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Introduction
Cancer exerts a lot of pressure on family and government resources. In the United Kingdom, of the four deaths that occur, one is a cancer case. Cancer affects many parts of the body and has diverse presentations and complications. Its treatment process is also complex. These factors present major challenges to the health professionals like the oncologists and radiotherapists and to the National Health Service. The public still regard cancer as one of the threatening disease. Government agencies have devised several ways like screening and prevention to help reduce deaths that occur as a result of cancer. Many health care providers recommend early clinical diagnosis of cancer as a sure way of its management when it presents itself. Two policies, personal and professional development plans and National Health Service Knowledge and Skills Framework will particularly be discussed in this essay. This essay seeks to discuss and evaluate how quality management policies help in ensuring that the staff within the cancer services the therapeutic radiographers, medical physics staff, clinical oncologists, nurses, and the support staffs have the necessary knowledge and skill to provide high quality services.
Quality management policies would ensure that appropriately trained medical staff is stationed within the cancer unit and that there is some degree of developed specialization in provision of medical care to patients. The policy should ensure that it is only the consultant surgeons who oversee surgical management of cancer in particular anatomical areas (Benner and Benner 1). The surgical management of cancer should cover cancers as well as non malignant conditions. Specialty interest in breast cancer and gastro-intestinal cancers should be developed. This will help in enhancing cancer care as surgical services in various hospitals will be organized. Appropriate policy framework will ensure that relevant professional bodies unanimously come up with minimum acceptable volume of work in any cancer is accelerated. The policy should ensure that issues related to workload and specialization is appropriately addressed so that every staff working in radiology and oncology laboratories are apportioned acceptable work volume.
Personal/Professional Development Plans and Cancer Therapy
Nurses and other health professionals role in cancer therapy among the cancer patients are very diverse. These professionals may be cancer specialists stationed in specialist cancer units, where as the others may just be people who interact with cancer patients in their daily undertakings. In this perspective, their roles would be immaterial (Cancer Research UK 2). The most important thing is that these people have continuing professional development needs inclined towards caring for cancer patients, members of their families, and their carers.
Health services provisions and professional role definition keep on changing and much emphasis is now put on delivery of care back at home. Health care professionals from different geographical boundaries are now able to collaborate to oversee the integration of service delivery responsive to the needs of patients irrespective of where the service is accessed. Changes in structure of population are likely to influence cancer care in future (Hope 10). Because of increased improved nutrition and other factors many people are likely to live longer. Studies show that cancer incidence increases with age. Therefore the number of people suffering from cancer is likely to increase in future. Studies show that in Scotland by the year 2020, the number of new cases suffering from cancer shall have reached a record 36, 500. Majority of these cases will be co-morbid conditions. Cancer is currently being viewed in the perspective of being a long term condition. In formulation of long term services, rehabilitation process, and self care development, it is imperative that individuals with cancer, their carers and family members are brought on board. These are bound to impact on education and teaching offered by the professional in future. It is very important to benchmark clinical practice and education against the framework of competency.
The Scottish National Health Service Education considered developing a competency framework for the nurses and this later incorporated nurses and allied health specialists. Because of the popularity of the framework, it was rolled out across the entire health care sector. Major challenge the framework has had to contend with has been the practitioners uncertainty about which framework to make use. For people working with cancer patients, the competency framework should embrace aspects of comprehensive professional development framework that addresses capability and competence (Salisbury center for mental health 5). Capability encompasses current competence the job requires with a possibility of developing future competence. This is the core of Scottish health care professional action plan.
Determination of competencies for particular role has been complicated by frequent changes in professional roles. Quick change of provisions of education to capture developments that have taken place within health services has also been made difficult. Wide range of duties done by nurses and the allied health professionals makes it even harder to construct a working personal and professional development framework. However, a capability framework ensures flexibility and adaptability in training and education. This ensures that health care delivery demands are met. Capability framework therefore appears to be the suitable framework for professional development among the nurses, allied health professionals working with cancer victims, care givers and family members.
Professional development framework has three levels; the core level, the specialist level, and the advanced level. At the core level should be nurses and the allied health professional that interact with cancer victims, their family members and those who care for them. The fame work should focus on the care that adults suffering from cancer should be accorded. Palliative care should also be included in the framework with intent of providing elaborative palliative care framework. The core level acts as the ground level to professional development framework. The framework also includes cancer specialists working at different levels having varying degree of expertise. Professional development framework is wholly embedded on the concept of capability. Capability has got to do with continuing development of practitioners ability and their potential facilitation. It is a very important tool in lifelong learning process and in personal and professional endowment (Scottish government 3). Competence gives description to what a person has good knowledge of or is in a position of doing, and these peoples skills and attitude at specified periods of time.
Capability gives an insight into a person can apply, adapt and make use of new knowledge he or she has acquired from experience and their continued effort to improve on their performance. Complexity is not an integral part of competencies. Efficient practitioners require more than one competency to effectively undertake their roles. The ease with which one adapts to frequent changes endow them with professional judgment, skill needed for decision making, and knowledge gained out of experience one acquires from different fields. When the practitioners have more expertise, he or she is able to adapt to complex situations.
Capability framework is involved with realization of peoples full potential, development of an environment where people can adapt and apply the knowledge and skills they have acquired, experiential learning, and development of a foresight for what may happen in future. The elements complement in process professional development, in process learning, and individual development goals. Capabilities incorporate performance component, an ethical component. Performance component delves into what people endear to their hearts that they endeavor to achieve in the work place.
Ethical component encompasses knowledge of culture, institutions values and social awareness and how they can be used in professional practice. There is also a component that encourages reflection on whatever action that has been executed. Better still; some components emphasize commitment employing the use of new models of professional practice where acceptance of responsibility for lifelong learning is emphasized (Scottish executive health department 5). Finally, there are components of competency that are pivoted on the professional ability to implement evidence based interventions effectively bearing in mind the changes that take place in health care system. Capability framework outlines what practitioners ought to do in their practice. Capability frameworks derive their support from discipline specific frameworks that give the expertise level required.
Competency frameworks for professional who care for cancer victims do not have nationally accepted standards. It brings on board practice learning processes that capture what practitioners ought to achieve. Capability is normally is normally looked in the perspective of current competence integrated with future potential competence development. Essential shared capabilities initially used with people suffering from mental health problems have been adopted for use with cancer care professionals. Essential capabilities for cancer care have borrowed heavily from the mental health capabilities (The society of radiographers 5). These capabilities are equally as none overrides the other in importance hierarchy. They are therefore not ranked.
Practitioners working closely with cancer victims their families and those who care for them should work in partnership by coming up with a working relationship with cancer victims, the members of their family and those who care for them and a multi-professional colleague who design, , deliver and evaluate treatment beyond geographical and professional enclaves. Practitioners should respect diversity by providing treatment and care with respect to diversity. The practitioners should practice ethics by this they should recognize cancer victims individual rights, their family members and those who take care of the cancer patients. There should be informed decision making. Care and treatment should be given based on professional ethics, legal ethics and the laid down codes of practice.
Practitioners should also be in a position to challenge issue related to inequality by recognizing the fact that even cancer victims, their family members and those who take care of them have got their rights. This will help in ensuring that these people get the best of the services from the professionals. The services offered should disregard the stage of cancer, the cancer victims personal circumstances or their location geographically. The practitioners should also identify the cancer victims individual needs, the needs of their family members, and the needs of those who take care of the cancer victims. They should work in partnership with these people to identify their health and well being, social care requirements. Needs of those who take care of these cancer patients and those of their family members should be focused on.
The practitioners should provide good patient oriented care center that provide responsive care and medical intervention that meet cancer patients expectations, expectations of their family members and those of who take care of them. Every activity done should heavily regard professional codes of conduct and clinical requirements. Practitioners should uphold best practice requisites by conducting continual reviews and doing evaluation to ensure that services offered meet specific individual needs of the cancer patients, needs of their family members and those of who continually take care of them (Wilkinson, Lellopoulou, Gambles, and Roberts 750). Rehabilitation approaches should also be promoted by recognition of the need for rehabilitating all cancer victims regardless of the stage of cancer and stage of its treatment.
Practitioners should partner with cancer individuals, members of their families, and those who take care of them, and other specialists in coming up with realistic goals, instill a feeling of hope, programmes of rehabilitation should help in development of realistic goals. Practitioners should help in promotion of self care and empowerment by supporting people who engage in addressing health care needs and encouragement of independent living. Finally practitioners should concern themselves with learning and personal development. Practitioner has to be abreast with the changes that have been effected in the practice. Practitioners should constantly have desire to extend their knowledge and experience by taking part in lifelong learning activities. Constant pursuit of personal and professional development should be based on reflection and supervision that is done inside and on the practice. Communication is not accorded the efficient capability it is suppose to given despite the fact that it forms a major component of the framework.
Structure of the Framework
Framework has got four domains, namely the knowledge for practice, the multi-professional approach, ethnicity practice, and care and intervention. Of the four domains, each has its capabilities, the practice learning outcome and the key content. Capabilities spell out the broad statement of intent. Practice learning outcome details knowledge, skills that professionals should exhibit in the office. Key content depicts an outline of knowledge. Framework is often used to assess ones life, for personal development planning, team development, education, and training development, work based learning development.
The National Health Service Knowledge and Skills Framework
The framework enables healthcare professionals conducting radiotherapy to come up with necessary strategies to enhance safe practice. The framework identifies the knowledge and skills necessary for safe practice in the radiotherapy discipline as well in cancer treatment in general. The framework targets registered nurses and therapy radiographers. It may also in way target specialist registrars working in the radiotherapy section. Radiotherapy review is supposed to effectively asses ones situation while undergoing external beam therapy. It also intends to contain patients psychological and physical side effects while at the same time responding to their care needs.
The treatment review is supposed to provide services that mitigate problems that come about as a result of radiotherapy treatment. It is also supposed to keenly monitor report and act on unprecedented radiotherapy reactions (Wilson and Holt 686). The framework helps in upholding practice standards in radiotherapy care, allow for self assessment, enable non interrupted professional development, teams within radiotherapy are also developed, it normally act as a guide for initiation of education and training, and it also enables for development of guide for work based learning. The KSF framework normally has five domains of practice namely knowledge for practice, the multi-professional approach, ethical practice, care and intervention, and finally the personal, professional and service development.
The knowledge for practice forms the basis for effective cancer care. The multi professional approach illuminates capabilities that act as requisite for working in partnership with individuals other professional and agency teams. Ethical practice is supposed to anchor on values and attitudes that form the basis of the practice. Care and intervention is all about description of the capabilities unique to evidence provision anchored on cancer care. Personal professional and service development involve keeping abreast with changes encountered in practice and participation in lifelong learning. Service development is supposed to improve quality of the services delivered to the cancer patients undergoing radiotherapy. Each of the domains is suppose to have aspects of capabilities, practice learning outcomes, key content, and indicative KSF links.
Capabilities underline the elaborative statement of merit. Practice learning outcomes outlines the knowledge, skills and attitudes professionals should incorporate into practice. Key content is all about coming up with knowledge base needed for achieving the learning outcomes. Framework repeatedly uses the word individuals, but the practice outcomes are also applicable to family members, friends of the cancer victim and also those who take care of the cancer victims. Practitioners should know how to get both local and national policies and update his or her knowledge about these policies to enable them practice effectively and safely.
The practitioner should also be aware of other alternative treatments that are likely to jeopardize or inhibit or accelerate radiotherapy effects. They should also be in a position to explain to the cancer patients the preventive measures that can be adopted to avert the side effects that radiotherapy is associated with. The practitioner should be in a position to explain the pattern of side effects that are likely to accompany radiotherapy done on specific sites and regimes. The practitioner should be aware about the intent of radiotherapy and therefore be in a vantage position to disseminate this information to cancer patients. They should be having good knowledge about the likely potential late effects of radiotherapy. One of the concepts used in the radiotherapy treatment includes reports by National Radiotherapy Advisory Group (NRAG) that develop different technological innovations in order to make the radiotherapy treatment more relevant to modern advancement in this sector.
Practitioners should integrate effective assessment, into clinical observation and communication skills to know whether an individual is fit enough to undergo radiotherapy treatment (The society of radiographers 6). They should assess the severity of the side effects with the help of a recognized toxicity grading system, universally accepted protocols and documents and appropriately recommend services to the individual if need be. Assessment process should apply the knowledge of side effects of specific radiotherapy regimes. Where supportive treatments are needed antibiotics and steroids can be used.
Conclusion
The practitioners are supposed to use professional judgment to assess the potential and actual impact of cancer. Practitioners that deal with patients with cancer should acquire knowledge and skills in order to improve their professional capabilities. The modern sector of health care introduces new methods every day, which means that professionals in cancer therapy should be ready to implement new techniques and methods in practice. National Radiotherapy Advisory Group (NRAG) is one of the policies that reports the results of radiotherapy researches and innovations and enables professionals in the relevant sector to acquire the latest information that can contribute greatly to the improvement of the quality of treatment received by patients with cancer and other types of tumors that can be treated with the help of radiotherapy.
Works Cited
Benner, Patricia, and Patricia E. Benner. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Upper Saddle River, New Jersey: Prentice Hall, 2001. Print.
Cancer Research UK. Breast Cancer UK Incidence Statistics. London: CRUK, 2010. Web.
Hope, Roslyn. The Ten Essential Shared Capabilities A Framework for the whole of the Mental Health Workforce. London: Crown Copyright, 2004. Web.
Salisbury center for mental health. The Capable Practitioner. London, Salisbury center, 2001.
Scottish government. Better Health Care. Edinburg, Scottish government, 2007.
Scottish executive health department. Moving From Care To Enablement: A Delivery Framework for Adult Rehabilitation in Scotland. Edinburg, SEHD, 2007.
The society of radiographers. Learning and Development Framework for Clinical Imaging and Oncology. London, 2007.
The society of radiographers. Positioning Therapeutic Radiographers with Cancer Services: Delivering Patient Centered Care. London, 2006.
Wilkinson, Susie, Chad Leliopoulou, Michael Gambles and Alfred Roberts. Can Intensive Three-Day Programmes Improve Nurses Communication Skills in Cancer Care? Psycho-Oncology 12(8):747-59.
Wilson, Tim, and Tim Holt. Complexity and Clinical Care. British Medical Journal 32.3 (2001): 685-688.
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