Background With the explosion of effective treatments for cancers, approximately 500,000 UK citizens are living with the physical and psychological consequences. In 2013 the National Cancer Survivorship Initiative, including Macmillan Cancer Support ‘Recovery Package’(RP), was launched, focused on improving quality of life for these people. We report our approach and progress at UHCW.
Method We initiated a multi-professional steering group, including hospital staff, commissioners, a GP, rehabilitation and exercise specialists and a patient representative. The Health Needs Assessment (HNA) was in elementary use, but needed encouragement. Cancer care reviews(CCR) are the province of General Practice – our GP member is driving it. For the End of treatment summaries, EoTS, (for professionals) and Health and well-being events, HWbE, (providing information, support and signposting for patients empowering them to self-manage, with support, the emphasis being on living well beyond cancer), we initiated two ‘task and finish’groups.
Results HNA – initially one nurse incorporating it, now eight.
CCRs – unfunded, but education and incorporation ongoing.
EoTS – through collaboration with oncology IT team automatically generated letters developed in oncology electronic medical record and prescribing system, informing on potential medium – long-term treatment side effects, using a structured and consistent format. Piloted for curative radiotherapy in prostate cancer – telephone audit conducted after a month with recipient GPs – letters modified accordingly. Summaries currently active for four cancer sites, three launching imminently. Systemic treatment summaries in development.
HWbE – new concept, no prescribed format, nor any budget so initial ambitions refined. All patients starting treatment invited to monthly events. Six attended the first. Most recently (the fourth), there were 38. Evaluation enthusiastic and positive from patients and relatives.
Conclusion Implementing RP is challenging, requiring effective co-operative multi-professional/multi-agency collaboration. Automated summaries, audit, feedback, imagination and flexibility are crucial.
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