Macmillan in the Midlands Recovery Package Resource

The information below is taken from the Macmillan Recovery Package Definitions Document

A person should be offered support from primary care during and after treatment.  To support this, primary and secondary care need to communicate effectively and there should be clear lines of responsibility and accountability in each setting along the treatment pathway and beyond.  If relationships and communication between secondary care and primary care are established early, this supports a smoother transition from secondary to primary care once treatment is completed.

The responsibility of secondary care is to ensure that clear and comprehensive information is provided to primary care and the person being treated for cancer.

The responsibility of primary care and the individual is to ensure that:

• this information is understood both by the necessary primary care professionals and by the person undergoing treatment
• the person living with cancer is aware of any actions they need to take to help them to manage their own care
• the Treatment Summary and other information, such as HNA’s and care plans, inform discussions between primary care professionals on how actions will be followed up.

The Treatment Summary is primarily an important communication tool which can be used in both primary and secondary care settings.  It also serves as a record that the person and their professional can look back on and use to inform conversations.  For this reason, a Treatment Summary (or the equivalent document that lays out treatment information and the possible consequences of that treatment, in a clear and structured way – from here on termed ‘or equivalent’), should always be offered to the person completing treatment, and should be in a format that they, as well as professionals, can understand.  People can often struggle when they are seen less in secondary care and, while the Treatment Summary is a communication tool for professionals, it is also an enabler for ongoing support. It allows primary care to have more informed, meaningful conversations post treatment.

When
A Treatment Summary (or equivalent) should be produced, at the end of each phase of active treatment (after primary treatment and any subsequent phases of treatment). A delay in sending the Treatment Summary (or equivalent) to primary care informing them of diagnosis and treatments can result in a lack of appropriate support as the GP and primary care team may be unaware that the person has finished treatment.
Furthermore, the Treatment Summary (or equivalent) provides essential information to enable a more thorough and comprehensive Cancer Care Review in primary care.  
Optimal times for the Treatment Summary (or equivalent) to be communicated to primary care and to be given to the individual could be:

• at the last post-treatment review appointment after treatment
• before the person is transferred to stratified care or long term follow up with longer intervals between touch points within secondary care.

 National guidance advises that the patient should receive the Treatment Summary within six weeks of the end of their treatment.  More needs to be understood about the mechanism of how and when the Treatment Summary typically lands in primary care and how triggering a Cancer Care Review works best in primary care.  There are no prescriptive time frames in the Measurement Framework due to the complexity and variations in treatment.

Who does it and where

The Treatment Summary (or equivalent) is produced by secondary care.

The relevant professional in either secondary or primary care can use this information to inform a conversation with a person about their treatment.   The discussion may form part of a general post-treatment or discharge conversation, and it is important that all relevant information is shared, and that symptoms of recurrence and the potential consequences of treatment are highlighted during this discussion.  A copy of the Treatment Summary should be given to the person finishing treatment so they can refer to it if they need to.  However, as explained in the ‘what’ section above, it is the responsibility of secondary care to give clear and comprehensive information to primary care – not the responsibility of the person living with cancer.