Article Text

Download PDFPDF

P-39 Macmillan ten top tips for challenging conversations
  1. Elise Lang,
  2. Gemma Eccles,
  3. Sarah MacAuley,
  4. Sue Llewellyn and
  5. Juliet Norwood
  1. Macmillan cancer support, Wales cancer centre, Velindre University NHS trust, Swansea Bay healthboard


Background A multi-professional team working for the Macmillan Primary Care Cancer Framework (MPCCF) Wales embarked on a project to establish standardised prognostic terminology for clinicians to use when sharing oncological prognosis between clinicians. Communication, when done well, improves the experience of PABC and reduces distress and complaints, yet often clinicians have had no formal communication skills trainings post qualification.

Method Two separate surveys were disseminated to people living with cancer/their carers (PABC –people affected by cancer) and clinicians who engaged in prognosis discussions with cancer patients. To explore the survey findings in more depth, two separate workshops were held with clinicians who engaged in prognosis discussions with cancer patients (October 2020) and PABC (November 2020). In addition, a small clinical group, with representation from all Welsh health boards met on three occasions to discuss the findings, share learning and agree outputs.

Results Workshops with PABC (delegates=14) highlighted that in consultations with patients, whilst the terminology was important, the manner and environment in which the prognosis was shared was paramount. PABC strongly voiced that their recommendations be shared widely to improve patient experience and the Macmillan 10 Top Tips (TTT) were organically established. Their common themes to improve conversations with PABC include environment, language, exploration of patient understanding and the need to update PABC about delays in the running of the clinic, amongst others.

Conclusions The TTT should be shared with all clinicians who discuss cancer prognosis but also with clinic co-ordinators in order that clinics are planned with consideration to this framework. Applying TTT where relevant will improve the experience of PABC. Communication skills should be refreshed regularly throughout a clinician’s career not just in their undergraduate experience. In a changed clinical world due to the pandemic these TTT also support improved virtual consultations and patient led care.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.