Patient, general practitioner and oncologist views regarding long-term cancer shared care

Abstract

Background. The rising incidence of cancer and increasing number of cancer survivors place competing demands on specialist oncology clinics. This has led to a need to consider collaborative care between primary and secondary care for the long-term post-treatment care of cancer survivors. Objective. To explore the views of breast and colorectal cancer survivors, their oncologist and GP about GPs taking a more active role in long-term cancer follow-up care. Methods. Semi-structured interviews using a thematic analysis framework. Respondents were asked their views on the specialist hospital-based model for cancer follow-up care and their views on their GP taking a greater or leading role in follow-up care. Researcher triangulation was used to refine the coding framework and emergent themes; source triangulation and participant validation were used to increase credibility. Results. Fifty-six interviews were conducted (22 patients, 16 oncologists, 18 GPs). Respondents highlighted the importance of GPs needing specialist cancer knowledge; the need for GPs to have an interest in and time for cancer follow-up care; the GPs role in providing psychosocial care; and the reassurance that was provided from a specialist overseeing care. A staged, shared care team arrangement with both GPs and specialists flexibly providing continuing care was found to be acceptable for most. Conclusion. Collaborative care of cancer survivors may lessen the load on specialist oncology clinics. The findings suggest that building this model will require early and ongoing shared care processes.