The nurse has set up two weekly face to face clinics at Peterborough Hospital, one weekly face-to-face clinic at Stamford Hospital, plus a monthly face to face clinic at outreach sites, which include Wisbech Macmillan & Hudson Palliative Care Centre, the Johnson Hospital in Spalding and Oundle GP surgery. Patients are being added to these clinics on a weekly basis.
On average patients booked into these clinics are travelling between 20-40 miles less to appointments when attending outreach clinics.
The nurse has also set up a weekly telephone consultation clinic for stable patients post radiotherapy and prostatectomy, of which 235 patients have appointments in the future and this is increasing on a weekly basis:
- 100% of patients felt the telephone consultation clinic mirrored the advice, care and treatment provided by a face to face consultation.
- 100% of patients said they would be happy to use the telephone consultation clinic service in the future.
The initiative has freed up consultant time to enable them to see more new patients and more complex patients. Since the introduction of the nurse led service, there are free slots and no overbooked clinic slots.
Waiting times for first clinic appointments have improved, and two of the three oncology consultants have doubled the amount of new patients seen within a month. The time in which patients have been able to be seen has improved considerably and more than halved for one of the three consultants.
Feedback from patient questionnaires has demonstrated improved patient choice, satisfaction and experience focusing on “holistic needs”:
- 100% reported they felt waiting times had improved
- 100% reported they were satisfied with the new nurse led service
- 100% of patients appreciated having longer clinic appointments
- 100% reported they felt able to talk to the nurse about their holistic concerns, treatments and symptoms
The project has helped to reduce emergency admissions by initiating interventions earlier and preventing the need for acute care.
As a result of working closer with community services to co-ordinate the patients’ pathway and cancer journey, referrals to other services, such as district nurses, community Macmillan nurses, dietitians and hospice care have all increased.
Symptom management for palliative patients and facilitation of the wishes of these patients regarding their end of life care planning has improved.
The initiative has helped to decrease the length of stay for prostate patients by assessing them if admitted and ensuring investigations, interventions and treatments are initiated and co-ordinated earlier.