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| | Referral and investigation | Diagnosis | Treatment and decision | Treatment | Posttreatment |
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| Communication | (i) Contact telephone number of someone empathetic | (i) Should a more senior health professional be delivering news—diagnosis? | (i) Better communication needed between people and services | (i) Make sure patient knows who to contact in between appointments | (i) Helpline telephone number—easy access |
| (ii) Consider language used—do patients understand 2 ww pathway? urgent referral? | (ii) Who can I contact after for follow-up care? |
| (iii) Change “pathway” to “journey”? or other | (iii) Opportunity to discuss other illnesses |
| (iv) Cancer pathway support |
| (v) Cancer referral route support tool |
| (vi) Language needs to be more personal/softer—“you,” “I,” “your,” etc. |
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| Info/signposting practical | (i) What do I do if I cannot speak English? | | (i) Signpost where to get help with state benefits | (i) Financial, benefits, employment, housing advice | (i) Short-term and long-term effects of treatment |
| (ii) Key contact numbers | (ii) Signpost to additional resources—nutrition, dietician, physical activity | (ii) Physical exercise guidance—prehab |
| (iii) Add practical prompts | (iii) Where can I get practical advice? Financial, transport, support groups | (iii) Info personal care—hair colouring, etc. |
| (iv) Local services |
| (v) Who do I contact if I am on a 2 ww referral if I have questions |
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| Emotional support info and signposting | (i) Local support groups | (i) Professionals giving feedback on diagnosis should be able to answer follow-up questions if they are delivering diagnosis news | (i) Signpost to local Macmillan information and support centre and support groups | | (i) Signpost to services for after care |
| (ii) Where can my family get support? | (ii) How do I tell my family? | (ii) Faith groups? |
| (iii) My cancer is genetic—where can I get support to discuss with family? |
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| Patient/carer/relative-centred care | (i) What can I expect to happen at the appointment? | (i) Diagnosis will be given by consultant and cancer nurse specialist | (i) Are clinical trials available? Pros and cons? | (i) How might treatment affect other conditions? | (i) What type of care will I get from my GP—how will I make sure this happens? |
| (ii) How do I make sure I get answers? | (ii) How long will hospital follow-ups last? |
| (iii) Can I bring a friend with me? | (iii) Late onset side effects? |
| (iv) Specific signposting to give patient back control |
| (v) Practical guideline/timeline—if you have not heard back by this time, call this number |
| (vi) Family support | (iv) What is next? |
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| Supporting navigation | (i) Are the appointments currently happening within 2 ww? | (i) Clear info about all possible side effects | | | |
| (ii) Do you triage a delay? |
| (iii) Tailor info around different patient journeys—e.g., A&E/GP route |
| (iv) A short flowchart at the beginning of the checklist would be helpful outlining why you are being referred, who you should contact with questions, a contact number |
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| Info exchange | (i) Add positive messaging | (i) If cancer diagnosis—consider signposting to wider support, i.e., not just emotional. Charities, prehabilitation and support with exercise, healthy eating, nutrition, online forums, etc. | (i) Provide videos | | (i) Short version and detailed version of tool |
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