NEWS

Marie Curie Cancer Care
Every hour of every day, Marie Curie Cancer Care makes a real difference to the lives of people with cancer and their families across the UK. Every minute of every hour someone is being cared for by a Marie Curie Nurse.
They work across the UK – from remote Scottish islands through villages and towns to the biggest cities, giving people the choice to be nursed in their own homes, surrounded by the things they hold most dear and supported by their families. Some people prefer to be cared for elsewhere – and that’s why Marie Curie Cancer Care has 10 hospices in England, Scotland, Wales and Northern Ireland, dedicated to improving the quality of life for patients. The registered cancer care charity provides practical nursing care for 17,000 patients a year throughout the UK, offering support to around half of all cancer patients who die at home. It is an unfortunate fact that one in three people will develop cancer and one in four will die from the disease.
Research has shown that 70% of cancer patients would like to die at home, but only a quarter do. Through fundraising, Marie Curie Cancer Care aim to increase this figure and help more people fulfil their last wishes. Nursing help is given at no charge, but it comes at a cost to the cancer care charity. Every penny entrusted to the charity has to be carefully invested and trustees expect best value for money on any expenditure. Idle talk costs lives Every day, nurses, patients, consultants, relatives and other support staff need to talk. To make this happen, decisions have to be made to ensure that first class communications systems are in place to support all of the efforts of staff to care for patients across the country. Even the briefest of phone calls to bring help and reassurance to those affected by cancer can make a significant impact on their circumstances. For this reason, robust communication lifelines exist for hospices, administration sites, shops and fundraising centres is key.
In the late ‘90s, Marie Curie Cancer Care engaged in a program to put such systems in place to provide site to site, extension to extension dialling at low cost. The communication system was deployed across the network of hospices, shops and fundraising offices and was sustained over a five year period. As new technology and methods of working evolved however, Marie Curie Cancer Care recognised that some of the more advanced business processes that were required would be difficult to achieve with that existing communications infrastructure. Toward the end of the five year plan, it was clear that to be able to continue to deliver the best possible care to patients, a new approach would be required. That approach would not only encompass existing levels of communications, but would extend the capabilities and at the same time reduce costs for the cancer care charity. An example of the changes expected was a direct result of how the organisation worked. Many extensions were infrequently used and, because of the way that the services was charged, certain lightly used extensions were very expensive to sustain. Peter Crutchfield, Director of Service Modernisation at Marie Curie Cancer Care, described the scale of the situation, “We found that only 10% of all calls made were inter-site. This meant that the network we used to link the sites together was significantly under utilised and so, overly expensive. When we researched how our hospices used the network, we found them to be prime targets for change. They rarely made calls to other Marie Curie sites, predominantly taking incoming calls from the public or calling other care providers such as the local hospital. The old network was not the most economical means to deliver the critical telephony services these sites needed. In addition to this, the IT team at Marie Curie Cancer Care identified that they needed a more granular and accessible means to manage the network. The nature of the organisation was that time was precious and any problems arising needed to be addressed quickly and accurately and backed up with good reporting practices.
Decision Time Recognising that the quality of life for so many patients relied on the use of the best systems and services, the cancer care charity issued an invitation to tender for a complete infrastructure upgrade to include cabling, network services, migration away from the existing network and a replacement telephony solution. Initially only 19 key sites were selected for reworking. The sites comprised 10 hospice locations and 9 administration and fundraising centres. Following a rigorous selection process, Marie Curie Cancer Care selected Communication-STEM (C-STEM), a vendor independent solution provider, to facilitate the upgrade of the charity’s Network Services infrastructure. A fundamental element of their proposal was the implementation of the Avaya IP Office which would become the hub of their overall solution. In total, the five year contract awarded to C-STEM extended to a fully managed service solution. Stuart Johnson, Telecommunications Manager at Marie Curie Cancer Care was particularly attracted by CSTEM’s approach. “We already had experience of CSTEM as they had previously implemented a complex communications solution at our UK Headquarters for Nurse Referral. The replacement of the Centrex arrangement was an even more demanding requirement however. We knew that we would need a supplier who would be honest enough to tell us not just what they could do, but also what they couldn’t do and how they’d work round those problems. The other bids indicated that everything was possible, no matter what. C-STEM made it very clear that certain deliverables would be difficult to achieve but impressed us by describing how they work with third parties to make the whole solution work to specification.
They also took it onboard to integrate as many existing functions of the organisation into their Avaya IP Office offering.” It was the aspect of alliances with other highly respected service providers and their relationship with the manufacturer that secured the project for C-STEM. Stuart Johnson continued, “We knew C-STEM well enough and had sufficient experience of their professional working practices to give us confidence. We understood that they would be able to fulfil to our requirements through their strategic alliance relationships.” Peter Crutchfield was also keen to work with CSTEM. He felt that the nature of their bid would offer greater resilience because of the level of commitment of the partners involved. “C-STEM arranged for backup agreements with their strategic partners so that each of them knew the detail of our network. This ensured they could support each other mutually in the event of a catastrophic failure. We saw it as having a very large service organisation working inside Marie Curie Cancer Care, reporting to Stuart Johnson - all part of his team. This means that we don’t need to worry about minor network changes or upgrades for some years to come as we have this long term agreement with C-STEM.” Strategic Partnerships C-STEM were the prime supplier and introduced major partners Westcon, Logicalis, ANS and BSCL to the project. These influential organisations, under the C-STEM banner, came together to deliver networked services, product supply, installation, infrastructure, connectivity, configuration, testing, support and training, initially to 19 sites.
The program of works was significant, to the extent that porting large quantities of telephone numbers from the old network over to ISDN called for highly focused project management to avoid service disruption. The risks were not trivial though. Peter Crutchfield explained, “There is always a risk when changing the status quo, in that it could be problematic. The practicalities of migrating live hospice sites over to a new network was something we feared we would lose sleep over and we were really apprehensive of the prospect of any downtime. Thankfully we were able to outsource the entire roll-out and our rigorous evaluation of C-STEM ensured that the risk of downtime was minimised. They made it all happen seamlessly, from coordinating the migration of the numbering scheme to remote management of the installed systems.” The scalable networked solution The Avaya IP Office family was delivered as the best solution to the differing problems of scalability, management, ease of use, accessibility, cost and product strategy. The nineteen key sites identified for the initial roll-out supported from 11 to 216 extensions. As the smaller sites incurred high costs within the old network, the benefit of the IP Office family, scaling from 2 to over 360 extensions with growth supported by simple addition of expansion units, was ideal for the charity. It meant that a single platform could be offered across the network, with an identical look and feel for all users and with no compromise on quality.
During demonstrations, Marie Curie Cancer Care were pleased to see that in contrast to their previous network, Avaya IP Office offered simple tools for different levels of management requirement. The fact that all IP Office switches could be monitored remotely was also a powerful influence in the decision making process. “Our sites stretch across the UK with the most remote, in terms of accessibility, being Belfast,” said Stuart Johnson. “Our hospice staff are not equipped to help fix telephone problems and they have other priorities to work on. For C-STEM to be able to access these sites remotely and securely was a great feature for us. It meant we could expect increased system availability as they could address problems quickly without the need to attend site.” Staff had become familiar with the old system and Marie Curie Cancer Care made it clear that the new telephone system needed to be easy to work with. To ensure that every member of staff was able to use the handsets and system properly, a simple training package was delivered by C-STEM to reinforce a common understanding of how the system would work for all staff.
User Applications an objective of the cancer care charity is to provide the best support and response when there is no one to talk to, out of hours. To address this requirement, each IP Office was bundled with VoiceMail Pro to offer auto attendant and voicemail services. By linking VoiceMail Pro to the existing legacy paging system, C-STEM made it possible for concerned callers to get in touch with support staff around the clock. Personal productivity tools were also included in the CSTEM package with Avaya Phone Manager Pro, designed to allow PC users to control their telephones at the click of a button. This was particularly helpful for receptionist staff and team leaders who would be given the ability to see at a glance who might be available to take a call. Hospice staff could even control door entry or fire alarms through Phone Manager Pro. Avaya IP Office supports analogue, digital and IP handsets and this was another key point for the charity. Unlike other suppliers, who bid only IP, C-STEM recognised that the features needed could all be addressed by the use of lower cost digital handsets. The chosen devices needed to support CLI Display, Line Divert, Extension and Group Pickup and Voicemail waiting alerts among a number of other generic features. Computer control of telephone handsets (or CTI) was also a requirement which was delivered through IP Office. These were all factors which would drive down the total cost of ownership of the overall solution. “We couldn’t justify the cost of IP Telephony at the time,” said Peter Crutchfield, “and we had no real applications which would exploit it, but we were relaxed in the knowledge that we could take advantage of simple upgrade paths in the future. Marie Curie Cancer Care intends to link into the NHS IP Telephony Infrastructure in the future and the scope of the solution to move the charity entirely into the IP environment is in line with that prospect. C-STEM have a strong relationship with Avaya and strengthened our confidence that we were making the right decision.
We were particularly reassured by the clarity and vision of the long term strategy that Avaya were able to describe for their IP Office portfolio.” Reassuringly Reduced Costs Looking at the results so far, Stuart Johnson, who keeps an eye on telephony spend, indicates that even in the early stages of this program, savings are being seen. “C-STEM made a real difference with their knowledge and relationship with BT to equip all of our remote sites with ISDN2 and ISDN 30 lines at no cost to us. This has saved us almost £40,000 in outlay on the installation. We have also started to see real reductions in our call expenditure due to the combination of services provided by C-STEM. Thanks to IP Office, we have been able to retain and exploit our legacy systems - something which our old network would not have allowed us to do easily. Working with C-STEM and using IP Office has enabled us to take control, our risks have all been managed and we now have a service that we can rely upon to ensure we continue to give the best possible care for the sick and dying,” said Peter Crutchfield. What the future holds The charity has to ensure that patient care comes before everything else. Extending the use of IP Office to strengthen bonds with other organisations and giving carers and patients new services is all now available. Concepts such as secure Virtual Private Networking (VPN) with the NHS IP Network will enable first class transfer of patient data between the charities hospices and health authorities. Support for home workers during fundraising campaigns can be provided, allowing them access to voice and data services over ADSL broadband and act as an extension of the cancer care charity network.
The nursing management team can hold UK wide meetings by using conference calls thanks to IP Office VoiceMail Pro, reducing time travelling and so saving the charity money. Analogue phones at the patient bedside is now a realistic service, allowing patients to be contactable by concerned relatives. Conference calls to friends and relatives can link an entire family, around the world, into a single phone call for those in care. Multimedia to the bedside also becomes possible, with the potential for radio, TV, films and internet access into hospice locations. Peter Crutchfield concluded; “We need to prioritise and think about practicalities of cost and value for money, but we are confident that we now have the infrastructure in place to start thinking about the future.