Designing Services for Cancer in Older people (DiSCO)

Kumud Kantilal, University of East Anglia


The number of older people (those aged 65 or over) living with and beyond cancer (OPLWBC) is growing but side effects can last for years after completing cancer treatment. Pharmacists have a key role in side effect management, but they and the wider primary care team are not meeting the needs of OPLWBC .  We have found that over half of OPLWBC have long-term side effects of which four out of five told us they have physical effects like diarrhoea and seven out of ten told us they have emotional effects like feeling low.

We want to develop a way for pharmacists to work with the wider healthcare team to better support OPLWBC to manage long-term side effects. We have reviewed previous research to find out what might work (intervention components). We plan to use these to develop a new way of working for the healthcare team.  This will include things like a description of the training for the healthcare team and how they want it e.g. computer, paper or in person and how often, a description of how the healthcare team will communicate with each other and what they will need to do for OPLWBC. We will also use theory to find ways for helping the healthcare team carry out the new ways of working.


This project aims to identify what healthcare workers need to do and what needs to be in place to allow them to do it to help OPLWBC to manage the long-term side effects of cancer treatment.  


The project will have four parts. Firstly, we will use previous research to find out what the intervention components are, such as what will be done by community pharmacists, GPs and nurses, and what their training might look like, how long it will take and how often it needs to be repeated. 

In the second and third part, we will work with pharmacists, GPs and nurses to fine tune the intervention components. We will also ask them what they think may help or hinder them in delivering the new way of working. We will combine this information with theory to find tried and tested ways for making the most of things that help and finding solutions for the things that hinder.  These are called behaviour change techniques.

In the fourth part, we will present the intervention components together with the behaviour change techniques to GPs, nurses, community pharmacists, patients and commissioners.  We will make necessary refinements to ensure that the final service specification is thought to be useful, acceptable and feasible to all parties.

We will write up what happened in our research and publish in both research and professional journals, our website and conferences. Links with organisations such as Macmillan Cancer Support and Big-C, which focus on improving cancer care, will help us to spread the findings of the research across Norfolk and the UK and to patients.

This project is running from 01/11/2019 and is due to finish on 31/10/2020