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CANCER SUMMIT JAN 2014 Maria Callaghan. GETTING IT RIGHT FOR OUR PATIENTS And for the staff!

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Presentation on theme: "CANCER SUMMIT JAN 2014 Maria Callaghan. GETTING IT RIGHT FOR OUR PATIENTS And for the staff!"— Presentation transcript:

1 CANCER SUMMIT JAN 2014 Maria Callaghan

2 GETTING IT RIGHT FOR OUR PATIENTS And for the staff!

3 WHY DO WE NEED TO CHANGE Improved health, physical fitness and nutrition decreases risk of breast cancer recurrence and death from breast cancer Current follow-up is a huge strain on NHS resources but more importantly it does not provide the quality we are aiming for. We believe there is a different way which improves efficiency and quality. We will then have the capacity to see patients quickly at time of need

4 Moving Forward after Breast Cancer I wish to discharge most patients early from active follow-up; knowing we have given them the knowledge and information and confidence they need to return to as near normal life as possible (better in many). I want our patients to know that should they have a problem they have sufficient knowledge to seek help from the most appropriate health care professional. See the right person quickly.

5 cliniciansNo of OPDsReason BSU Diag Radiologist/ BCN 2+?lobular/multifocal/axilla Symptomatic Diag Surgeon/ BCN 2+Psych/staging/recon Treatment (Surgery/ NACT/PET) Surgeon +/- BCN May need further surgery Results Surgeon/ BCN 1Treatment Summary Referral to CCOOncol +/-BCNseveral PRN Wound clinic Nurse +/-cons 1+ (may be lots) Routine F/upCons or ANPUpto 10 Individual/info on demand/ Extra F/ups via GP/BCN/CCO Cons +/-BCN1-2 minNew problem * New referral GP/CCO/Radio Cons/BCNRe-start

6 Reason BSU Diag ?lobular/multi /axilla (pt letters diet/exercise) Symptomatic Diag Psych/staging/ recon Treatment (Surgery/NACT/PET) May need further surgery HNAs Survivorship.Moving Forward file Results NEW Treatment Summary/Bone health letters etc. Advice re diet/excercise Referral to CCO RT/CHEMO education PRN Wound clinic Routine F/up Individual/info on demand ???????????? Extra F/ups via GP/BCN/CCO ? New problem * Route taken ? New referral GP/CCO/Radio ? recurrence/ second ca

7 clinicianOPDs Reason BSU Diag Radiol / BCN 2+ ?lobular/multi /axilla (pt letters diet/exercise) Symptomatic DiagSurgeon/ BCN2+ Psych/staging/ recon Treatment (Surgery/NACT/PET)Surgeon +/- BCN May need further surgery Holistic needs assessment BCN/ ANP 1 Survivorship. Moving Forward File ResultsSurgeon/ BCN1 NEW Treatment Summary/Bone health letters etc Referral to CCOOncol +/-BCNseveral RT/CHEMO education PRN Wound clinic Nurse +/-cons 1+ (or many) ROUTINE F/upCONS / ANP upto 10 Individual/info on demand ???????????? Extra F/ups via GP/BCN/CCOCons +/-BCN1-2 min ? New problem * Route taken ? New referral GP/CCO/RadioCons/ BCN Re-start ? recurrence/ second ca

8 WHY DO PATIENTS COME TO CLINIC Reassurance and psychological support:  Test results: ? write and phone for benign Trial protocol To ask about : side effects of treatment, problems after surgery, should their family be checked?, can they have reconstruction  To check whether it has come back X

9 Health/Well-being/Education Exercise: Shoulder physiotherapy Warm up Exercise physiotherapist Personal exercise plan Cancer patient group exercise class Mainstream exercise Morale boosting/Buddying/FUN! Information Family history Reconstruction X-ray F/up Side effects,post-surgical problems, pain Late effects chemo/RT Psychosexual/confidence/ Fear of recurrence Financial/work Nutrition/smoking

10 cliniciansNo of OPDsReason BSU DiagRadiologist/ BCN2+ ?lobular/multifocal/axilla. Pt info from start. Pts weight Symptomatic Diag Surgeon/ BCN 2+ Psych/staging/recon/smokin g/diet/excercise HNABCN Psych/reduce need for phone calls /attendances Treatment (Surgery/ NACT/PET) Surgeon +/- BCN May need further surgery Results Surgeon/ BCN 1Treatment Summary Referral to CCOOncol +/-BCNseveral PRN Wound clinic Nurse +/-cons Only when really necessary more education to reduce attendance Health and Well- Being Clinics 1 x ANP/Cons /BCN 4-8 sessions but upto 40pts Move from support Patient self-management Final reviewBCN/ANP +/_Con

11 How do we do this? Health/wellbeing: away from breast unit (St Caths) after adjuvant treatment. (3/12 post RT, 6/12 chemo) Groups of women do chatting and support well All will be advised this is an impt part of Follow-up Px like Ais, RT and Chemo Not all will manage d/c from active f/up. ?annual review, phone calls, GP Will still get mammos/ trial f/up Separate clinics for recon/FH info in MF files At final review: Is d/c appropriate for this particular patient Need agreement for easy,quick referral for new assessment GP may feel at Cancer Review OPD that patient needs more individual in-put from us


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