Coproducing personalised care in a digital age: using the Adversity, Restoration and Compatibility (ARC) framework to inform the co-design of a digital care planning tool for people with colorectal cancer.
A predicted 4 million people will be Living With and Beyond Cancer (LWBC) in the UK by 2030. Although the NHS is committed to providing personalised care and to identify individual needs of those who are LWBC, we know that the content, delivery, and timing of personalised care and support planning differs across practice. The nature of the changing COVID-19 environment also means that existing supportive cancer care services that have traditionally used face-to-face approaches are being rapidly re-designed, with more services replacing in-person interactions with digital care. While the virtual environment provides an opportunity to offer timelier care, it also poses the risk of limiting access and influencing the quality of conversations and relationships between clinicians and patients. The research will assess digital health contributions to personalised care and explore how to improve the quality of personalised care and support planning in cancer services.
The concept of LWBC moves away from cancer survivorship (which implies a definite conclusion to cancer) as the dominant discourse in cancer care. The ARC framework, built from a synthesis of 73 studies of personal experience, outlines three interlinked themes that describe the patient experience of LWBC; Adversity (realising the impact of cancer and treatment), Restoration (managing and coping with new challenges) and Compatibility (reflecting on how cancer has affected life). The study will explore how the ARC framework and what we know about LWBC can be used to inform the co-design of a digital care planning tool for people with colorectal cancer. Video-reflexivity will be used to review current practice and to identify what good practice looks like. The study will then go on to generate design principles, using an accelerated experience-based co-design approach.
The electronic holistic needs assessment developed by Macmillan Cancer Support will be used as a case study to help advance this aspect of healthcare improvement studies.