A Cancer Research UK programme which teaches doctors to communicate the bad news of cancer looks set to provide the model for a government training strategy.
Results of a five-year study published in the Lancet has prompted Cancer Director Prof Mike Richards to commit funds to kick-start the programme.
This research is the first major randomised trial into the benefits of communication courses for clinicians, and provides definitive proof that an intensive course really does benefit cancer patients and doctors.
It follows previous studies which have shown that patients are unhappy with the amount of information they are given in clinics and how it is delivered, particularly when doctors are dealing with cancer and discussing complex and distressing information.
“Good communication between cancer doctors and their patients is vital because it can have a huge influence over patients treatment and quality of life. And poor communication leads to dissatisfaction both for patients and clinicians,” says Prof Lesley Fallowfield, lead author of the study and Head of Cancer Research UK’s Psychosocial Oncology Group at Sussex University.
“In the course of a career spanning 40 years a senior doctor will talk with around 150,000 to 200,000 patients and their families, but around half of doctors have never had any form of communications training. Doctors themselves recognise their deficiencies in this area, which time and experience alone do not resolve.
“This latest research shows once and for all that this training course really works, improving the way doctors interact with patients in clinics,” she adds.
The work spans two of Cancer Research UK’s initial aims: to provide training for cancer doctors, and to be the authoritative source of information on cancer, empowering patients to make informed, up-to-date decisions about their treatment.
“The marking of government money is a good start towards fulfilling the promises made in the NHS Cancer Plan, says Prof Gordon McVie, Joint Director General of Cancer Research UK.
“This is an extremely important study into an area of patient care which has been neglected until now. I am delighted that a first step is being made towards ensuring cancer patients and doctors will no longer be failed by the system. It is an important victory for patients because it proves that when they speak, we listen and government listens,” he adds.
Cancer Director Prof Mike Richards says: “I welcome the results of this study, which provides conclusive evidence of the benefits of communications skills training for senior clinicians. We know that good communication is of great importance to cancer patients. The next important step is to establish the programmes to train the trainers, so that this type of training can be much more widely available.”
The Cancer Plan (page 13) reads:
“The NHS plan will introduce a new joint training across professions in communications skills. By 2002 it will be a pre condition of qualification to deliver patient care in the NHS that staff are able to demonstrate competence in communication with patients. And for cancer we shall give staff additional training in communications and in the provision of psychological support.”
Around 160 senior doctors and over 2,000 patients from 34 UK Cancer Centres took part in the trial, which involved observing consultations both before and after the training course.
Improvements were reported immediately after the course and maintained at 3 months. Doctor’s attitudes seemed to focus more on the patient and be oriented less towards the disease, they showed increased expressions of empathy and were better at summarising difficult information.
The Department of Health have agreed £100,000 towards the first stage of the programme.