Download Lung Cancer Care Pathway and Rehabilitation

Lung Cancer Care
Pathway and
Rehabilitation
Sonia Connors
Palliative Care Physiotherapist
North Tyneside General Hospital
[email protected]
Key Issues
• Cancer Rehabilitation poorly developed
(particularly in comparison to stroke or cardiac
rehabilitation).
• Outcome of NECN Peer Review of Cancer
Rehabilitation Measures – achieved 6%
compliance
• Lung Cancer Rehabilitation pathway needs to be
meaningfully integrated into the main Lung Cancer
Care Pathway
AHP Mapping Exercise for NECN 2009
• Many rehab services provided by AHPs working at
level 2 or 3 without specific funding
• < 4.5 WTE Specialist Dietitians and < 7 WTE
Specialist physiotherapists/ per million population
in NECN with specific funding for Cancer patients
(diagnosis to EOL care)
• Only .6 wte AHP is specifically funded for lung
cancer and only one AHP is reported to attend a
lung cancer MDT (North Tyneside)
National Developments
• 9 tumour specific, evidence based
rehabilitation care pathway
• 10 symptom specific pathways of care
with defined therapy intervention
• Published evidence base to support
cancer rehabilitation
www.ncat.nhs.uk
Care Pathways
Cancer Symptom Pathways
•
•
•
•
Breathlessness
Pain
Lymphoedema
Spinal Cord
Compression
• Continence
www.ncat.nhs.uk
• Fatigue
• Mobility and loss
of Function
• Anorexia/cachexia,
weight loss
• Dysphagia
• Communication
Difficulties
Cancer Rehabilitation – referral to
generic or specialist AHP
Is the
symptom
of little
concern or
already
self
adapted?
YES
NO
Encourage
self
management
& offer
supportive
written
information
Is the
symptom
impacting
on function
or quality
of life?
NO
YES
Is the
symptom
likely to
impact
treatment
options or
become
more
debilitating
over time?
YE
S
NO
Refer to Specialist
Cancer AHP
services who can
offer expert advice,
an integrated care
plan and ongoing
support for future
potential problems
Refer to symptom
care pathway &
consider referral to
generic AHP
services for
assessment and
advice
Barriers to referring to AHP’s in NECN
• Number of HCP’s involved – may be delays
in referrals
• Assessment may not include consideration
of rehabilitation need
• No access to AHP’s in lung clinics generally
• HCP’s not being aware of role of AHP’s and
what we can do i.e. not just about supply of
equipment
• Limited time for AHP assessment/
intervention due to staffing availability
Local Developments
• Cancer Rehabilitation Patient Information Leaflet.
• Cancer Rehabilitation Services directory is being
developed.
• Building relationships with Lung cancer CNS’s to
raise awareness of AHP roles.
National AHP Workforce Model
for Cancer
• Workforce tool developed with the National
Centre for Workforce Intelligence
• Calculates number of WTE AHP Staff needed
to provide care for a given number of patients
How can the Lung NSSG help?
• How can we build the NCCT Lung Care
Rehabilitation Pathway into the NSSG
agenda for engagement by
organisations across localities?
• Prospective audit of referrals to AHP’s
within NECN to identify when patients
are referred/ by whom.