National Cancer Survivorship Initiative

Central Hall, WestminsterMonday 21 September 2009

Assessment and Care Planning

Two Million Survivors

But how many have a care planfor survivorship?

“My cancer experience was really stressful asI’m self-employed and have had a lot of workworries. I’ve finished treatment but the hardestpart about the cancer now is how it has affectedme mentally.’ I’m convinced that every ache or pain that I get is the cancer returning.”Anthony. Testicular cancer 2007

Assessment and Care Planning Workstream

Assessment and care planning at key stages in the cancer journey ensures that patients needs are identified and met.

“I’ve learnt that survivorship is all about living with the emotional and physical effects of a cancer diagnosis.” Beth, cervical cancer in 2005

What has the workstream been doing?

• Developed the assessment and care planning framework

• Developed and testing Treatment Summary Record for acute teams to complete and send to GPs

• Auditing effectiveness of GP 6 month cancer review

Next Steps

• Select test communities

• Explore changes to follow up systems

• Expand testing of treatment summary records

• Develop resources to help GPs ensure the effectiveness of their 6 month cancer reviews

Our aim is to ensure two million survivors have a care plan

• If you are interested in becoming a pilot site

• Or currently use a careplan for survivorship

we are interested in hearing from you – please contact

Noeline Young

nyoung@macmillan.org.uk

Two Million Survivors

But how many GPs are aware of the treatment that their patients have

received

and their survivorship care plan?

Assessment and Care Planning Workstream

• Through mapping GPs have identified a need for more information about care and treatment:– Details and Staging of disease– Consequences of treatment– Risk stratification and possible symptoms of

recurrence– How people can get back into the system

What has the workstream been doing?

• Developed a Treatment Record Summary– To be sent on the completion of treatment

from the treating clinician to the patient & GP– Currently at pre-pilot stage

Two Million Survivors

But how successfully does the GP Cancer Care review meet their needs?

What has the workstream been doing?

• Auditing the impact of the Cancer Care review– which GPs carry out with patients 6 months

after receipt of diagnosis.– To inform the effectiveness of the review

Two Million Survivors

But how does Follow Up care need to change to meet their needs?

What has the workstream been doing?

• Reviewed the current forms of follow-up care

• Considered follow-up care in relation to risk stratification

• Reviewing pilot sites and hospitals offering alternatives to follow-up care

• Currently considering the benefits of a post treatment clinic

• Plan to pilot post treatment clinics in 2010

Post Treatment Clinics

• A post treatment clinic would provide the opportunity to inform and educate patients about the clinical aspects and the ongoing management of their disease

• It would provide information about local facilities and support groups

• Access to support and information related to returning to work, financial benefits and social support