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P-95 A review of outpatient enhanced supportive care services
  1. Cahal Rafferty and
  2. Richard Berman
  1. The Christie NHS Foundation Trust


Introduction The ESC Team at The Christie is unique in that it offers supportive care for patients across the whole continuum of cancer (including curable, incurable but treatable and survivor cohorts). Historically there has been no single point of access (SPA) referral method to these services. This caused inconsistencies in referrals, which posed a greater challenge in triaging referrals and hence there was potential for a negative impact on emergency hospital admissions. This necessitated the creation of an SPA referral system to outpatient ESC services.

Method An SPA electronic referral proforma was created and a platform was used to collate data from 3 months’ worth of referrals, which included:

  • Urgency of referral;

  • Disease type;

  • Treatment intent;

  • Reason for referral.

Results 28 patients were included in the results. 32% of referrals were deemed urgent and 82% were managed in accordance with the triage algorithm. The treatment demographics of patients referred were:

  • 71% were deemed ‘palliative – incurable but treatable’;

  • 11% were for best supportive care only and;

  • 18% were being treated with curative intent.

  • Symptom control was the main cause for referral, with pain management (89%) being the most common symptom.

  • Review by the service caused admission avoidance of 36%, while 18% required admission to The Christie hospital and 3% required admission to another NHS trust.

Conclusion By streamlining via an SPA to the ESC services, it is possible to show the positive effect this has on admission avoidance because of more timely review of patients, which also likely improves patient experience. Most patients fall within the ‘palliative - incurable but treatable’ category; this reflects new and emerging cancer treatments extending patients’ lives. It is reasonable to assume that this cohort will increase in coming years, necessitating the expansion of ESC outpatient services s at The Christie.

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