The BMJ Awards 2018: Cancer Care Team of the YearBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1244 (Published 19 March 2018) Cite this as: BMJ 2018;360:k1244
- Nigel Hawkes, freelance journalist
- London, UK
Barts Health Cancer Care@Home
Many patients with non-aggressive cancers that are either in remission after treatment or have not been treated but need surveillance come to clinics once or twice a year to check for changes. Among patients at Barts Health NHS Trust with some blood cancers, these visits added up to around 1500 clinic appointments a year, says Samir Agrawal, consultant haemato-oncologist at the trust.
Visits often involved long waits in busy clinics that were running late. “There is really no reason to come in just to have a chat with a doctor,” he says. A survey showed that 82% of patients would be happy to be monitored remotely, with blood taken locally. “Barts is a huge trust so patients can either have blood taken at one of the trust’s other hospitals, and then the results are on our system, or we can send them blood bottles already labelled in the post, blood is taken at their GP surgery and sent back to us by post.”
Consultations are then conducted by phone or video. Advantages for patients include savings on travel time, less time taken off work, and appointment times that suit them.
Patients like the service, it saves money, and it eases pressure on the clinic—but medical colleagues have been harder to persuade. “To have a viable NHS we’ve got to move away from bringing patients in because it’s more convenient for us,” Agrawal says. “Colleagues say they might notice a change in a patient in a face-to-face consultation that they’d otherwise miss. But it’s the patient who knows when there’s something wrong, not us.”
Improving breast screening
When Rupika Mehta, a consultant radiologist, became director of the breast screening unit at Medway NHS Foundation Trust in Gillingham, targets were …