Psychologists have broadly welcomed the government’s new five-year NHS Cancer Reform Strategy (see tinyurl.com/3bd8zw), although there is some concern that the role of psychologists in cancer care has not been made more explicit.
Professor Sheila Payne, a health psychologist and Chair in Hospice Studies at Lancaster University, told us that the new strategy ‘provides a number of opportunities for psychologists’, including: in the design and delivery of health promotion and cancer prevention interventions; understanding people’s ‘models of illness’, to reduce the time people wait before reporting symptoms to their doctor; helping improve the presentation of information; and understanding inequalities in care - how and why survival rates are affected by factors like social demographics.
‘It is also very important that this new strategy has again highlighted the need for psychological support at all stages of cancer,’ Professor Payne added. ‘And it is also welcome that cancer survivorship has been recognised as an important issue. Psychologists need to be encouraged to direct greater attention clinically and in research to the long-term impact of cancer.’
Christine Kalus, Macmillan Consultant Clinical Psychologist at the Rowans Hospice in Hampshire, also welcomed the strategy and praised the requirement for all cancer professionals to complete communications skills training. However, Kalus noted that neither clinical nor health psychologists are explicitly mentioned in the 144-page document. ‘It’s a missed opportunity. There is a robust literature on the importance of psychological support, yet the new strategy is not strong enough to encourage commissioners to beef up psychological services, certainly not in hospitals where they’re often very weak.’
In particular, Kalus said there is too little attention given to the needs of carers, even though ‘we know that if the carers collapse then the care for the patient does too’. There is also no mention of bereavement.
Dr Elaine McWilliams, who also works at the Rowans Hospice, called for a clear policy on the minimum levels of psychological support. Without that, ‘change will be slow or even in some cases regressive, and will be dependent on local commissioning priorities rather than a true understanding of psychological need’.
According to Kalus, there are pockets of good practice, yet other areas struggle to recruit a single psychologist. ‘We need to ask what more can we be doing to get out there and make health commissioners aware of best practice in psychological care,’ she said.
cj
|
The Psychologist
