1. Greater Manchester Cancer
HNA and Care Planning Progress so far; trajectory to full implementation; eHNA barriers and successes; care plans Lindsey Wilby Macmillan Project Manager – Living with and Beyond Cancer
5th December 2018

2. Benefits of HNA

3. Holistic Needs Assessment: Macmillan concerns checklist
Can be carried out whenever and wherever necessary, but we have targets of…
Nurses do a lot of this naturally, but using the process brings up things they wouldn’t have thought of – so much more patient-centred
Totally relevant to patients with an incurable diagnosis

4. It can feel like an uphill struggle…
Greater Manchester Cancer
It can feel like an uphill struggle…

5. eHNA Greater Manchester Cancer
eHNA training webinar:

6. Greater Manchester Cancer
Benefits of eHNA
It is patient led, and patients can prioritise their individual concerns.
As the process is electronic it is much easier to audit and analyse activity data for reporting, or to identify local service needs.
Data can be used to monitor the number of assessments done, and care plans provided, as well as those patients who have declined an assessment.
The care plan can be ed to the patient and their GP for future reference.
It can also be used by the nursing staff to evidence the depth of care and support they provide to their patients.
Data will be shared across GM…eventually

7. Concerns identified
Patient information sheets for all the HNA concerns are being developed by Macmillan. Currently available are:
Constipation
Diarrhoea
Eating, appetite and taste
Education
Heartburn and indigestion
Hot flushes or sweating
Memory or concentration
Nausea or vomiting
Pain or discomfort
Sleep problems
Tired, exhausted or fatigued
Work (employment)
Worry, fear or anxiety

8. Regard for patient’s viewpoint Ability to prioritise concerns
Benefits of Care Planning
Refocusing on what is important – without a care plan the HNA can just be a tick box exercise
Regard for patient’s viewpoint
Ability to prioritise concerns
Patient has a written record of the plan which they can refer to/share with other HCPs
Individualised, high quality care
Supports self-management

9. Greater Manchester Cancer
Progress across GM
9 out of 10 sites are signed up to eHNA; with varying degrees of implementation
c.2000 HNAs per quarter are captured by current data reporting across GM – but we know that more than that are being carried out
NHSE metrics will give us more data
Aiming for “full” implementation by March 2020
Aiming for all HNAs to result in a care plan? Or at least a “personal action plan”?

10. Time Hardware Connectivity Compatibility Care plans Other
Greater Manchester Cancer
Challenges
nurses sometimes say “I already do this; I don’t need a new tool to tell me how to assess my patients”
Culture
for nurses (and others) to devote to HNA
Time
availability of tablets or other interfaces in clinic
Hardware
with Trust WiFi; does the WiFi reach the clinic?
Connectivity
Compatibility
with Trust systems (eHNA/Somerset)
Care plans
what does good look like?
???
Other

11. Solutions – how to overcome these challenges?
Greater Manchester Cancer
Solutions – how to overcome these challenges?
Culture
Time
Hardware
Connectivity
Compatibility
Other