Framework for Effective Cancer Management (FECM)
1. What was the issue/problem identified?
Decisions about cancer services in NHS Fife were being made without direct patient input. While clinical expertise was strong, there was no mechanism to integrate lived experience into governance. This created a risk that services were being planned and improved for patients, but not with them, potentially overlooking practical and emotional realities of care.
2. What did you do?
NHS Fife appointed patient representatives to the Cancer Governance and Strategy Group (CGSG), embedding the patient voice at the highest decision-making level. To support meaningful engagement, preparatory sessions were provided by the Lead Cancer Nurse, giving representatives the knowledge and confidence to contribute effectively. A structured framework for ongoing involvement was established, ensuring representation was sustained and systematic rather than ad hoc. Importantly, the approach was aligned with the Cancer Strategy for Scotland 2023–2033, which highlights the need for meaningful patient involvement in service planning and delivery.
3. What was the outcome?
The inclusion of patient representatives reshaped the group’s culture, moving it from a professional-led forum to a co-produced strategy. Governance decisions became more patient-centred, addressing hidden barriers such as communication gaps, emotional support, and access challenges. Professional assumptions were constructively challenged, ensuring services reflected lived realities as well as clinical perspectives. A cultural shift took place: policies are now shaped with patients, not just for them. Patient representatives themselves reported feeling integral and valued, reinforcing that their contributions were essential rather than tokenistic.
Contact
Murdina MacDonald, Lead Cancer Nurse — murdina.macdonald@nhs.scot