Abstract

Background
Since March 2012, Macmillan Cancer Support has funded an intervention in Lincolnshire whereby carers of people affected by cancer and other long-term conditions at end-of-life are offered a bespoke package of support. The intervention involves the employment of a full-time specialist Macmillan Carers Support Worker (employed by Carers Connect through a contract with Lincolnshire County Council) to co-ordinate packages of support to carers of palliative and end-of-life patients. The aim is to achieve a holistic and integrated package of support, to streamline lines of communication between the carer and health, social care and other services to remove duplication of procedures across different agencies.

In order to evaluate the impact of the above intervention, Macmillan Cancer Support commissioned the University of Lincoln to undertake this research.
Aims
• To explore the experiences of those in receipt of the intervention and those involved in its delivery.
• To inform the funders of particular strengths and weaknesses of their service.
Methods
• A sample of 50 anonymised carer case studies was analysed.
• 10 in-depth interviews with carers in receipt of the intervention were conducted.
• 1 in-depth interview with the Macmillan Carer Support Worker was conducted.
• Interviews were analysed using the Framework method of qualitative data analysis (Ritchie & Spencer, 1994).
Results
Participants were most commonly referred into the service via health professionals, however some participants were not aware of how they were referred or (prior to the point of referral), of the service itself. The service appeared to be meeting a specific need of carers, in that it focused specifically on the needs of the carer, something that is not being met elsewhere. A positive outcome that has arisen from frequent communication (whether over the phone or face-to-face) was that the carer has felt reassured through having background support. All of those interviewed reported that the personal attributes and specialist skills of the support worker had influenced their satisfaction with the service. Participants also remarked on how they were signposted to a wide range of useful resources, which helped to streamline communication between the carer and other health and social care services.

Conclusion
Overall the evaluation found that the Macmillan end of life carers support service to be a successful intervention within a social care setting. The participants whom we interviewed had no overtly negative opinions on the service in its current format and all held it in a high regard. Participants overwhelmingly felt that both the content and the way in which the service was delivered by the Macmillan support team were excellent. Given that the Macmillan End of Life Carers Support Project is still in its relatively early stages of development, it is recommended that further evaluation be conducted once the service has become more fully established.