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Skin Cancer Nursing
A Nursing Perspective from a Specialist
Skin Centre
Karen Pocock
Skin Cancer Clinical Nurse Specialist
St.Helens & Knowsley Hospital Trust
Content
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Dispel myths
Role of Skin CNS
Geographical boundaries
Patient Journey
Which patients should be referred?
Referral process in to SSMDT
MDT Link – value of
Who are the SSMDT?
The future
Summary
Dispel Myths - Macmillan
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Macmillan does not mean end of life!!!!
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Macmillan
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is a source of information for patients/families dealing with
cancer.
is a source of information for health professionals working in the
cancer field.
aims to improve the lives of people affected by cancer.
Role of the Skin Cancer CNS within
the specialist Centre
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Diagnosis – End of Life
Link to all hospitals/teams/other skin CNS
Clinical expert
A resource
An educator
Change Agent
Researcher
Advocate
Geographical Boundaries
Nobles IOM
Glan Clwyd
Chester
Bangor
Broad Green
STHK
Wigan
Halton
CCO
Southport
Aintree
Ormskirk
Warrington
Patient Journey
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Diagnosis (dermatology, plastics, GP)
Referred to Specialist Skin Centre
Surgery (plastics)
Waiting for results
Possible further surgery
Scans, further investigations
Possible referral to CCO - radiotherapy
Possible referral to oncology - clinical trials, chemo
Possible referral to other specialist centres i.e. Christies,
Glasgow.
Living with cancer
End of life
CASE STUDY
So how do we help?
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Smooth patient Journey
 Act as a link between all teams
 Communicate to other Skin CNS
 Relieve patient/family anxieties
 Point of contact / key worker
 Refer on to other teams throughout the network
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Lymphoedema nurses
Counselling/clinical psychology
Prosthetics, Physiotherapy
Palliative care
Holistic therapies
Which patients should be referred
to the SSMDT?
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Any complex skin cancer requiring wider excision
 Wider excision & SLNB
 Local recurrence
 Lymph node Dissections
 Head & neck melanoma
 MOHS
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Oncology
Discussion only for expert advice
See Network Guidelines
SSMDT Referral Form
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All patients need to be referred via form
 Clinical information
 Send relevant investigations with form
 Fax to Barbara Marsh
 Listed for SSMDT
 Deadline Thursdays 12 noon for MDT discussion
 Appointments generated via Barbara ASAP
Barbara Marsh
01744 646776
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MDT Link – HUB of team
Role
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Receives all initial referrals via fax
Constructs MDT list
Meets deadlines for cancer targets
Makes referral appointments
Chases investigations i.e. scans, histology
Uploads data to somerset
Contacts patients
Acts as a link to other trusts
The Team at STHK
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2 MDT co-ordinators
3 Core Plastic surgeons - specialists in skin cancer
surgery
6 Dermatologists
1 Medical oncologist
1 Clinical Oncologist
2 Histopathologist
2 Radiologists
2 CNS’s
1 Research Nurse
Variety of associate specialist surgeons/nursing/clerical
staff
The Future
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Continue to develop the service
 Nurse Led Clinics / clinical diagnostics in melanoma
 Electro chemotherapy
 Increased clinical trials portfolio
 Patient led support groups
Summary
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The Skin Cancer CNS is here as a result of the national
cancer agenda, as with all other tumour sites.
The role of the CNS can enhance the quality of care
delivered to each individual patient with skin cancer by
being their key worker.
The patient journey is complex, given the geographical
boundaries of where they come from.
MDT co-ordinator is a main link to SSMDT
See Melanoma network guidelines for referral criteria to
SSMDT
We want to work together with all members of the team
putting the patients needs first.
The patient is the most important person of all our work.
Thank you