Collaboration between doctors and nurses in children's cancer care: insights from a European project.

PURPOSE: It has long been recognised that effective cancer care is not possible without multi-professional team working. Collaboration and multi-professional working however are known to be less than straightforward. This project aimed to use a collaborative approach to explore and facilitate professional groups to work together more effectively in the field of children's cancer care. METHOD: Based on an earlier project in Italy, a three-year seminar series was organised involving both a doctor and nurse from 15 paediatric haematology/oncology units across Europe. Participants had to be able to speak English and commit to participate in annual seminars as well as the development and implementation of a local project to enhance doctor-nurse collaboration in their own unit. Appreciative Inquiry was the methodological approach used to address organisational as well as interpersonal change. RESULTS: Fifteen doctor-nurse teams were initially selected from a range of different countries, and 10 completed the project. Key outcomes reported include implementation and successful completion of projects, publication of the results achieved, participant satisfaction with improvements in collaboration. Feedback from participants would suggest that change had been implemented and possibly sustained. CONCLUSIONS: Active involvement and group support were required for success. More formal relationships needed to be activated with participating centres to guarantee support for those involved in implementing lasting change. A web-based resource to allow other programmes and centres to use the resources developed has been made available. The same approach, we believe, could be used to improve multi-professional working in the care of other childhood illnesses.

Children need a national service framework.

THE NHS Plan is being enthusiastically implemented by commissioning authorities and targets to improve the health of the nation are set for such preventable killers as heart disease, accidents, cancer and mental illness. However, children are the one client group specifically excluded from all the National Service Frameworks (NSFs) and are consistently underrepresented at health policy and government level. Yet they are our nation's most precious resource ( Aynsley-Green et al 2000 ).