Background/Aims The need for holistic support to address the psychosocial impact of cancer has featured in NHS recommendations since 2004. This article describes the review, rewrite and evaluation of the North Central and North East London region ‘level 2’ psychological support skills training for oncology clinical nurse specialists. Methods The review was conducted in 2016–18; the new training package was then rolled out and evaluated in 2018–19. The re-written training includes models of individualised assessment based on psychological theory, including adjustment and adaptation. It also includes self-care exercises, providing experiential learning for the dual purpose of self-care and as potential material to teach to patients as level 2 interventions. The new training model requires follow-up attendance in clinical discussion groups to consolidate knowledge and skills development. In total, 135 clinical nurse specialists attended over an 18-month period. The evaluation involved pre- and post-training questionnaires. Results Evaluation suggests the new training is valued by clinical nurse specialists, is pitched at the right level and increases clinical nurse specialists' subjective ratings of confidence and identification of psychological need, onward referral and self-care. Conclusions The new package provides a useful development of the level 2 training model. Future plans are discussed.
� Clinicians should consider using the Patient Health Questionnaire (PHQ)-8 as a preferable alternative to the PHQ-9 for measuring outcomes in psycho-oncology services � There is compelling research demonstrating equivalency between the PHQ-8 and PHQ-9 in assessing for depression and measuring symptom severity � Psycho-oncology service users may object to the wording of the 9th item in the PHQ-9 which intends to screen for suicidal ideation � The 9th item has been criticised as a poor tool for assessing suicidality � Data collected locally through routine practice is provided to support the argument made in the wider literature.Demonstrating both quality and outcomes in health services ensures patients receive care that is safe, effective, patient-centred, timely, efficient, and equitable. 1 Quality addresses the clinical and opera-
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