Needs assesments transform care for Stobhill Breast Cancer project

Breast cancer is the most common cancer in the UK with one in eight people predicted to be affected with the disease within their lifetime.

The Stobhill Hospital Transforming Care After Treatment (TCAT) project run by the breast surgery team aims to improve support for patients when they go back to their everyday lives after hospital treatment for breast cancer. It is the first trial of it’s kind within the Glasgow region and finds a more collaborative approach of working with third sector support organisations within the area.

The evidence gathered to support the project showed that although patients feel very supported through their hospital treatment the quality of  follow up care for breast cancer patients is not as effective as it could be and many incidences of recurrence are detected outside clinic visits.

The consequence of their treatment not only impacts on their physical condition, but also on their psychological, financial and social functioning, often resulting in return visits to hospital clinics.

Every year the Stobhill Hospital Breast Cancer Clinic diagnoses over 260 cases of breast cancer and patients are followed up annually via a consultant clinic for 10 years. There are currently over 2,000 patients a year requiring follow up.

The project aims to provide a new way of following up patients that allows them to have a structured conversation with the cancer nurse specialist and puts them in touch with as much support in the community as possible but also provides them with the information they need to empower them to find support themselves should they need to.

Since starting the project in October last year over 200 patients in their first and second year after hospital treatment have been invited to take part in a new Transforming Care After Treatment Mammogram Clinic. These patients are sent a holistic needs assessment questionnaire that gives them the opportunity to record any concerns they may have.

Patients bring this questionnaire along to the mammogram clinic. The Breast Cancer Nurses are then to use this record to call the patients and discuss their concerns in more detail.

So far TCAT patients have recorded over 200 concerns ranging from fatigue, side effects of medication, mental health or financial issues.

Over the last year we have been working to build new links with support organisation in the community like Breast Cancer Care and Macmillan’s Improving Your Cancer Journey as well as other local groups when appropriate, that can help patients with these concerns.

All patients taking part are offered the opportunity to attend the Moving Forward Courses based at Stobhill run by Breast Cancer Care – these courses offer support and guidance beyond active treatment as well as sessions on self checking and menopausal symptoms. Some of these information sessions are run by the clinical staff at Stobhill. Moving Forward also gives patients the chance to get together and support each other.

Despite the growing demand for Moving Forward group sessions they are not for everyone and the beauty of the questionnaire is that it allows the nurses at  Stobhill to develop a tailored post treatment care plan to suit each individual patient.

Interim findings around the project are very positive, with 98% of patients invited to take part have welcomed  the opportunity to record their concerns.  A patient group that has been set up to support the design and delivery of the project has given it their resounding backing.  There has also been a 33% drop in consultant visits and a 50% increase in referrals to Moving Forward that has resulted in additional courses being added to meet the new demand.

The clinical staff at Stobhill, Radiographers, Surgeons and Nurse Specialists have worked hard to make sure the new model is safe as well as effective and are enthusiastic about the new opportunities that it brings to improve support for their patients to help them to move forward with their lives.

By Anna Morton, Macmillan Cancer Support TCAT Project Manager

Stobhill Breast Cancer project is part of the Scotland-wide Transforming Care After Treatment programme, which is a partnership between NHS Scotland, Macmillan Cancer Support and local authorities. The Stobhill project is funded by Macmillan Cancer Support.