Pancreatic Cancer

Professional care

People we interviewed were keen to praise the care they had in the National Health Service but admitted that sometimes they had not been happy with it.

Adrian had on the whole found the health professionals he had met helpful, sympathetic and knowledgeable. Tony said that he could not fault the care he had received. William spoke highly of the specialist nurse who kept him informed before his operation, and others praised the way their surgeons had explained what would happen (see ‘Communication with health professionals’). Richard (Interview 22) recalled that during his illness he had had a consultant who really knew him and who treated him as an individual. He greatly valued such continuity of care.
Many people spoke highly of their nursing care in the intensive care unit and on the wards. Davinder was most impressed by the way the nurses changed the sheets while she was still in bed. Lesley said the ward nurses were always there when she needed them. Some remembered the excellent care they had received from specialist nurses, either after surgery or while having chemotherapy. Richard (Interview 22) had a nurse he could ring or email at any time for advice (see ‘Other sources of support’). Vicky had a specialist nurse who would visit her at home. Alison praised the radiotherapists and Helen said the physiotherapists were ‘great’. Ben was well cared for and supported by his district nurse and others spoke very highly of their Macmillan, palliative care or hospice nurses (see ‘Other sources of support’).
Some aspects of NHS care attracted negative comments. Some people were upset that their doctors had taken so long to make a diagnosis (see ‘Hearing the diagnosis and prognosis’). Others were concerned about poor doctor-patient communication, and poor communication between hospital doctors and GPs. John (Interview 21), for example, thought that there should have been better communication between his wife’s surgeon and his wife’s GP. His wife, Ann, had been given high doses of painkillers, which made her vomit and made her very drowsy. Her GP found it hard to adjust the dose without more information from the surgeon and sometimes a GP could not reach the consultant at short notice (also see ‘Communication with Health Professionals’).
Other people complained about various aspects of care, such as mixed sex wards, lack of hygiene, and their nursing.
 
Ann said that some of the nursing had been wonderful but some had been terrible. Some nurses didn’t seem to know how to make patients comfortable. Ann recalled that nurses spent time ‘chatting away’ at the nurses’ station when she needed them to make her feel better. Fred also said that the nursing care had been mixed. He thought that some nurses were ‘very nice’ but others had been a ‘bit rougher’. He also thought that there had been a shortage of nurses at night time and that some of the auxiliary nurses on duty at night had been very noisy.
After her operation Ann complained about lack of communication between junior doctors, particularly at weekends. She couldn’t always get a doctor’s attention and felt that this delayed the diagnosis of her life-threatening infection a few days after the operation.

William recalled overworked nurses, who had no time to stop and talk. A great deal seemed to depend on which doctors and nurses were on duty and how busy they were at the time. Carol was upset because when she got back to her ward after her stay in the intensive care unit the nurses got her name wrong. Carol wondered if the nurses knew who they were dealing with. Phil felt that the nursing in the clinic where he had his chemotherapy was a bit ‘impersonal’.
While there was much praise for excellent relations with individual doctors and nurses the aspect of care which seemed particularly important was the way in which professionals with different skills within the specialist cancer unit cooperated as a team. Fred described how the whole team came to the daily morning ward round and then different members of the team came back individually to explain their particular area of expertise and offer help if needed. Several of these specialists would give their contact details so that they could be reached easily both while the patient was in hospital and then at home. William was introduced to a link nurse before his operation and has spoken to him regularly since. Carol had a chemotherapy nurse whom she could phone whenever she needed something.
 
Where this failed, patients like Davinder felt very let down. Davinder felt that the physiotherapists should have prepared her for what to expect when she got home. She felt unprepared for difficulties, such as getting out of bed. She also thought that the senior nurse should have organised a home help and personal care for her or that she should have contacted her GP to ask him to do this (see ‘Potentially curative surgery’). Donna’s district nurses had been very nice but she complained that she sometimes had had to wait much too long for them to arrive to give her analgesic injections.
The team approach was equally important in General Practices where GP’s were able to organise district nursing, physiotherapy, counselling and other services directly. People who praised their GPs appreciated being made to feel that they were special, not having difficulty getting appointments, good arrangements for getting prescriptions, regular telephone contact and home visits, and appropriate referrals for additional support. Lilian said she had had ‘wonderful treatment’. Her GP had been very supportive and had told her that she could visit the surgery at any time for advice, at the same time letting her know that she was prepared to visit her at home if the need arose (see ‘Other sources of support’). The receptionists at Lesley’s practice allow her to phone for prescriptions which would not be allowed normally. Ben particularly appreciated the way his GP surgery would give him quick appointments and enabled him to renew his prescriptions through the pharmacy.
 
A few people we interviewed had had private health care. Alison said that medical and nursing care that she had experienced had been ‘brilliant’. After the operation she went into the High Dependency Unit; later she had her own room where the nurses had plenty of time to chat with her.

(Also see ‘End of life and professional care’ and ‘Other sources of support’.) 

Last reviewed June 2015.

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