Macmillan lung cancer specialist supportive service
Category: Pre-Diagnosis and Referral
The problem identified
Patients with lung cancer are often travelling great distances to hospital clinics appointments for routine follow up when they may only be seen for a 10 minute appointment and many of their psychological, emotional and social care needs for quality of life and survivorship care will not be met. The geography of the Health Board makes travel difficult and journey times long. Transport links are poor and many travel long distances on minor roads. Patients say they would like to be treated closer to home.
The intervention made to change the problem
A bid was put forward to Macmillan to develop the lung cancer specialist support service, this included funding for a band 7 lung cancer nurse specialist to set up an outreach service for patients with lung cancer in primary care.
The outreach service includes clinics in local hospitals, GP surgeries and various community settings and provides specialist lung cancer nursing support to patients and families closer to home at all points of the patient pathway. Outreach clinics and home visits, where appropriate, are offered to patients who have stable disease following treatment or are managed for best supportive care, and those who are being monitored for progression or recurrence and for patients needing pain and symptom control management. The focus was on quality of life for patients with non-curable disease and survivorship care for those post radical treatment.
How it changed my practice
Prior to the development of the outreach service it was not possible to offer adequate and/or equitable support to patients throughout the lung cancer patient journey. Patients at the beginning of the diagnostic pathway were adequately supported by the hospital LCNS, and patients with complex needs nearing the end of life were well supported by the palliative care team. However, patients who, having completed their treatment and were being monitored for progression and/or recurrence in respiratory and oncology clinics, were inequitably supported in their complex holistic needs. The instigation of the lung cancer specialist nurse outreach service has provided support for patients throughout their cancer journey at the right time, by the right person, in the right place. This has, prevented unnecessary trips to hospital for patients and families and enabled patients to be cared for closer to home. The influence of specialist liaison and communication between the acute and primary care sectors has transformed communication ensuring a seamless service for patients between hospital and community.
Resource / Cost implications
New Band 7 post funded by Macmillan
References
Right Care, RightTime, Right place€ EveryTime. Hywel Dda Health Board FiveYear Plan 2010/2015 http://howis.wales.nhs.uk National Cancer Patient Experience Survey Programme (2010). National Cancer Patient Experience Survey Programme 2010, Survey Report. DOH 2010, http://www.dh.gov.uk