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12Research into cancer careImproving supportive carefor people in transitionA Macmillan-funded research project is investigating the supportneeds of people with progressive illness and their carersIn the last few editions of Macmillan Voice, we have beendescribing the work of the Macmillan Palliative andCancer Care Research Collaborative (MacPaCC). Thegroup’s aim is to understand and improve cancer care.Earlier articles featured MacPaCC projects about:• how to care for people with cancer as early as possiblefollowing diagnosis (winter 2009)• how specialist and generalist nurses work with eachother and with other professionals, carers and patients inproviding supportive care to cancer survivors (spring 2010).In this edition, we profile a study about supportive care needsled by Dr Stephen Barclay. Stephen and his colleagues areespecially interested in exploring what patients and theircarers want as they approach the transition from supportivecare to palliative and end-of-life care.How to best support patients at a time of transitionStephen’s study involves two groups of people with contrastingprogressive illness: people recently diagnosed with incurablelung cancer and people with severe chronic obstructivepulmonary disease (COPD). The team want to find out whatStephen BarclayStephen is a practising clinician anda university researcher with a longstandingrelationship with Macmillan.Based part-time at the Universityof Cambridge, his main field ofacademic expertise is the GP’s rolein palliative care. He is also theSpecialty Director for Palliative Care in the medical schooland a practising GP in Cambridge and Honorary Consultantin Palliative Medicine at the Cambridge Hospice.Stephen’s work with Macmillan began in 1995 whenhe became a GP facilitator and continued with hisappointment as a Macmillan clinical fellow. He is currentlya Macmillan postdoctoral research fellow.‘Staying involved in clinical practice and academiahelps me do research that will be useful “on the ground”,’he says.Further informationDr Stephen BarclayCambridge Universitysigb2@medschl.cam.ac.uk01223 330300their care, support and information needs are at a time ofdeteriorating health and how these needs can best be addressed.For people with lung cancer, the prognosis is generallyvery poor. About half of people diagnosed with lung cancerwill die within four months according to a Scottish study.‘These people move from supportive care into thepalliative care stage very quickly,’ says Stephen. ‘We wouldlike to understand what they and their carers think are keymarkers of high-quality care during this very difficult time.’The challenges are different for people with COPD.Patients may have a transition from supportive to palliativecare, but this transition is not as clear cut or as easy toidentify as it is with cancer.Current services often do not meet these people’s needs,with lack of communication between doctors and patientshighlighted as a major barrier to better care.‘We need to understand much more about whatapproaches to care work best for this group of patients.There is a tendency to think that the cancer model of care isa “one size fits all”,’ Stephen says.‘I really want to get inside the mindsof my colleagues, to see how weapproach the care of these verydifferent illnesses.’Stephen’s team will explore priorities for care in interviewswith patients and carers. His team will also interview GPs andcommunity nurses who are looking after both a person withlung cancer and someone with severe COPD. The aim of theseinterviews is to see what these health professionals regard askey issues for patient care and service development. This willhelp the team compare approaches to these people’s care.‘As a GP myself,’ says Stephen, ‘I really want to get insidethe minds of my colleagues, to see how we approach thecare of these very different illnesses.’Through this study, Macmillan will gain a greaterunderstanding of caring for people in transition and providingservices that best meet the needs of patients and carers.Further informationJanice KoistinenMacmillan Projects Support ManagerWarwick Medical School02476 575 509j.koistinen@warwick.ac.ukMacmillan Voice summer 2010