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18th July 2016

Person-Centred Cancer Care in Wales: Simple Steps – Big Difference

With lifetime prevalence moving towards 1 in 2, cancer care is likely to touch all of us at some point of our working lives. The high incidence also means many individuals in residential and domiciliary care settings will need cancer care, in conjunction with primary, and specialist services. Interestingly, one staple of good social care is also now being recognised as an essential ingredient within cancer care too. Namely, making care truly 'person-centred'.

All too often the person can be lost within the battery of tests and treatment types which cancer sufferers have to undergo - and the needs of the person are subsumed within this 'treatment-focused' approach. As a result psychological, spiritual, financial, occupational and emotional needs can be forgotten, when with a more holistic approach, much could be done within existing resources and facilities to meet these needs too.

''Coming out of hospital was like falling off a cliff, there didn't seem to be anything to support me when I got home. I was still recovering from the effects of major surgery and as I live on my own I wasn’t able to cook or take care of myself let alone think about returning to work. I became isolated, depressed and anxious."

Championing the cause for person-centred cancer care in Wales is Macmillan Cancer Support Cymru. In their document 'Cancer: Time to Choose, 2016,' they make a strong case. They argue that all individuals diagnosed with cancer should have a holistic needs assessment undertaken using a recognised assessment tool. The outputs from this assessment should then be included within a document which forms the basis of a care plan utilised by all agencies involved with the service user. They argue that only by recognising the needs of the whole person can the individual be put at the heart of their care.

"Person-centred care means that the needs of the person living with cancer are always at the heart of how services are planned, not the needs of the service providers." Macmillan Cancer Support Cymru.

Macmillan identify six key factors necessary to make a reality of person-centred care.

  • Active involvement of the individual in planning and understanding their care plan.
  • Personalised and holistic needs assessments and written care planning .
  • Well coordinated continuity of care.
  • Good communication between agencies.
  • Information and support.
  • Signposting to financial, practical and emotional support.

Theses are relatively simple but often overlooked steps. For example Macmillan's research shows that only 1 in 5 Welsh patients reported being offered a care plan. This was consistently highlighted by patients within the consultations carried out by Macmillan and has become a central plank of their drive towards person-centred care.  For those in social care settings, implementation of the care plan will require genuine collaboration between health and social care services, and this reality highlights the folly of making arbitrary distinctions between health and social care.

Involving the individual in active consideration of their overall needs and assessments is more than just a desirable service characteristic. Individuals involved in this way are likely to feel better supported as well as empowered to identify potential problems within their own care. This more proactive and holistic care model is likely to be more effective and resilient in the longer term. Person-centred care, therefore, also makes sense from a practical and value for money point of view, because of the big difference it can make to care.

Check out Macmillan's 'Time to Choose, 2016' (Wales) campaign at


Nic Bowler

Welsh Care and Social Services Inspectorate Specialist

Dr Nicholas Bowler is a researcher and consultant to government-level [Welsh Government Review of Secure Services, 2009] – specialising in QA/compliance focused projects. He has interests in clinically relevant training, service development and research. He enjoys working with clients to support them in identifying problems and initiating projects to improve practice. Read more

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