The Macmillan Nurses employed by NHS Western Isles provide a unique service to people affected by cancer. The work they do is patient-focused and seamless. There is no hospital Macmillan team, no community Macmillan team. There is one Macmillan Nurse team providing care wherever that need is identified. Wherever possible the patient will be supported by the same nurse from diagnosis to the end of his or her need for care, with nurses overcoming the challenges set by the geography of the islands, the road conditions, the ferry crossings and weather conditions to care for their patients.
The Western Isles is a group of islands off the northwest coast of Scotland. From the northern-most point of the Isle of Lewis to the southern-most point of the Isle of Vatersay is approximately 120 miles. The islands are linked by ferries and causeways, each providing challenges to the provision of local care to people affected by cancer. Most people live in remote, rural communities with few neighbours and little public transport. The proportion of the Western isles’ population over the age of 50 in 2005 was more than 40.6%. It is estimated that by 2024 there will have been an increase in the over-50s by up to 15.5%. On average there are about 200 new diagnoses of cancer each year within the Western Isles. It is estimated by ISD Scotland that there will be an increase in incidence of cancer in the Western Isles of 24.3% by 2023-27, with patients likely to be older and having several co-morbidities. People with a cancer diagnosis have their treatment managed by oncologists, haematologists and others in mainland cancer centres. This entails substantial amounts of travel for the patients at a time when they are often not feeling well.
To develop, adapt and provide a seamless service for people affected by cancer whatever the need that is identified and wherever the person is, regardless of the massive challenges inherent in the geography and climate of the remote, rural location of the Western Isles. To devise local solutions to challenges wherever and whenever they are safe and sustainable.
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