Seamless support

Autumn 2012

Dr Andrew Wilcock shares the achievements of the award-winning Macmillan Lung Cancer CARE team.

Over the past two years, the CARE team has helped over 540 people with thoracic cancer through its multidisciplinary approach.

Based at Nottingham University Hospitals NHS Trust, the team works with existing cancer and specialist palliative care services to provide holistic support to people with lung cancer and mesothelioma. There is a particular focus on the cachexia-anorexia syndrome.

The team was named team of the year at the 2011 Excellence in Oncology Awards|.

The team

The CARE team: Andrew Wilcock; Asmah Hussain, Data Manager; Helena Alvey, Physiotherapist; Cheryl Percival, Dietitian; Rachel Bentley, Occupational Therapist.

Our service

All people recently diagnosed with thoracic cancer are invited to complete the Sheffield Profile for Assessment and Referral to Care (SPARC) questionnaire to identify their holistic supportive and palliative care needs. The results are then discussed at a multidisciplinary meeting, which includes the lung cancer nurse specialists and a consultant in palliative medicine.

'I have the highest praise for this team, being helpful, courteous and readily available at all times'

This close integration is one of the most successful aspects of the service as it facilitates good communication and seamless support for patients and carers. Based on the needs uncovered, the appropriate team members visit the patient at home or at their next hospital appointment to carry out a more detailed assessment and provide therapy. All patients are assessed by the dietitian.

Achievements

The team has provided around 3,200 face-to-face appointments and 2,800 phone reviews. 80% of new, and 12% of follow-up assessments, take place in the patient’s home. The team has also:

- undertaken user satisfaction surveys, which show the team is held in very high regard

- evaluated contributions of individual team members, for example, dietetic data (poster presentation and submitted for publication), and occupational therapy data (forming the basis of an MSc)

- increased the number of people with thoracic cancer able to die at home (33 to 49%), reduced the number dying in hospital (46 to 36%) and the number of hospital days utilised (6,778 to 5,696)^[1]

- disseminated data through conferences, journals and linked with national initiatives

- provided teaching and training to a wide range of disciplines.

Where do we go next?

Despite these achievements, we were unable to secure ongoing funding for the service due to the economic climate. Subsequently, the team was reconfigured last year as a specialist palliative care rehabilitation service, applying the same principles of assessment and support to a wider group of patients.

We recently won a tender to provide such a service to patients within the community. This will ensure patients and their families continue to benefit from this type of care.

Reference

1. Nottingham Macmillan Lung Cancer CARE service. Final report. 2011