Edinburgh Napier University

  Introduction: Patients can be unprepared for the impact of cancer and treatment. A proportion have unmet needs. The Transforming Care after Treatment (TCAT) programme in Scotland aims to improve after care for cancer survivors. Funded by Macmillan Cancer Support through TCAT, the NHS Tayside project aimed to identify concerns in colorectal cancer patients using Holistic Needs Assessment (HNA) tool, the Concerns Checklist. Our work is helping to inform future practice developments, risk stratification and staff training approaches.

Material and method: Between October 2015 and November 2016, patients attending for follow up after treatment for colorectal cancer, were invited to complete an HNA and discuss this with a CNS. Working with Edinburgh Napier University, data on patient demographics, concerns identified and review processes (length of consultation, location) and actions, such as referral and signposting routes have been gathered for over 400 patients.

Results and discussion: Data from the first year shows that 2 in 5 patients have no concerns at end of treatment and patients who live alone or who live in an area of multiple deprivation have a statistically significantly higher average number of concerns. We are using this data to inform approaches to risk stratified follow up. Of those with concerns three-quarters have one or more physical concern. The top 3 concerns are-tiredness/exhaustion, diarrhoea and getting around. This data is informing the content of our Health and Wellbeing Events, staff training and signposting materials.

In addition, we will present patient and practitioner feedback that is being used to reflect on the current model of colorectal follow up,
including the timing of assessments and the value and outcomes of more person centred consultations.

Conclusion: This important Scottish study is assisting us to improve practice and policies for cancer survivors by ensuring that future service developments are evidence based and patient led.