Abstract
Introduction
In conjunction with Roche, a 18 month project was proposed to facilitate a more holistic approach in managing this patient cohort post-diagnosis and in turn improve outcomes, reduce length of stay and improve patient experience.
Method
The aim of the project was to design the MDT, ensure there is sufficient clinician capacity for implementation as well as develop accompanying pathways. The patient cohort was all patients with a diagnosis of Non-Hodgkin’s Lymphoma over the age of 65. Whilst all patients meeting these criteria would potentially be eligible to be reviewed by the MDT, the patients would first complete a comprehensive frailty assessment at the end of which the clinician will assign a clinical frailty score (CFS). Any patient scoring 4 or above with a clinical concern will be added to the MDT for review. The MDT itself will aim to address all aspects of the patient’s health care journey post diagnosis. To this end, the roles that have been defined as critical are: Haematologist, Geriatrician, Pharmacist, Physiotherapist/Occupational Therapist, Dietician, Clinical Nurse Specialist and Support Worker.
Results
Currently over 90 patients assessed. Over 60 discussed in MDT, with over 170 total reviews. Further qualitative TBC.
Conclusions
Currently at UHS there is limited provision of frailty services. This unmet need manifests as e.g. reduced rates of treatment completion or increased treatment modifications, increased length of stay for post treatment episodes, missed appointments and non-elective admissions. All of which subsequently impact the patient's prognosis and NHS resources. Evidence shows centres with a geriatric oncology service have seen increased success in completion of treatment for patients and length of stay reduced by an average of 4.5 days. This pilot has enabled the Trust to collate evidence of this being the case locally, ultimately facilitating improved patient experience, better patient outcomes and reduced
Comments
This is such important work and highlights the need to identify frailty in the cancer setting and the value of a multi-professional approach to care planning for older adults.