Perceptions of the cancer care left undone in primary and community services: A mixed methods evaluation

This is the peer reviewed version of the following article: Lawler,J., Lofton,L., and Leary, A. (2020) Perceptions of the cancer care left undone in primary and community services: a mixed methods evaluation, Health and Social Care in the Community which will be published in final form at https://onlinelibrary.wiley.com/journal/13652524. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions." Primary and community care in the United Kingdom are under increasing workforce and time pressures. How these pressures effect the delivery of cancer care has rarely been explored. This service evaluation aimed to elucidate some of the views of the workforce in this sector of what work in cancer care is left undone, and what they would like to be able to offer more of. An exploratory sequential design was taken including a questionnaire and interviews asking primary and community care staff in London about their workload in cancer care. Surveys were analysed using descriptive statistics. The evaluation revealed a perception from primary and community care that there is work in cancer care that is currently being left undone. 64% of the workforce across all professions reported that they worked 10 or more hours of unpaid overtime per week. Respondents identified psychological care for people with cancer, and bereavement care for families and carers of people with cancer as the most common areas that were left undone. They would like to do more proactive work, in place of the current reactive “fire-fighting” they are doing. For example, signposting available services to people with cancer and access to nutritional support. There was a desire for acknowledgement of the time and workforce pressures in primary and community care, and how these are hindering the delivery of care for people with cancer.