Improving patient outcomes following a cancer diagnosis.

Cancer survival is improving, incidence is increasing and, for many, cancer is now being regarded as a long-term condition. Traditional followup services are no longer meeting the needs of patients, nor are they sustainable. Based on a long-term conditions model, NHS Improvement is working with test sites to develop new pathways of cancer aftercare. This article describes the new self-managed pathways and how they support recovery and health and wellbeing. With half of people with a cancer diagnosis having at least one other chronic condition (Elliott et al, 2011) and cancer more commonly being a disease affecting the elderly, community nurses have a role to play in sustaining self-management and supporting the seamless and coordinated delivery of these pathways. They are well placed to reinforce messages given in secondary care, to sell the benefits of a healthy lifestyle, to be aware of the local amenities to signpost patients to, and to encourage their uptake and embed self-management.

Improving services for long-term conditions.

Providing services by personal need, rather than by specialty, could improve services and make better use of NHS resources. NHS Improvement's long-term conditions pathway recognises nurses' key role in planning care and responding to need, and offers four key steps for better care.

Testing care pathways for prostate cancer survivors.

Although prostate cancer incidence rates have risen sharply over the last 30 years, the survival rate is also high. New pathways of care are needed to support patients, where appropriate, to self-manage. This article describes a project that is testing risk-stratified care pathways and nurses' role in this new model of care.