PP33. NURSE-LED TELEPHONE CLINICS IMPROVE PATIENT SATISFACTION AND ENHANCE FOLLOW-UP FOR BENIGN / LOW GRADE TUMOUR PATIENTS

Abstract

BACKGROUND: Addenbrooke's Hospital (CUHFT) is the regional specialist neurosurgical centre for East Anglia, providing neuro-oncology care to a catchment population of around 4.0 million. Our consultant-led brain tumour clinics are heavily overbooked, leading to long outpatient waiting times and poor patient satisfaction. These clinics see a combination of new patient referrals, those for results / onward planning and those on long-term follow-up. For those with low grade or benign tumours either on post-surgical follow-up, or for those with radiological diagnosis on surveillance scanning only this is often compounded by high non-attendance rates (DNAs). To combat the above issues, a dedicated telephone clinic run by a Clinical Nurse Specialist (CNS) was established for those patients on long-term radiological follow-up. AIMS: To improve follow-up for those patients on long-term surveillance with a single point of contact for advice, signposting and support. To enhance the process of care and patient satisfaction. To reduce outpatient waiting time delays and free up clinic capacity. To free up consultants time. To enable documentation of specialist nurse input / number of patients seen. METHOD: In 2011 the Trust's first commissioned nurse-led telephone clinic was established. It works like any outpatient clinic - administrators book onto it and a date / time is sent stating this is for a telephone consultation. The patient has to consent for telephone follow-up by the consultant and subsequently discharged from consultant-led care. The patient would have their follow-up scan undertaken locally, followed by a telephone review where their scans are viewed remotely via the Image Exchange Portal. The consultant previously responsible for the patient discusses follow-up plans with the CNS ahead of time. The consultation is held in a clinic room, away from the CNSs office, to allow for uninterrupted conversations and ensure confidentiality. Each slot is allocated 30 minutes and a GP letter dictated. RESULTS: In 2011, only 5 patients were under telephone review. The clinic currently has 204 patients with only 2 non-attenders in 2015. A patient satisfaction survery was sent to 94 patients who had a clinic review in 2015. 62 completed surveys were returned (66% return rate). Overall satisfaction score was 95%. Other questions scoring over 90% satisfaction rate included patients gaining a complete understanding of their diagnosis; a chance to ask questions / seek clarification and an explanation of their recent scan results and having confidence in the nurses competency levels. CONCLUSION: Structured Nurse-led telephone clinics is a unique follow-up alternative to outpatient clinics for brain tumour patients. It enhances patient satisfaction and lessens the burden on over-subscribed outpatient clinics. Whilst telephone clinics only generate 23 per patient (versus 150 for consultant clinics), it helps save money to the overall health economy and NHS budget, which in today's financial times is something to be encouraged and adapted by other centres as a model of best practice.