Developing a NI Acute Oncology Service Round Table Discussions Liz Henderson Advisor to Macmillan...
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Transcript of Developing a NI Acute Oncology Service Round Table Discussions Liz Henderson Advisor to Macmillan...
Developing a NI Acute Oncology Service
Round Table Discussions
Liz HendersonAdvisor to Macmillan Cancer Support
Discussion agenda
• Take note of your concerns and claims about AOS in NI
• Identify the key issues/questions that emerge• Briefly explore these• Prioritise what is required
Claims
• What positive statements could you make about current acute oncology arrangements
2 minutes
SummaryCLAIMS• Patients are in the system and
being managed• Regional input and improved NS
management in AE’s• Collaboration & education in AE• Nurse led 24hr helpline
standardised with UKONS• Unit/centre patient pathways for
chemo complications• SHSCT AOS • Regional collaboration on MSCC• Funding approved for Oncologists
to support AOS• Offer of funding from Macmillan
for AOS nurses
CONCERNS• Current system inadequate
– no mechanism for CUP – no coordination for MSCC – palliative care pts admitted to assess, instead of
assess to admit – no coordination between departments and
oncology
• Patient safety risk• Patient poor experience • AE already swamped and demand
increasing • Gone as far as we can without
additional resource • Changing context increasing risk of
variation in standards• Lack of clarity around nursing role • Hub and spoke model means
haematologists feel ‘put upon’• Commitment and availability of all
oncologists
Issues emerging
• An issue is a reasonable question raised through better understanding of claims and concerns
Questions
1. What are the essential ingredients of AOS?2. What is stopping us from delivering an
effective AOS across NI?3. What would enable us to deliver an effective
AOS across NI?4. What are the key priorities to be addressed?5. What can be done to address these, and by
whom?
Common elements of all successful models• There are many individual models which can be
successful in a variety of different settings but essential core components include:
• Good leadership• Representation from all interested parties • A good relationship between Medical and Clinical
Oncology • Specialised advanced nurse role required in order
to run a successful service
Brian Haylock, Clatterbridge
What are the essential ingredients?
• AOS team with named lead and core membership
• Assessment• Agreed pathways • Good IT links and flagging
systems • Fast track clinics, • Referral protocols, • 24 hour triage line and on
call consultant service, • Regular morbidity &
mortality meetings and prospective data collection
• Coordination & communication• Cooperation & commitment
• WHAT MODELS?
NI Model (s)?• Regionally commissioned model
with local flexibility– Regional plan, recruitment, policies,
pathways, standards of car e -NI Measures / – Service Specification
• Team approach: AOS Nurses & AO Consultants ( Units 5 day oncologist present)– Hospitals with A&E but no cancer
services – access to AOS nurses as minimum
• Importance of data collection/ management
• IT enabled service / communication mechanism
• Initial focus 5 unit/centre
• Need continuity of care• Buy-in all parties• Involvement all stakeholders• Sustainability and resilience • Leadership present and visible in
hospital• Multidisciplinary – skills mix /
advanced roles nurses• Good communication with
primary consultant• Not 1 size fits all• Need be attractive posts
Questions
1. What are the essential ingredients of AOS to provide a safe and effective service?
2. What is stopping us from delivering an effective AOS across NI?
3. What would enable us to deliver an effective AOS across NI?
4. What are the key priorities to be addressed?5. What can be done to address these, and by
whom?
Questions
1. What are the essential ingredients of AOS to provide a safe and effective service?
2. What is stopping us from delivering an effective AOS across NI?
3. What would enable us to deliver an effective AOS across NI?
4. What are the key priorities to be addressed?5. What can be done to address these, and by
whom?
Questions
1. What are the essential ingredients of AOS?2. What is stopping us from delivering an
effective AOS across NI?3. What would enable us to deliver an effective
AOS across NI?4. What are the key priorities to be addressed?5. What can be done to address these, and by
whom?