Block 9 - part 3

Question 1

Conclusions of eurocare-II report

Answer 1

Despite limitations for the methodology, cancer survival in the UK in 1980s/90s was one of worst in Europe.
Expert advisory group formed to the chief medical officer in 1995, which generated the calman-hine report

Question 2

What did the Calman-Hine report (1995) do

Answer 2

Examined cancer services in the UK and proposed a restructuring of cancer services to achieve a more equitable level of access to high levels of expertise throughout the country

Question 3

6 consequences/aims of Calman-hine report

Answer 3

All pts have access to uniformly high qual of care
Public/professional education to recognise early cancer symptoms
Clear information about treatment options and outcomes for pts, families, carers
development of cancer services should be pt centred
Primary care central to cancer care
psychological needs of cancer sufferers and carers recognised

Question 4

Calman-hine solutions

Answer 4

3 levels of care: primary, cancer units serving district hospitals, cancer centres
key to managing pts would be MDT

Question 5

Role of cancer units

Answer 5

Treat common cancers, diagnostic procedures, common surgery, non-complex chemo

Question 6

Role of cancer centres

Answer 6

Treat rare cancers, radiotherapy, complex chemo

Question 7

National service framework

Answer 7

National standards, support program implementation, establish performance measures (progress within agreed timescales)

Question 8

Main aims of NHS cancer plan (2000)

Answer 8

Save more lives
Ensure cancer pts get right professional support, care and treatments
Tackle health inequalities
Build for the future

Question 9

NICE guidlines which followed the cancer plan (2000)

Answer 9

Manual of cancer (2000) and (2004)

Question 10

6 key areas for action in the cancer reform strategy (2007)

Answer 10

Prevention
Early diagnosis
Better treatment
Living with and beyond cancer
Reducing cancer inequalities
Appropriate care setting

Question 11

Which cancers are screened for?

Answer 11

Cervical, breast, bowel

Question 12

National cancer survivorship initiative

Answer 12

partnership with cancer charities, clinicians and patients, considered a range of approaches to improving services and support available for cancer survivors

Question 13

Main outcomes for ‘improving outcomes: a strategy for cancer’ (2011)

Answer 13

Prevention and early diagnosis, quality of life and patient experience, better treatments, reducing inequalities

Question 14

Some inequalities experiences amongst cancer patients

Answer 14

White pts report more positive experience
younger people least positive about experience
men generally more positive about care
non-hetero patients less positive experience
Patients with rarer forms of cancer poorer experience of treatment and care

Question 15

Outcomes from the independent cancer taskforce (2015)

Answer 15

Spearhead radical upgrade in prevention and public health, drive national ambition to achieve earlier diagnosis, establish patient experience as being on par with clinical effectiveness and safety, transform approach to support people living with and beyond cancer
Necessary investments to deliver high quality services
Overhaul process for commissioning, accountability and provision

Question 16

Body image

Answer 16

perceptions, thoughts and behaviours relating to ones appearance

Question 17

biological disturbance

Answer 17

chronic illness leads to loss of confidence in the body, followed by loss of confidence in social interaction or self-identity

Question 18

Examples of things which affect body image

Answer 18

scars, prosthetics, mastectomy, impact on sexuality, stoma, hairloss, weight loss/gain

Question 19

Importance of hair

Answer 19

Important site for individual and group identity, symbol of femininity, stigma, loss of patient control of their status of sick

Question 20

functions of the clinical record

Answer 20

Support patient care, improve future patient care, social purposes at request of patients, medico-legal document

Question 21

What should be recorded in clinical record

Answer 21

presenting symptoms, relevant clinical findings, diagnosis/differentials, care/treatment options, risk/benefits of care and treatment, decisions about care/treatment, actions taken and outcomes

Question 22

features of paper records

Answer 22

continuous, portable, writer identified, legibility issues, must be dated and signed

Question 23

Electronic record features

Answer 23

Problem orientated, searchable, structured, safer prescribing, clinical decision support software

Question 24

Use of records in audit, research and management

Answer 24

support clinical audit, facilitates clinical governance, facilitates risk management, support clinical research

Question 25

duty of care

Answer 25

legal obligation imposed on an individual requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others

Question 26

negligence

Answer 26

failure to exercise the care that a reasonable prudent person would exercise in like circumstances

Question 27

4 ethical principles

Answer 27

Beneficence, non-maleficence, autonomy, justice

Question 28

3 ethical theories

Answer 28

consequentialism, deontology, virtue ethics

Question 29

consequentialism

Answer 29

correct moral response is related to the outcome or consequence of the act

Question 30

deontology

Answer 30

places value on the intentions of the individual and focuses on rules, obligations and duties

Question 31

virtue ethics

Answer 31

right living is derived from the moral character of the agent

Question 32

how do you evaluate an argument

Answer 32

get clear on logical form of the argument, query if valid and sound

Question 33

reasons an argument may be invalid

Answer 33

different premises may express different concepts, confusing necessary with sufficient, insensitive to the way in which claims are qualified, argument begs the question

Question 34

reasons an argument might be unsound

Answer 34

Argument is invalid, argument valid but one or more premise is false (false/controversial moral/empirical claim made)

Question 35

what should be avoided in arguments

Answer 35

Straw man fallacy, ab hominems, appealing to emotion, begging the question, argument from fallacy

Question 36

straw man fallacy

Answer 36

simply ignoring the person’s actual position and substituting it for a distorted, exaggerated or misrepresented version of that position

Question 37

ab hominems

Answer 37

directed against a person rather than the position they are maintaining

Question 38

argument from fallacy

Answer 38

conclusion must be false, because premises are false (non necessarily)

Question 39

Moral argument

Answer 39

seek to support a moral claim of some kind, must provide supporting reasons for claim

Question 40

deductive argument

Answer 40

purely logic, this means this, therefore this means this

Question 41

inductive argument

Answer 41

making an argument based on observation, more probable conclusions (seeing is believing but you may not have seen anything)

Question 42

Why are MDTs needed in cancer care

Answer 42

Modern management, delivery of care often fragmented over several hospital sites, probably better outcomes for patients managed in MDT

Question 43

Core medical MDT staff

Answer 43

Physicians, surgeons, oncologist, radiologist, histopathologist, specialist nurses, MDT coordinator

Question 44

Extended MDT staff

Answer 44

physio, dietician, palliative care, chaplin

Question 45

Functions of MDT in cancer care

Answer 45

Discuss new diagnoses, decide on management plans, inform primary care of plan, designate key worker for patient, develop referral, diagnosis and treatment guidelines, audit