Breakthrough Breast Cancer’s service pledge for breast cancer: Improving services through patient involvement


Session type:

R. Kester1, S. Rawlings1, C. Wood1, E. Heard1
1Breakthrough Breast Cancer, London, UK


Breakthrough's Service Pledge enables healthcare professionals and patients to work in partnership to improve local breast services. Since 2004, the Service Pledge has benefitted 30,000 patients across the UK.


Breakthrough works closely with hospitals to develop their own ‘Service Pledge' by carrying out in-depth patient experience surveys and face to face interviews. At each hospital, a member of the breast care team takes the role of ‘Pledge Lead'. Patient representatives are identified to work with the Pledge Lead to understand and evaluate patients' experiences of care. Working with the wider MDT, realistic improvement goals are identified, turning patient voice into constructive action. Service Pledge booklets are given to patients setting out standards of care as well as the goals set for improving services.


Local improvement goals provide tangible actions from patient involvement, and range from introducing a photographic guide to breast surgery and reconstruction to establishing a nurse-led drop-in clinic. There are limitations, and financial constraints are increasingly cited as reasons for being unable to implement some improvements. Nurses have indicated pressure on their time is increasing, and their fulfilment of the Service Pledge can be constrained by their other commitments.


Healthcare professionals involved have reported patient views are a powerful tool for securing change. In some hospitals the value of involving patients has been less a means of identifying improvements and more a mechanism to build momentum and support to address issues already highlighted. 50 breast units across the UK have taken part in the Service Pledge, with a further 19 planned for 2012. Breakthrough is committed to exploring opportunities to adapt this model across and beyond cancer services, and is working with Breast Cancer Care to explore a Service Pledge for Secondary Breast Cancer to enable people with metastatic disease to help shape their breast care.