The Patient Pathway A Multidisciplinary Approach
Jan 21, 2016
The Patient Pathway
A Multidisciplinary Approach
Head & Neck MDT
• A Multidisciplinary team (MDT )is composed of members from
different professionals with specialised skills and expertise.
• Members collaborate together to make treatment
recommendations that facilitate patient care developing
individualised treatment plans based on best practice.
• Focus on the physical and psychosocial needs of the patient.
Multi-Disciplinary Working
• Enhances Patient Care /Experience
• Compliance with NICE guidelines (2005), Cancer Reform
Strategy (2007), Peer Review Measures.
• Offers a Holistic approach and Support for the patient and their
carers from diagnosis to end of life.
• Requires efficient communication and team work working
towards the same goal.
Surgical Pathway
Surgical Patient
CNS/Head and Neck
ENT.
Research Nurse
SALT
Dietitian
Pre- Op Assessment
Prosthetic DepartmentWound Care
Medical Team/Surgeo
n
Nursing Staff – In Patient
Nutrition Support CNS
Physiotherapist
Oncology Pathway
Oncology Patient
Head and Neck CNS
Radiographers
Research Team
Nutrition Support CNS
Oncologist/Medical team.
DietitianChemotherapy Nurses/Team
(Nurse Led/CDU)
SALT
Restorative Dentist
Palliative Care Team/Hospice
MARS
Additional Support Services/Team
• Social Services
• Occupational Therapist
• Smoking Cessation
• Alcohol Support services
• Counselling/Listening/Clinical Psychologist
• Macmillan CAB
• District Nurses/Community Teams
• Fountain Centre
• Support groups
Multi Professional Clinic
Run by Allied Health Professionals
• Head & Neck CNS
• Nutrition CNS
• Speech and Language Therapist
• Dietitian
Who is it for?
• For patients about to undergo chemoradiotherapy or
radiotherapy who need a feeding tube
• For patients 2 weeks post chemoradiotherapy/ radiotherapy
• For follow up patients who require team input
• 6 - 8 patients per week
Benefits
• Allows patients time to absorb diagnosis & treatment plan
• Opportunity for patients & family members to ask questions
• Allows post treatment follow up determined by need
• Team working
Radiographer Review
• Weekly on treatment review of all RT and chemo/RT patients (inc. H&N lymphoma
and skin)
• Collaborative working with CNS team (joint reviews for chemo/rt pts)
• A pt. support and experience role (to improve pt. experience as a whole)
• Promote & empower pt. to understand symptoms & their causes & how to minimise
these where possible e.g. good oral hygiene
• Liaise with AHP & medical teams to ensure all aspects of treatment efficient, well
explained & appropriate
• Department point of contact for all H&N RT issues
• Pt. point of contact for all H&N issues
Radiographer Review
• Promotion of good clinical practice within radiotherapy H&N pathway
• Introduce advance practice in a H&N setting in RT e.g. MSc. qualification, specific
H&N competencies, general healthcare provision (obs. venepuncture, wound
dressings)
• Introduce grading and toxicity scoring systems to evaluate on treatment progress of
and recommend interventions for specific side effects
• Implement service improvements • e.g. polymem for wound dressing & medihoney for skin care
• A hug
The Macmillan Aftercare and Rehabilitation Service (MARS)
Supporting people during their treatment for and recovery from head and neck
cancer.
A team of Allied Health Professionals (AHPs) specialising in Head and Neck cancer
(HNC), comprising: Dietitians; a Speech & Language Therapist; Nutrition Nurses;
Care support worker.
Based at the Royal Surrey County Hospital, with outreach clinics at Frimley Park,
East Surrey, Ashford, St Peter’s and Basingstoke Hospitals as well as at the Royal
Surrey County Hospital.
Work alongside Head and Neck Consultants with close liaison with the Clinical Nurse
Specialists.
Aims & Benefits of the MARS team
• Provide a collaborative patient-centred specialist service to address the complex needs of this patient group, at a location close to the patients home in a ‘one-stop MDT shop’
• Help patients achieve optimal functioning after treatment (within limits of the disease + personal situation)
• Promote self-care/management in a supportive environment + enable access to resources or onward referral to other agencies
• Meet national and local policies & guidelines on cancer survivorship
• Ensure continuity of care from the cancer centre out to cancer units
• Reduce demand for appointments at the cancer centre (RSCH)
• Improve patient experience and satisfaction
Contact Details
Kate Edwards [email protected]
MARS: 01483 408 379
Winner QiC Oncology Awards:
‘Supporting people through a
team approach’!