurse to contact with questions to allay their fears and concerns, and having time to go through the treatment. Our wraparound care and wide range of services really sets us aside from other home care providers; working with Healthcare at Home allows me the dedicated time that our patients deserve at this most difficult time for them and their families, and I’m proud to be there.


Making cancer treatment personal

Our head of cancer services Kate de Lord provides an overview of the systemic anti-cancer therapy we provide to patients in the comfort and convenience of their own homes.

A cancer diagnosis is frightening, not just for patient but for their families too. We pride ourselves on providing a personalised service with 24/7 support and a dedicated team devoted to each patient and their family to support them in navigating the road ahead.

Sometimes, a cancer diagnosis can make someone feel like their life has been taken out of their hands. Choosing to have their treatment at home where they feel safe and relaxed helps them feel empowered, and this active role in their own healthcare gives them more control over their lives.

Communication and continuity in care are key to personalised treatment

We have a standardised pathway in place for our patients. The care continues to be consultant-led for the duration of the treatment so we make sure we have all the information we need from the consultant in order to treat the patient and meet the needs of them and their family. We have a welcome phone call with the patient to reassure them that we’re there to support them and will take care of them every step of the way. We take time to answer any questions they may have, explain the next steps and ensure they know what to expect.

The patient then has a pre-treatment assessment and blood test between 24 hours and 72 hours before the treatment date. The day after the treatment a Healthcare at Home chemotherapy nurse will follow up with a call to find out how they are doing. Then, ten days later, the patient will have another nurse visit for a mid-toxicity assessment. Lots of cancer treatment can reduce immunity as well as blood count and can cause side effects. These normally culminate about ten days after treatment. The purpose of the nurse visit is to see how the patient is doing, find out whether they are experiencing any side effects and establish whether we need to provide any additional support for them.

Each patient will see one of three nurses for their treatment so it’s very much a personalised service with continuity of care. The nurses build up a rapport with their patients as they stay with them while they deliver their treatment.  They see caring for someone in the home as a real privilege – it’s a very personal space to be welcomed into and allows them to really get to know the patient and their life.

There are numerous benefits to having treatment in your safe space at home. We often get feedback from patients that they like not having the stress of travel and parking, or not being in the environment of a busy hospital and it’s reassuring for patients to know the team taking care of them. This means patients are more relaxed and it’s really helpful to minimise any unnecessary stress when you are going receiving treatment for cancer.

Specialised patient support 24/7

The other service we provide, as part of the national guidelines on cancer care, is having an allocated cancer clinical nurse specialist (CNS) with each patient having the same CNS throughout treatment. Essentially, this is the patient’s key worker. They don’t deliver treatment but support patients and their families with any worries or questions and can refer or signpost them to other support available.

Cancer is a life-altering condition and can turn patients’ lives upside down. Some will have a young family while others may have a complex situation, but everyone has their own story and support is key. The dedicated CNS is there to respond to the needs of the patient and family with face-to-face visits and video or phone calls.

Patients also have access to our Care Bureau, a 24/7 telephone line manned by our own in-house nurses. If anyone is feeling unwell or has any queries from a clinical perspective these can be assessed over the phone using the UK Oncology Nursing Society tool to identify and triage patient symptoms. As with all contact with the patient, the consultant is always kept in the loop as they are accountable for their patient’s care the whole time.

Training, quality and clinical safety are high priorities

We have 150 highly trained chemotherapy nurses who all have in-depth knowledge of the treatments they are giving. We run our own SACT course twice a year which is accredited by Birmingham City University at masters and degree level. This not only provides career progression to nurses but also helps us increase our team of skilled chemotherapy nurses.

All our nurses are reaccredited annually to make sure they are still competent. This takes the form of study days and supervised practice. We have a team of SACT practice development nurses who really support the nurses going through the course and those returning to practice. By investing in training, we can assure patients of a standardised practice with high-end care regardless of where they live.

Patients really appreciate our personalised one-to-one care, but our nurses get a lot of satisfaction from it too and find their work really rewarding. It’s a privilege to support people, in their own homes, during such a challenging time.

For more information on the services we provide, please email cancerservices@hah.co.uk

The comfort, convenience and flexibility we offer are really appreciated by our patients and their loved ones

Our general manager for private services Peter Snuggs provides an overview of the support we provide to consultants and their patients.

Over 90% of the private funded care we provide is systemic anti-cancer therapy in the home and we cover a broad range of drug therapies. Our care is always consultant-led and delivered by our highly-trained, in-house team of chemotherapy nurses. In the last 12 months, more than 300 consultants have referred patients to us. Currently, around two thirds of UK oncologists refer their patients to us for chemotherapy services.

The scale of our business is not the real story however. What sets Healthcare at Home apart is that we’re able to deliver complex care in the comfort of a patient’s own home and there are all kinds of benefits to this. This truly is a patient-centric and patient-appreciated service. Patients generally feel a lot more relaxed at home, have more space and can enjoy a familiar environment. It’s also convenient and hassle-free, removing the need for lengthy travel to and from the hospital for treatments with patients often relying on relatives to take time off to provide transport and support. Their risk of infection is also reduced if treatment can be provided in the home. We take away the need for patients to spend hours travelling, instead our nurses will arrive at a time convenient to the patient and provide the care required. The comfort, convenience and flexibility we offer are really appreciated by our patients and their loved ones.

Increasing our support for consultants

We have recently introduced a new support role – The Consultant Engagement Manager (CEM). We now have five Consultant Engagement Managers providing each of our consultants with a port of call to offer support around their private practices. Each CEM has an excellent understanding of the industry and the service Healthcare at Home provides. They are also responsible for identifying new consultants to the market and those that haven’t previously referred patients to home care.

We have been providing private cancer therapies in the home for over 25 years and there is an enormous team that supports consultants and their patients. We have 150 chemotherapy nurses in-house across the UK and we treat over 2,500 private patients every year. We care for a similar number to that of other large private cancer centres and we treat 100 different cancer areas. We also have clinical nurse specialists who provide much-needed holistic care to patients, offering advice and holistic support organisations. In addition to those directly involved in providing care to the patient, we have an extensive network of regional team managers and clinical service managers who are always on hand to assist consultants and ensure our patients receive the very best service.

Another new role we have created and successfully tested is the Patient Liaison Lead (PLL). They will be based at our Burton-upon-Trent head office and will be a critical point of contact to ensure all aspects of the patient’s care is effectively coordinated across our consultants and clinical teams. They will register patients, schedule appointments and be a key contact for our consultants to ensure they and their patients have everything they need. We will always ensure everything is in place to make each treatment a success and I want our patients to think that we’re almost telepathic about their needs as a result of this patient liaison lead role. It’s an exciting time and the changes we have made have been incredibly well received by both consultants and patients.

Consultants will receive the very best service from us, every time, all the time

Consultants can expect a highly efficient and quality service as we’re working together as a single team. They will be liaising with only one or two people within Healthcare at Home. They will receive closed loop communication which means that if they talk to us about a patient and then send a follow-on email – we will acknowledge this and we’ll continue to keep consultants informed about what’s happening with their patients.

In terms of technology, we offer the iQemo system free to all our consultants. It’s an external system that we use as our primary choice of software to manage patient registrations. iQemo is also an electronic prescribing system which enables consultants to log details about their patients including the therapy they have been referred for and the drugs that are required. When this electronic referral lands in our system, we’re then able to process this and admit or register patients.

iQemo is an incredibly efficient system that isn’t unique to Healthcare at Home but it’s certainly one that is very well received by our consultants. It just makes life easier for them. Consultants can also expect that we provide a very reliable, safe and efficient service. At Healthcare at Home, patient safety is paramount and we take it very seriously.

Here’s an example of feedback from a consultant oncologist that refers patients to us:

“Healthcare at Home provides patients with a safe, effective and friendly service which helps me manage their cancer better,” – Professor Joe O’Sullivan.

We were delighted to hear this. We want our users, both consultants and patients, to feel served by our process, not processed by the service. Personal relationships and earned trust are at the core of what we do.

We partner with public, pharmaceutical and private providers to deliver services for patients that are essential for sustainable healthcare.

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96% of people using our services would recommend Healthcare at Home1

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24 hours-a-day, 7 days-a-week all-year-round support line, staffed by clinical experts, for people receiving care from Healthcare at Home. For Care Bureau contact information, please refer to your patient information booklet

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  1. Patient experience survey results: Patient voice: we’re listening, Jan-May 2017. Access here.
  2. Care Quality Commission, Healthcare at Home (Bristol) Quality report, August 2016. Access here.