Telephone follow-up clinic for patients with resected primary lung cancer
Category: Follow-Up and End-of-Life Care
The problem identified
Introduction of a CT based follow-up programme for patients with resected primary lung cancer means that patients are required to make two trips to the hospital, one for the CT and another for the results once the images are reported. Patients find this burdensome, with traffic and parking problems causing particular concern. Some patients live a considerable distance from the hospital and can have difficulties making the journey on public transport. Most patients appreciate the increased level of surveillance offered by our CT based programme and are happy to make one journey for imaging.
The intervention made to change the problem
We have introduced a telephone follow-up clinic for patients who have undergone CT imaging. Patients are given the option of transferring to the telephone clinic or attending a face-to-face clinic for their results at each appointment. The telephone clinic is run by the nurse practitioner who is experienced in seeing patients in the face-to-face follow-up clinic. Patients are sent a timed appointment and their contact number confirmed prior to the appointment.
The consultation is structured in the same format as a face-to-face appointment with the nurse practitioner. A record of the appointment is made in the patient's notes and a clinic letter is sent to the GP and other relevant healthcare professionals summarising the consultation. Patients whose concerns cannot be adequately managed via the telephone can be booked into the next available face-to-face clinic appointment. A database of patients seen in the telephone clinic is completed prospectively.
How it changed my practice
The nurse practitioner now runs one telephone clinic per week in addition to the scheduled face-to-face clinics. This has increased overall clinic capacity within the department and reduced the waiting time for appointment for patients who need pathology results. Patient feedback in the first 3 months of the clinic has been positive.
Resource / Cost implications
CCG approval for the change in clinic structure, with associated cost implications (tele-med appointments are charged for at a lower rate). Reduction in the waiting time for face-to-face clinic appointment, for patients who require them.
Hands-free telecoms equipment for running the clinic.