ABS ePoster Library

It is recognised that cancer survivors can have many unmet needs. There is a high level of demand on the current 'follow-up' clinics due to the number of patients now living with and beyond cancer. In addition the current 'follow-up' model is standard for all cancer patients and disregards individual diagnoses and needs of patients. The clinics can often be over-booked resulting in long delays which can increase anxiety. Importantly patients' perception of the value of attending a 'follow-up' appointment can lead them to a false sense of security. Consequently they can find it difficult when they are discharged from 'follow-up'. Out-patient appointments also have time and cost implications for hospital trusts. It is therefore recognised that this model is not the most effective way to enhance patient care. We have developed a new model of monitoring and aftercare to improve the pathway of care for primary breast cancer patients that should benefit patients and meet their needs more effectively. This work is further supported by the Department of Health's '5 Year Survival Plan' that focuses on addressing any unmet needs and helping patients move forward. Patients are given a treatment summary appointment approximately 4 months after completion of their initial treatment. This appointment lasts 45 minutes and electronic holistic needs assessment (e-HNA) is completed with any needs identified being addressed. From this a careplan is written and an action plan is completed if required. During this appointment the patient's diagnosis, histology and treatment is again explained to them. Patients are also informed about any side-effects from their treatment as well as the signs and symptoms that could indicate a local or distant recurrence. An appointment for the Trust's health and well-being event, 'Looking Forward, Moving On' is also offered to the patient. These patients are assessed to determine whether they will be suitable for supported self-management which would mean that follow-up appointments would cease although they would still be invited for an annual surveillance mammogram for the next 5 years. If the patient develops a concern they are encouraged to contact the Breast Clinical Nurse Specialists who will arrange for them to be seen in a clinic by a Clinician.
Initial patient feedback has been extremely positive and patients appear confident about this new model of care.