Background Enhanced Supportive Care (ESC) is a fresh approach to supporting people through cancer treatment. At its heart is better and earlier access to expertise in managing the adverse effects of cancer and cancer treatments. ESC is recognised nationally by NHS England, and received a Quality in Care (QiC) award (February 2016).
Methods In (2012–2015), The Christie NHS Foundation Trust (a major cancer centre) piloted ESC across 4 cancer disease groups (skin, breast, hepatobiliary, upper GI). We provided appropriate supportive care treatments, at an early stage, for patients who were starting to develop problems with pain or symptoms, related to their cancer or cancer treatments. We also worked with oncologists to improve communication with primary care teams. In order to facilitate early involvement, we rebranded and changed the name of our team from ‘palliative care team’ to ‘supportive care team’.
Results A reduction was seen in the relative number of emergency admissions in disease groups where there has been significant ESC support. Such reductions were not seen consistently in those disease groups that did not receive significant ESC support. This reduction in emergency admissions suggested a potential £1.38m saving over a three year period. ESC also demonstrated improved patient and carer experience. Patients benefitted from being presented information in a hopeful and positive way. The initiative was warmly welcomed by colleagues in oncology.
Conclusion The landscape of cancer is changing due to better treatments. More and more people are living longer with chronic cancer. In line with emerging research on the benefits of early palliative/supportive care, ESC demonstrates improved quality and reduction in overall healthcare costs. The reduction in emergency admissions may reflect early detection and management of symptom problems, preventing these from escalating. The next phase of ESC broadens access to supportive care through integration with acute oncology and development of local ambulatory ESC units.
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