Cancer memory mate: implementing a healthcare innovation to support the management of cancer treatments and side effects in people with memory problems in South Wales, UK

Introduction: An estimated 11% of patients have dementia prior to a cancer diagnosis (Ornstein et al. 2020). These patients have poorer cancer treatment outcomes compared to those without dementia (Hopkinson et al. 2016). Cancer Memory Mate developed from our previous research (Hopkinson et al. 2020) is a specially trained oncology professional who offers advice and resources to support safe cancer treatment in someone with a memory problem, a common symptom of dementia. Aims: To report obstacles and enablers influencing implementation of Cancer Memory Mate in a cancer centre in South Wales, UK. Methodology: The Cancer Memory Mate project was launched on 30/9/2020. Clinical observations (n=3), and semi-structured interviews with staff (n=9) were conducted prior to training of 24 Memory Mates and launch. Further observations (n=7) and staff interviews (n=28) were conducted post-launch to explore the obstacles and enablers to implementation. Data were analysed using the Normalisation Process Theory framework of Duke et al. (2020). Results: The concept of Memory Mate had some level of coherence for staff who described how it can improve the patient pathway and experience. Moreover, staff invested time in becoming Memory Mates, demonstrating cognitive participation. Staff strived to take collective action to provide the best possible care for cancer patients, although certain professionals might only champion particular elements of being a Memory Mate. Reflecting on implementation, Memory Mates expressed the need for further service promotion, as some staff members had limited awareness of the project. This obstacle could be attributed to service organisation issues and the COVID-19 pandemic. Conclusion: Cancer Memory Mates were enthusiastic about the project and gave examples of Memory Mate improving the supportive care of patients and carers. Obstacles to implementation were wider staff awareness and service organisation issues that need to be addressed for Memory Mat