Introduction There is growing awareness that cancer services need to address patients’ well-being as well as treating their cancer. We developed systematic approaches to (1) monitoring patients’ symptoms including depression using a ‘Symptom Monitoring Service’ and (2) providing treatment for those with major depression using a programme called ‘Depression Care for People with Cancer’. Used together, these two programmes were found to be highly effective and cost-effective in clinical trials. The overall aims of this project are to: (1) study the process of introducing these programmes into routine clinical care in a large cancer service, (2) identify the challenges associated with implementation and how these are overcome, (3) determine their effectiveness in a routine non-research setting and (4) describe patients’ and clinicians’ experience of the programmes.
Methods and analysis This is a mixed-methods longitudinal implementation study. We will study the process of implementation in three phases (April 2016–December 2018): ‘Pre-implementation’ (setting up of the new programmes), ‘Early Implementation’ (implementation of the programmes in a small number of clinics) and ‘Implementation and Maintenance’ (implementation in the majority of clinics). We will use the following methods of data collection: (1) contemporaneous logs of the implementation process, (2) interviews with healthcare professionals and managers, (3) interviews with patients and (4) routinely collected clinical data.
Ethics and dissemination The study has been reviewed by a joint committee of Oxford University Hospitals National Health Service Foundation Trust Research and Development Department and the University of Oxford’s Clinical Trials and Research Governance Department and judged to be service evaluation, not requiring ethics committee approval. The findings of this study will guide the scaling up implementation of the programmes across the UK and will enable us to construct an implementation toolkit. We will disseminate our findings in publications and at relevant national and international conferences.
- cancer care
- implementation processes
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Contributors MW: study design and conduct; manuscript writing. JW: study conception, obtained funding, study design and conduct, manuscript writing. KB, NS, AR, AM, CF: advised on the study design, manuscript review. MS: study conception, obtained funding, study design and conduct, manuscript writing.
Funding This study is funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford Health NHS Foundation Trust. The clinical programmes are funded by Oxford University Hospitals NHS Foundation Trust in collaboration with Macmillan Cancer Support charity. NS’ research is supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust. NS is a member of King’s Improvement Science, which is part of the NIHR CLAHRC South London and comprises a specialist team of improvement scientists and senior researchers based at King’s College London. Its work is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), Guy’s and St Thomas’ Charity, the Maudsley Charity and the Health Foundation. AR’s research is supported by the NIHR Collaboration for Leadership in Applied Health Research and Care Wessex at the University Hospital Southampton NHS Foundation Trust.
Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests NS is the director of London Training & Safety Solutions, which consults on team training, human factors and patient safety.
Ethics approval The study has been reviewed by a joint committee of Oxford University Hospitals NHS Foundation Trust Research and Development Department and the University of Oxford’s Clinical Trials and Research Governance Department.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement We do not plan to share data obtained during this study.
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