Implementing the ‘recovery package’

Recovery Package Risk stratification of care / pathway re-design – eg. 2016 UK sarcoma guidelines Holistic Needs Assessments Structured assessment / care planning Health and Wellbeing events End of treatment education / information events Treatment Summaries template of information from acute providers, to GPs Cancer Care reviews (GPs)

Impact of the recovery package For people living with and beyond cancer Increased quality of life Improved health and wellbeing More confidence in their ability to self-manage their health Make appropriate use of resources (eg.↓ in ED and GP attendances) Live longer due to healthier lifestyle and better management of consequences of treatment Wider benefit Stratified pathways Fewer face to face follow ups Reallocation of resources, to focus on those with complex needs

Electronic Holistic Needs Assessments (eHNA) Established eHNA Sarcoma CNS led clinic Patients booked in 6 weeks after end of treatment 1 hour clinic slot with known CNS eHNA completed, care plan formulated with patient and shared with GP TYA IAMs

Electronic Holistic Needs Assessments (eHNA)

Health and Wellbeing Events Sarcoma Living Well Day Teenage and Young Adult Specific Events Living Well Course 6 week course aimed at promoting individual self management ‘Next Steps’ days, generic Health and Wellbeing ½ days ‘HOPE’ – community based 2 day course, building reliance, goal setting, moving forward

Health and Wellbeing Events CNS introduction to the day

Health and Wellbeing Events Physio session, getting active again

Health and Wellbeing Events Break time – market stall information gathering, meeting other patients, CNSs, AHPs

‘that many people have gone through the feelings I have experienced” “There’s a lot we can do to improve our quality of life”

Treatment Summaries Standard format summary letter to GP, including: Diagnosis and treatment details (with dates) Possible treatment consequences Alert symptoms that require referral back Secondary care ongoing management plan Secondary care contact details (in hours / out of hours) Referrals made Required GP actions Summary of information given to patient Completed at the end of each treatment modality (eg. surgery, chemotherapy, radiotherapy) Copy sent to GP & given to patient so both aware of ‘red flag” symptoms for reoccurrence / when and how to get in touch

Treatment Summaries

North Bristol EHNAs at end of treatment as part of End of Treatment clinic. Becky will soon have her own clinic Health and Wellbeing Events: Generic fortnightly Cancer information clinics for patients to access at diagnosis Generic Living Well with cancer programme Sarcoma CNS team will offer quarterly? Sarcoma specific education events post surgery Treatment Summaries: Aim to integrate into EHNA clinics. Looking at how to introduce more widely across the Sarcoma service for all patients

University Hospital Bristol HNAs Electronic holistic needs assessments available on iPads, PDF care plan can be added to CDS TYA IAMs Health and Wellbeing Events Generic ½ day ‘Next Steps’ events every 8 weeks Treatment Summaries After each treatment modality (eg. chemo, RT)

Yeovil HNAs – in discussion about nurse led clinic for HNAs – preliminary discussion about local nurse led follow up at YDH, supported by Bristol sarcoma team for low risk. Health and Wellbeing Events – aware and sign posting to Bristol events. Local SPRING programme – generic 12 week course post treatment run by YDH physiotherapy. Treatment Summaries – on going communication with local primary care – formal treatment summaries not undertaken presently. Additional local support – psychological support services CAB Macmillan team

Additional support available Macmillan NSG Wellbeing Centre UHBristol Cancer Information and Support Centre Outlook and camouflage makeup Psychological Support Services Penny Brohn Cancer Care The Harbour Macmillan Rehabilitation and Support Team Macmillan CAB Benefits Service Macmillan Bristol Buddies