Parallel Session 4.4 My Pathway, My Choice


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  • 1/ Pts currently receiving or recently finished SACT Variation in national practice, scope to improve pathway, increasing cost and incidence of cancer 2/ Reports - National Confidential Enquiry into Patient outcome and death (2008)- pts require prompt access to specialist care when illness arises. Recommendation access 24 hour telephone helpline, UKONS evaluation recommends 24 hour telephone triage toolkit be intro nationally, Best practice statement neutropenic sepsis – 24 hr tele access and prompt admission if required Policy- SGHD, Better Cancer Care (2008), Quality Strategy (2010), NHSScotland Efficiency and Productivity Framework Publications – Flannery (2009)- examining telephone calls in ambulatory oncology – Journal of Oncology Practice King (2011) Towards saving a million bed days, reducing length of stay through an acute oncology model of care for inpatients diagnosed as having cancer Mistry (2012) Systematic review of studies of cost effectiveness of telemedicine and telecare. Journal Telemedicine and Telecare Directives- SGHD(2011) Best practice statement neutropenic sepsis, CEL 6 (2012) National cancer quality programme/ guidance of the safe delivery of systematic anti cancer therapy 3/ SLWG- nominations sought from regional networks, NHS 24, Emergency medicine and primary care. 16 nominations (8 deputies). Initially 2 groups- focus on front end service, onward referral and management- became one
  • Parallel Session 4.4 My Pathway, My Choice

    1. 1. Improving Outcomes byImplementing a NationalTelephone Triage Service Dawn Orr, Nurse Consultant, Clinical Decision Making
    2. 2. National telephone triage service forpatients receiving or recently completed SACT orradiotherapy  Aim of the session…  Share….Background, Context, Future  Describe work carried out so far  Describe the next steps  Raise the profile and sense check
    3. 3. Background• Nationally consistent telephone triage service• Reports/Policy/Publications/ Directives• Short life working group
    4. 4. Front End: NHS 24 – Cancer Team Model V 0.2 – 05.03.12On commencement of treatment every patient is issued with an ‘alert card’ based on the template set out within the NPS BPSwhich advices the patient to call NHS 24 – Cancer Team if the patient has a healthcare concern Patient at home NHS 24 – Cancer Patient is Patient is managed has a healthcare Team answer Triaged using according to concern UKONS Tool triaged alert Patient or carer NHS24 – Cancer Call Handler takes Green – Advice follows the ‘alert Team – Call the patients details. given card’ and calls the Handler asks the Call Handler talks Amber – Follow up dedicated number NHS24 standard the caller through after 24hrs by NHS for the NHS 24 – initial questions. If the UKONS Triage 24 – Cancer Team Cancer Team serious health tool. Double Amber or concern advices Completed tool is Red – Assessment caller to Dial 999 electronically auto - required within shared with the secondary health prescribing team. care setting. Call Hander [Band 2 AfC] supervised at all times by Senior Staff [Band 6 AfC] on a maximum 5:1 basis. It is the responsibility of each All Cancer Team staff complete competence NHS Board to determine and based training. share with NHS 24 how that All call are monitored and audited. assessment will be managed
    5. 5. Referral On: Management Within Secondary Care Model V 0.2 – 05.03.12On commencement of treatment every patient is issued with an ‘alert card’ based on the template set out within the NPS BPSwhich advices the patient to call NHS 24 – Cancer Team if the patient has a healthcare concern Patient triaged Patient referred to Patient attends Initial treatment / Patient managed using UKONS secondary care secondary care management plan by Prescribing Tool by triage service for assessment implemented TeamDouble Amber or Each NHS Board Receiving Service Initial treatment / Patients ongoing careRed – Assessment has responsibility assess the patient management is transferred to therequired within to have an identified and develop an options: Prescribing Teamsecondary health Receiving Service initial treatment / • discharge withcare setting to accept referrals management plan agreed follow up • admit to general Effectiveness of medical ward of model will be attending hospital reviewed:There is national Receiving Service provided by NHS Board will: • admit to cancer • Auditconsistency with all • Meet a set of minimum clinical standards that centre • Patient Experiencefront door services match the NPS BPS(2011), the future CEL • admit to ITU • M+M Reviewusing the UKONS (2012) and the UKONS (2012) AO Guidelinestraige tool: • Have capacity to manage multiple referrals• NHS 24 Receiving Service model could be:• Primary Care • Acute Oncology Team Priority is for at the earliest point all treatment• Emergency Care • Oncology Emergency Assessment Area / management transfers from the Receiving• Other? • Emergency Medical Assessment Team Service to the patients Prescribing Team
    6. 6. Benefits• Safe reliable triage tool• Dedicated phone number/ cancer• Dedicated Secondary care• Audit trial to support quality and demand• Robust governance framework• C ost effective• Timely access to Acute Oncology Service
    7. 7. Next steps• Preparation of training programme• PID development• E health input• Sharing electronic records
    8. 8. Thank