The model demonstrated the feasibility of a primary care led follow up for stable prostate cancer patients. A local incentive scheme with initiatives to share best practice and reduce variation was developed and 57 of the 59 practices in the Croydon area have enrolled. The remainder two practices will consider enrolling in the new financial year 2016/17.
The project aimed to improve the patient experience by improving communication to patients with a welcome pack, welcome appointment and emphasis on addressing holistic needs as part of the on-going follow up. Results from a patient experience survey indicated that patients are generally happy with the service and their transfer to primary care. At the end of the project phase, over 70 patients were transferred to primary care and 49 face-to-face Welcome Appointments were conducted.
The number of patients followed-up in primary care under the new holistic arrangement is 527. This included patients that were already receiving primary care follow-up.
Training and development for primary care professionals on prostate cancer and the needs of patients living with and beyond cancer was developed. Only 17% of professionals who were surveyed completed these, and a requirement to attend an event and/online module and subsequent audit would be recommended for consideration by commissioners as part of the planning process.
An economic evaluation was conducted comparing the costs of the new primary care pathway and the local incentive scheme against the secondary care pathway. The new pathway provides a direct healthcare costs saving of 57% per patient over a five year period. This is due to a decrease in both the use of expensive consultant appointments and requirements for hospital transportation in the secondary care pathway.