1. Implementing the ‘recovery package’

2. Recovery Package
Risk stratification of care / pathway re-design – eg 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)

3. 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

4. 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

5. Electronic Holistic Needs Assessments (eHNA)

6. 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

7. Health and Wellbeing Events
CNS introduction to the day

8. Health and Wellbeing Events
Physio session, getting active again

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

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

11. 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

12. Treatment Summaries

13. 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

14. 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)

15. 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

16. 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