Published 6 January 2009, doi:10.1136/bmj.a3151
Cite this as: BMJ 2009;338:a3151

Letters

Metastatic spinal compression

Coordination improves outcomes in malignant cord compression

The first 150 words of the full text of this article appear below.

The guidance from the National Institute for Health and Clinical Excellence (NICE) on malignant cord compression argues that a committed, coordinated approach is needed.1 Following the Scottish audit (CRAG),2 all health boards in Scotland were advised to implement rapid referral systems and coordinate the process of early diagnosis. This Macmillan supported initiative has made good progress. The Scottish Cancer Networks have appointed project leads, fast track referral is being implemented, a national minimum dataset has been agreed with the Scottish Government Information and Statistics Division, and a national education toolkit is being developed in collaboration with Macmillan and NHS Scotland.

In Tayside we have a cord compression hotline with a coordinator who works closely with a senior clinician. The results for the first 100 hotline patients are now available. Half of them had either malignant cord compression (46) or malignant nerve root compression (5).

The median time from general practitioner . . . [Full text of this article]

Pamela Levack, consultant in palliative medicine1, Lynsay Allan, project manager1, Lee Baker, statistician2, Trudy McLeay, radiographer1, Graeme Houston, consultant radiologist1, John Dewar, consultant oncologist1, Sam Eljamel, consultant neurosurgeon1, Robert Grant, general practitioner3, Alastair Munro, consultant oncologist1

1 Ninewells Hospital, Dundee DD1 9SY, 2 University of Dundee, Dundee, 3 Kirkcaldy

pamela.levack@nhs.net


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