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125 Percutaneous cervical cordotomy – an equitable service across Scotland
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  1. Lesley Somerville,
  2. Eilidh Burns and
  3. Jonathon McGhie
  1. NHS Greater Glasgow and Clyde

Abstract

Background The Interventional Cancer Service (ICPS) was established as a multi disciplinary service in July 2014. Patients with uncontrolled cancer pain due to pain severity or with intolerable side effects from analgesia are assessed. If suitable, patients are offered an intervention, including Percutaneous Cervical Cordotomy (PCC). The service strives to provide an equitable service to all. Since 2017 the ICPS has provided a PCC service to the west of Scotland and beyond.

Patients are assessed by our multi-disciplinary team. For a proportion of these patients an intervention is offered to help with refractory pain.

The ICPS uses Scottish Index for Multiple Deprivation (SIMD), a national classification tool. This considers education, health and employment to give an assigned score.

Aim To ensure PCC’s are offered equitably across different deprivation quintiles.

Method Using the ICPS database, a retrospective analysis of all referrals to ICPS since establishment of the PCC Service in March 2017. Excel spreadsheets used to gather information on patients offered a PCC. Further analysis of those patients who subsequently declined a PCC, those who deteriorated and were unable to proceed and those who went to theatre.

Results Since March 2017, 341 patients have been referred. See Table 1: 66 patients were offered a PCC. 11 turned this down. 11 subsequently deteriorated and were no longer appropriate. 44 patients went to theatre for a PCC. 6 of those patients were either unable to complete due to technical difficulties or patient tolerance. 38 had a PCC procedure.

Abstract 125 Table 1

Conclusion ICPS offers PCC across the quintiles showing no disadvantage. The weighting of those offered a PCC is towards the more deprived areas. This coincides with patients in more deprived areas of Scotland being a third more likely to have a cancer diagnosis. Further work to look at SIMD quintiles of all referrals could prove meaningful.

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