Macmillan Cancer Support is one of the largest British charities and provides specialist health care, information and financial support to people affected by cancer. It also looks at the social, emotional and practical impact cancer can have, and campaigns for better cancer care. Macmillan Cancer Support's goal is to reach and improve the lives of everyone who has cancer in the UK.
Acute oncology e-learning for staff who treat and care for people with cancer in the United Kingdom exists; however standardised, acute oncology competence assessment does not. This study reports the development and evaluation of a standardised acute oncology competence assessment integrated within an existing e-learning resource, which ultimately aims to improve cancer patient safety outcomes across the UK. The e-learning and assessment were developed for multidisciplinary staff working in any clinical setting where patients with cancer may present with urgent or emergency symptoms. For example, acute medical units, accident and emergency, same day emergency care, primary care and pre-hospital settings, such as paramedic services and general practice, as well an introductory resource for staff new to working in oncology. The study team, multidisciplinary professionals and cancer-specialist educators from across the UK co-designed a Digital Competence Assessment for ‘practice Level 1’. An existing ‘Introduction to Acute Oncology E-learning Module’ was revised to include the novel Digital Competence Assessment (together the e-learning and competence assessment were termed: The Level 1 Acute Oncology Passport). This was piloted and evaluated across the UK during Phase 2. Quantitative data from pre (n = 376) and post (n = 176) Level 1 Acute Oncology Passport responses were analysed using descriptive and inferential statistics. Free-text responses were analysed using content analysis. There was a significant increase in learners’ level of confidence about their acute oncology knowledge and skills pre and post e-learning and digital competence assessment. The Level 1 Acute Oncology Passport was evaluated as relevant, pitched at the correct level and an appropriate measure for assessing acute oncology knowledge and skills competencies. The main challenge reported was lack of study time. There was also a desire for support of acute oncology knowledge and skills development in the workplace, alongside or following e-learning. Acute oncology is an important area of practice for improving outcomes for people with cancer, but for acute oncology to be effective it requires a knowledgeable and skilled workforce. The acute oncology learning needs of staff caring for people with cancer in other countries are likely to be similar to the UK. Although respondents were staff who opted to complete the online learning, assessment and evaluation survey, our e-learning and digital assessment of competence Passport was found to be engaging, relevant and acceptable, demonstrating the value of co-design. It also increased learners’ confidence and knowledge about acute oncology. However, dedicated time and support are needed for healthcare staff to develop knowledge and skills to ensure safe outcomes for people with cancer. We suggest that similar education and competence assessment resources are needed to address acute oncology learning needs among the broader cancer care workforce.
Abstract Introduction About 13,000 new patients are diagnosed annually with a primary brain tumour in the UK and less than 20% of patients survive 10 years post-diagnosis. Patient-Reported Outcomes and Experiences (PROMs & PREMs) are largely used in clinical trials that recruit fitter and younger patients than patients routinely treated. Indigo is a randomised controlled digital clinical trial aimed at capturing adult cancer patients’ PROMs and PREMs. Methods We have implemented an online, patient-completed, randomised observational trial. We identified all patients who self-reported having a brain tumour and assessed their EQ-5D-5L scores, demographics and socio-economics metrics, and their use of health services. Results Between January 2025 and 1st of February 2026, 67,860 patients provided informed consent and enrolled in the trial, of whom 188 patients (0.3%) had a brain tumour and were eligible for analysis. The median age was 55 years old, 95% were white; 93%, heterosexual and 51%, women. 59% were diagnosed over 5 years ago and the oldest year of diagnosis was late 1980s. 47% patients received surgery, chemoradiotherapy; 45% reported that their tumour was still present and 44% that their tumour was cured. Most patients reported problems with anxiety and depression (62%) and performing their usual activities (61%). Over 60% saw either their GP (69%) or their hospital doctor (62%) and 55% would contact their CNS if they had a concern about their diagnosis. Conclusion This is the first national study to look at quality of life and service use in brain tumour patients. Patients report issues with mental health and activities of daily living, and patients diagnosed over 5 years ago still have annual appointments. We are continuing to recruit to the trial.
Introduction Within the UK there are 33 deaths every day from prostate cancer, second only to lung cancer as the most common cause of cancer death in males in the UK. Of the 55 000 new cases each year, up to 50% of these patients will receive radiotherapy either alone or after prostatectomy. Although there have been significant improvements in the accuracy of radiotherapy delivery leading to better tumour targeting and a reduction in dose to normal tissues, significant permanent genito-urinary or gastrointestinal-related side effects are all too common. With nearly 80% of patients with prostate cancer surviving for 10 years or more, minimising life-limiting radiation damage to normal tissues is vitally important. However, at present, it is not possible to identify which patients will suffer a poorer outcome after radiotherapy. The aim of this study, improving radiotherapy in PROState cancer using EleCtronic population-based healthCAre data (PROSECCA), is to do this by using the existing information in a patient’s digital healthcare record. By linking primary, secondary and tertiary clinical data, including digital image information, with radiotherapy treatment plans and outcome data, the PROSECCA study will identify de novo predictive biomarkers of radiation response and provide clinicians with a tool to individualise a radiotherapy dose and plan to maximise cure and minimise toxicity.Methods and analysis The PROSECCA study is a large multidisciplinary project, the purpose of which is to analyse healthcare records from up to 15 000 patients with prostate cancer who underwent radiotherapy in the treatment of their cancer in Scotland between 2010 and 2022. Through the linkage of data obtained specifically for radiotherapy and data held within each patient’s unique electronic health record (EHR), the factors that indicate why some patients have a poor response to treatment, or an increased risk of side effects from radiation, will be identified. This will be made possible by the use of artificial intelligence and machine learning (AL/ML), which will help to identify at-risk patients earlier and allow adaptation of their treatment accordingly.Ethics and dissemination The study is being conducted in accordance with the ethical principles set out in the Declaration of Helsinki and Good Clinical Practice that respects and protects the rights, and maintains confidentiality, of all trial participants. The study protocol (V.1.0) was reviewed by the South Central Oxford A Research Ethics Committee (REC) on 13 December 2021 and received a favourable opinion subject to each National Health Service (NHS) organisation confirming permission for patients treated within their area. Approval for the use of unconsented healthcare record data for patients included in the study and treated at one of the five Scottish Cancer Centres required an application to the NHS Scotland Public Benefit and Privacy Panel for Health and Social Care (HSC-PBPP). Full approval from the HSC-PBPP panel was received on 1 July 2024, which covered the use of pseudoanonymised EHR data for all patients participating in the study. The study is publicly listed on the NHS Health Research Authority site, with IRAS ID 306245 and REC reference 21/SC/0402. Dissemination of the study findings will take place through field-leading cancer, radiation oncology and medical physics journals. All manuscripts will be approved by the main study team and authorship determined by mutual agreement.Trial registration number NCT06714630.
Pre-registration nursing and allied health professions students and cancer support workers can feel unprepared to care for people affected by cancer and at the end of life. To address this need, nine e-learning modules, collectively called ‘Foundations of Cancer Care’, have been developed aligned to the NHS England ACCEND Framework. The resultant programme is freely available to anyone with a UK email address via the NHS Learning Hub. To evaluate accessibility, structure, relevance, design and style of this nationwide digital education programme, and to understand the impact of the porgramme on cancer specific knowledge and clinical practice, an e-survey was developed based on the Kirkpatrick model of evaluation. On completing the programme, participants were invited to participate in the survey. Anonymised data were collated via the NHS Learning Hub and analysed using descriptive statistics. There was a mean of 343 distinct users per module and 123 participated in the evaluation. Most participants were student nurses (n=42, 33.9
Background The UN General Assembly (UNGA) stated that the right-to-water entitles everyone to accessible and affordable water. People living with cancer (PLWC) need water for numerous reasons including hydration, personal hygiene and infection control. In 2023, reports emerged of PLWC in Lincolnshire (UK) disconnecting their water supply from cost fears. We report on innovative ways to ease financial burden and provide equitable and affordable access to clean water for PLWC in rural and coastal settings. Methods Quantitative data from secondary care and qualitative data from community-practitioners investigating PLWC’s difficulties in accessing a clean and safe water supply were synthesised. A review of existing financial support identified no services directly addressing water. The Lincolnshire Living with Cancer Team approached water provider, Anglian Water sharing concerns, identifying common values, and confirming shared aims. A formal partnership was established to address these inequalities. Results Initial data reviews showed completion of 25,858 Extra Care Assessments between Jan-Sept 2023 (12 % increase on previous year). This has enabled over 30,000 people with long-term conditions, including PLWC, to access clean and affordable water, a personalised support package for their water bill, including income maximisation, debt management, payment breaks, and bill reductions. Conclusion Impacts of cancer extend beyond physical health, with many PLWC reporting financial distress. Some PLWC have taken extreme measures to reduce their water consumption when they actually need increased water volumes. A partnership approach between health, voluntary and community sectors with a water provider can help address these inequalities. Policy summary The study addresses national policy (NHS Long Term Plan 2019) by demonstrating how personalisation can be achieved for PLWC in a rural and coastal county. Internationally, it aligns to The European Code of Cancer Practice and seeks to contribute to its implementation UNGA Resolution 64/292, the universal human right to water and sanitation.
