Improving the Care Journey (ICJ)

NEW: About the Improving the Care Journey service

Improving the Care Journey (previously Improving the Cancer Journey) is a Macmillan-funded service delivered by NHS Orkney. While we continue to provide support for people affected by cancer, the service is now expanding to support people living with selected long-term conditions.

We are beginning this expansion with cardiac conditions and aim to extend support to more long-term conditions over time. The service focuses on helping people with their non-clinical needs, recognising that health conditions can impact many areas of life beyond medical treatment.

Improving the Care Journey (ICJ)

The Improving the Care Journey (ICJ) service is here to support anyone living in Orkney that has been affected by cancer or a selected long-term condition.

A health condition doesn’t just affect your physical wellbeing – it can impact many different aspects of your life and the lives of those around you. It can be difficult to know what support is available and how to access it. The Improving the Care Journey service, in partnership with Macmillan Cancer Support, can support you to access non-clinical services within Orkney.

ICJ remains a Macmillan-funded service and continues to support people affected by cancer. We are now expanding to support people living with selected long-term conditions, starting with cardiac conditions, with the aim of extending support to more conditions in the future.

How does it work?

You may already be accessing clinical support from GPs, specialists and nurses, in addition to this, the ICJ service can support you to access non-clinical supportive services. This may include support with:

  • Accessing information to answer questions or concerns about your cancer or long-term condition and treatment
  • Putting you in touch with local teams that can help you with money or housing worries and benefits
  • Caring or work responsibilities
  • Connecting with those that can support with addressing physical concerns
  • Accessing complimentary therapies where appropriate
  • Helping with emotional concerns, connecting you with wellbeing support and services

When people affected by cancer or a long-term condition access the ICJ service, an ICJ Link Worker will have a meaningful conversation with them to discuss their needs and concerns. They will be offered a Concerns Checklist, which helps to determine what matters most to that person.

A Concerns Checklist looks at needs or concerns a person might have about any area of their life, not just about their condition. These concerns can be:

  • Financial – e.g., how will I pay for my bills and food shop when I’m not working?
  • Practical – e.g., who will look after my pets / animals / house if I’m unwell?
  • Physical – e.g., how will my condition affect my energy levels and daily life?
  • Emotional – e.g., I’m worried about my family and friends, and feel anxious and lonely
  • Spiritual – e.g., how do I deal with past regrets or worries about the future?

Based on this assessment and conversation with the Link Worker, a support plan will be created to make sure the person is offered all the support they need.

A Concerns Checklist recognises that any area of your life that is affected by cancer or a long-term condition is important. It gives you the time to explore what resources, help and support is available locally for you.

You will usually complete the Concerns Checklist yourself, to ensure it reflects what matters most to you. Support with this can be arranged as needed. The Link Worker will then arrange an appointment by telephone, video call (Near Me) or in-person to discuss your needs and agree a support plan.

Support for Long-term Conditions

Improving the Care Journey now supports people living with selected long-term conditions, alongside those affected by cancer.

We are currently supporting people with cardiac conditions, with plans to expand the service to include more long-term conditions over time.

People living with cardiac conditions can access the same non-clinical support offered through ICJ, including help with financial concerns, emotional wellbeing, practical issues, and connecting with local services.

If you have a cardiac condition and feel you would benefit from support, you can be referred by a professional, make a self-referral, or contact the ICJ service to discuss your needs. Referral forms and contact details are provided below.

Where can I access the ICJ service?

The ICJ Service can provide support through the following options:

  • Over the telephone
  • Online via video call (Near Me)
  • Face-to-face – this is dependent on Link Worker availability

When can I access the ICJ service?

Opening times

Monday to Friday 09:00 – 17:00 (Closed on weekends or Public Holidays).

Contact Details

Email: ork.icj@nhs.scot

Phone: 01856 888084 (Public Health Department)

Referral forms: 

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