OA14.03 Integrating Therapies into a Specialist Lung Cancer Nursing Team: An Evaluation

Abstract

A diagnosis of advanced lung cancer inevitably results in deterioration in both health and functional status. This threatens a person’s independence and dignity and can be a burden to their family and carers. The lung cancer nursing team at Oxford identified a lack of timely therapy provision for their patient group and sought to improve this, concluding that having an occupational therapist (OT) in the team would significantly expand/diversify the service that could be offered to patients. Lung cancer therapy goals were identified as a) working with patients and carers to anticipate functional need rather than waiting for a crisis to occur b) providing a rapid, flexible and responsive service to those with existing needs and c) working in a keyworker role outside of traditional therapy expertise supporting patients at diagnosis, making treatment decisions and providing information. Funding was obtained from Macmillan Cancer Support for a three year project looking at delivering a new model of care. An Advanced Therapist Practitioner (ATP) with an OT background was recruited and embedded into the nursing team full time. Referrals were received from all members of the lung cancer MDT, the inpatient team, primary and palliative care. Interventions included home assessment, outpatient clinic review, breathlessness and anxiety management, provision of aids, support, education and advice. Data was gathered from a one year period when there were 305 new lung cancer diagnoses. 165 (54%) patients had identified therapy needs. A further 40 (13%) patients were seen by the ATP as part of her generic keyworker role. 205 referrals resulted in a total of 1005 interventions averaging 5 per person. Interventions were allocated to three levels ranging from simple telephone calls and liaison to complex case management. Average time from referral to first contact with the patient was half a day. The value of the role was measured in three ways: User Feedback Event, Satisfaction Questionnaire and a Stakeholder Questionnaire. Outcomes were overwhelmingly positive. Lung cancer patients have high functional needs. An ATP can become an integral part of traditional specialist nursing teams, is able to work in a keyworker capacity and is well accepted and used by the lung cancer MDT. The ATP role provides a strong bridge between primary and secondary care environments and preserves independence and dignity for longer. Evidence from users and stakeholders demonstrated high levels of satisfaction and quality of care.