Great Western Hospitals NHS Foundation Trust
Using the Holistic Needs Assessments to build links with community teams
Meet the team
The Urology-Oncology service is a well-established, visionary and expert team based within The Great Western Hospitals NHS Foundation Trust (GWH). They deliver acute and community services for Swindon and Wiltshire.
The big idea
The purpose of the project was to:
- Ensure that men with prostate cancer receive the quality care and support they need.
- Improve patient experience by signposting to other services to ensure any unmet needs are addressed and managed accordingly.
- Enhance the patients’ cancer care experience.
- To use the electronic Holistic Needs Assessment (E-HNA) to build links with community teams and support the national survivorship agenda.
This was achieved by the setting up of E-HNA clinics, living well days and starting a prostate cancer support group.
The CNS was also able to set up an additional Andrology Clinics and support the team with a Trans –Rectal Ultrasound (TRUS) Biopsy Clinic.
Making it happen
Nurse led clinics were established to implement an E-HNA to ensure men received ongoing appropriate, expert advice and support from allied health professionals. In addition, Survivorship themes were focussed on through health and well being days, a new erectile dysfunction clinic, and an end of treatment clinic that allowed men to discuss concerns and be signposted to relevant initiatives, support groups and GP/community services.
Finding out what works
The introduction of the E-HNA clinics has ensured a more holistic approach to supporting men with their cancer treatment. Meeting the needs of men’s holistic well-being, has led to better compliance to treatment.
The project has enabled men to self-manage and become empowered during their cancer journey. This has been shown to reduce anxiety in the patient group, freeing up more of the teams’ time to attend to other patients in clinic.
The main challenges were:
Men do not always attend their appointment as they are sometimes unsure why they need to attend. We now give our patients more detailed information and explain what the appointment letter will state.
Not all men who have been sent an E-HNA complete and return the assessment. We have recently devised a spread sheet to enable us to track patients who have not completed assessments. E-HNA ‘@home’ is now available, allowing men to complete E-HNA via email link at home, negating the need for a hospital visit, as this is then conducted via telephone appointment. The ability to complete an E-HNA at home has proven very successful due to the flexibility and gives patients time to reflect and not complete ‘on the spot’.
Many of the main concerns identified by patients relate to fatigue, erectile dysfunction, continence and the side effects of hot flushes. These are managed as part of patient care but the centre is looking at setting up pre-treatment seminars to address these concerns and ensure patients are aware of how to manage these side effects.
159 patients have been offered E-HNA’s. 123 of these completed an assessment. The remainder declined as did not feel they had any concerns to discuss.
• 77% of patients reported concerns regarding their well-being. All of these 77% were successfully signposted to other health professionals for support, advice and guidance.
• 100% of patients who completed E-HNA have given positive feedback. They value the support and opportunity to discuss concerns.
80% of men feel more able to self manage their condition following attendance at the Living Well days.
• Patient service has improved, as one concern identified was the lack of a support group for men and families with prostate cancer. As a result of this the Urology-Oncology Team has recently founded a support group for men with prostate cancer.
As a result of these positive outcomes, the Clinical Nurse Specialist is being funded long term by the Great Western Hospitals NHS Hospital Trust.