Psychosocial oncology services in New South Wales

Abstract

There is limited published evidence about how psychosocial services should be organised or routinely integrated into cancer services to ensure that cancer patients receive appropriate psychological, social and emotional support during periods of diagnosis, treatment and follow-up. This paper reports on a survey of 26 oncology services in New South Wales, Australia, to examine the current provision of psychosocial oncology services. The aim of the study was to gather baseline data and information about the provision of services and to identify significant challenges associated with the development and implementation of psychosocial oncology services. A total of 42% of staff at psycho-oncology services reported they could provide adequate psycho-oncology services, but 58% of sites said they could provide either only limited (27%) or very limited (31%) services. We found that services frequently identified challenges such as insufficient funding to employ skilled staff to provide psychosocial interventions, inadequate data to demonstrate the effectiveness of psychosocial interventions and, at times, lack of space to allow privacy for patient consultations. Future needs identified were strategic planning of psychosocial oncology services as part of broader cancer service plans, leadership of psychosocial oncology services, cohesive teams using agreed patient pathways or tools and integration into multi-disciplinary cancer teams. What is known about the topic? Psychosocial oncology services provide vital psychological interventions and social programs that can significantly improve patients’ adjustment to the experience of cancer. Limited evidence from other countries suggests there are significant challenges in developing and delivering quality, evidence-based psychosocial oncology services in a coordinated, cohesive and timely manner. Little is known about these services in the Australian context or the challenges they face. What does this paper add? This paper presents baseline information about the structure of psychosocial oncology services in NSW and identifies the significant challenges faced by these services. It describes these challenges with regard to service structures, availability and provision of services, screening for patient distress, strategic planning and funding, leadership and delivery-focussed issues. What are the implications for practitioners? There is a need for strategic planning of psychosocial oncology services as part of broader cancer service plans. Identified leadership of psychosocial oncology services and cohesive psychosocial teams that use agreed patient pathways or tools would be greatly beneficial, as would integration of psychosocial staff into multi-disciplinary teams. The findings may enhance quality improvement efforts in the development and delivery of psychosocial support for cancer patients, their families and carers.