Following the recent introduction of our Healthcare Plan to the Universities & Colleges sectors, we should clarify the Plan’s cover and treatment in respect of cancer and cardiac conditions.  

Will insured members have to wait longer for cancer and cardiac care through the NHS?

The current prediction is that one in two of us will experience cancer in our lifetime. Combined with the acknowledged increase in heart disease, it is no surprise that accessing the right care at the right time for these conditions is a high priority for our clients, and those considering moving to Patient Advocate.

All patient journeys start with GP’s consultation. Here they will discuss their symptoms and have low level investigations ordered, such as blood tests, ECG scans and x-rays. Should a GP feel that the symptoms have any possibility of being due to a cancer diagnosis, even when they feel it necessary to rule cancer out, they will still refer patients to see a secondary care consultant under the “two-week rule”. From a GP referral to see a Consultant will be no longer than a 2 week wait. For many patients, their wait will be less than 2 weeks, dependent on their clinical presentation.

NICE Guidelines aim to reduce the time that patients wait from, initially seeking advice from their GP, to treatment starting. The NHS provides the following reassurances:

Accurately diagnosing cancer can take weeks or months. As cancer often develops slowly over several years, waiting for a few weeks won't usually impact on the effectiveness of treatment. The National Institute for Health and Care Excellence (NICE) has produced referral guidelines for suspected cancer. Patients shouldn't have to wait more than 2 weeks to see a specialist if their GP suspects cancer symptoms and urgently refer. In cases where cancer has been confirmed, patients shouldn't have to wait more than 31 days from the decision to treat to the start of treatment.

For Patient Advocates clients, cover is included to support diagnosis through a private provider. Our nurse-led Managed Healthcare Team are here to facilitate the navigation through the healthcare system – both private and NHS. We also provide help with information and support through this period.

On diagnosis we would support the transfer back into the NHS for on-going treatment. An exception to this may be dermatological cancers, as suspicious lesions need to be removed in order to confirm a diagnosis.

Similarly, for cardiac conditions, symptoms and initial findings in primary care can be used to expedite a consultant appointment and any required investigations and interventions.

Is Private care better?

At Patient Advocate, we will research, on each claimant’s behalf, the centres of excellence for their condition. By doing this we can ensure that they are best placed to receive the highest quality of care and treatment.

Many Consultants that work in private hospitals have an NHS practice and so the only difference may be the environment. For many conditions, the services required to support claimant’s treatment and on-going management has the expertise centred in the NHS. With certain procedures it is important to consider the volume of procedures undertaken, alongside any additional support which may be needed, such as intensive care, and check that this is available.

Patient Advocate’s support ensures that patient’s have informed choice about where they can access their care, either from a local private hospital or at one of the NHS Centre of Excellence. For example, the Royal Marsden or Christie’s Hospital Manchester, The Royal Brompton and Harefield for cardiac conditions.

How do Patient Advocate make a difference?

For all conditions, particularly those that have an emotive and stressful diagnosis like cancer or cardiac, our nurse-led team supports claimants to access the right care, at the right time, in the right place for them. We ensure that care is joined up, additional information and support is provided.

Our team is skilled at navigating the healthcare system and can work hand in hand with claimants to ensure they have a good experience of healthcare, understand their condition, any treatment administered and ongoing management of their health. At Patient Advocate, we also remember that all claimants are a person, not a number or a diagnosis, and we focus on all aspects of their care alongside their pathway through the system.

For many people who experience a cancer or cardiac diagnosis their treatment and on-going management will last for some time. The impact of these diagnoses can last for years. Our team will work with each claimant to support them to be an active participant in their care and long-term management to ensure a better experience and support better health outcomes.

Jayne Molyneux BN(Hons),RN,DN cert., Head of Managed Healthcare Services, Patient Advocate Ltd   

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