Edinburgh Napier University

  Context, Circumstances and Concerns – the 3C’s in Cancer Follow Up and survivorship. Introduction The large scale Transforming Care after Treatment programme in Scotland (TCAT), has funded the development and implementation of 25 local projects, each with different local approaches to balancing needs in a changing context, through various follow up mechanisms and service delivery models. The overall programme seeks to improve the after care for people living with and beyond cancer and focusses on: improving patient experience and outcomes, enhancing service integration/coordination and empowering health, social care and third sector practitioners with the skills, knowledge, attitudes and behaviours to support excellence in survivorship. Methods This evaluation adopts a mixed method, multi-disciplinary team approach by adopting a Realist Evaluation framework; identifying the context, mechanisms and outcomes of survivorship interventions. Further more by embedding an Appreciative Inquiry approach to all fieldwork and analysis; what works well, what does not work well and lessons learnt. Results and discussion The presentation will describe and compare three exemplars of follow up approaches for three different cancers (lung, breast and prostate) being tested via TCAT to illustrate how the context of the follow up (location, timing), the circumstances of the professional and the patient (gender, age, profession) and the concerns identified need to be appreciated all together in order to understand truly how survivorship services and outcomes can be improved. Conclusion In conclusion our interim results raise the following questions, which require substantive research and evidence based answers in order to demonstrate efficiency and effectiveness of new follow up models. • What is the impact of the actual service design and means of delivery on outcomes and experiences? • What is the role of the professional in assessments at end of treatment? • What specifically triggers referrals and signposting to relevant care and support in the community?