Objectives There have been many models of providing oncology and palliative care to hospitals. Many patients will use the hospital non-electively or semielectively, and a large proportion are likely to be in the last years of life. We describe our multidisciplinary service to treatable but not curable cancer patients at University Hospitals Sussex. The team was a mixture of clinical nurse specialists and a clinical fellow supported by dedicated palliative medicine consultant time and oncology expertise.
Methods We identified patients with cancer who had identifiable supportive care needs and record activity with clinical coding. We used a baseline 2019/2020 dataset of national (secondary uses service) data with discharge code 79 (patients who died during that year) to compare a dataset of patients seen by the service between September 2020 and September 2021 in order to compare outcomes. While this was during COVID-19 this was when the funding was available.
Results We demonstrated a reduction in length of stay by an average of 1.43 days per admission and a reduction of 0.95 episodes of readmission rates. However, the costs of those admissions were found to be marginally higher. Even with the costs of the service, there is a clear return on investment with a benefit cost ratio of 1.4.
Conclusions A supportive oncology service alongside or allied to acute oncology but in conjunction with palliative care is feasible and cost-effective. This would support investment in such a service and should be nationally commissioned in conjunction with palliative care services seeing all conditions.
- Service evaluation
- Supportive care
Data availability statement
Data are available on reasonable request. A report of this paper is available on request from unity insights https://www.unityinsights.co.uk/about/ or from the corresponding author.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Twitter @simontavabie, @lumpyeggbass, @robhezzCCOT, @AndreaBruun
Contributors OM is the guarantor, obtained funding and had the original idea. ES, RH, KY were responsible for the data collection during the service delivery. AR, CM and LS were responsible for the analysis. ST, NW, DM, JD, ES, AB, SB and GW were part of the supervisory board and provided guidance throughout the project. All authors contributed to the preparation and final approval of the manuscript.
Funding Funding for this project was through a fixed term grant from NHS England/Improvement for the development of an Enhanced Supportive Care service in Oncology at University Hospitals Sussex and funding of the My Clinical Outcomes platform was from the Sussex Cancer Fund.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.