Cancer strategy - monitoring and evaluation: participatory systems mapping

Rich Picture insights

The notes and the pictures were used to draw out key themes that were common across the different participant perspectives. The key themes included: time; anxiety; where care happens; diagnostics; inequalities; and workforce morale. These were then used to come up with the three starting factors for the participatory systems mapping. The use of starting factors is encouraged in the PSM method [10]. The starting factors identified are listed below, alongside the relevant Cancer Strategy outcomes. Note that alignment to Cancer Strategy outcomes was carried out retrospectively and is included for information only:

• Time to diagnosis – aligns with the Cancer Strategy outcome of “Reduced later stage diagnosis”.
• Patient feeling supported – aligns with the Cancer Strategy outcome of “Improved experience of services, across all areas of care”.
• Access to care and treatment – cuts across the following Cancer Strategy outcomes: “Timely access to treatment”, “More people receiving curative treatment” and “Improved experience of services, across all areas of care”.

Over the course of the PSM process the starting factors evolved into focal factors as participants’ understanding of the system map evolved. The final focal factors are the actions considered by participants as essential for achieving the system goals. There were four final focal factors: coordinated care; patient feeling supported; access to care and treatment; primary care capability. Time to diagnosis was changed to “minimal time to diagnosis” and became a system goal.