Aim Breathlessness is one the most common problems experienced in cancer; evidence suggests that up to 79% will encounter this distressing symptom, which can undermine functional ability and compromise independence. Evidence suggests that while there are breathlessness management programmes, few exist specifically for cancer and none provided care and advice cross the eight domains which are physical, psychological, practical, nutritional, social, spiritual, financial and information. Method A survey of breathlessness programmes for people with cancer across South East Wales revealed inadequate provision, with current services unable to meet the demand. Additionally, they did not cover the eight domains of care necessary for the provision of holistic care. An evidence based non-pharmacological breathlessness management programme was developed as well as a workforce education programme to ensure the right level of skills and competence of those delivering the pathway. Results Fourty people were referred and 22 were seen. The most common presenting tumour sites were breast (N=12), lung (N=9), pancreas (N=3) and ovary (N=3). Of the patients who entered the pathway, 19 (83%) self-managed successfully and 3 (17%) required referral for specialist care such as nutrition, occupational therapy and physiotherapy. Conclusions and discussion While dyspnoea is not routinely assessed and is an expected burden for many people with cancer, simple self-management techniques used as this pathway can empower such people to cope a little better with the distress and life limiting effects of their dyspnoea. As this is a patient led intervention, they determine what level of advice and information they want and thus they are able to control this as well as the level of professional intervention accessed. Finally, though the pathway was developed primarily for people with cancer, it has been shown that it can be effortlessly transferred to other conditions where breathing may be compromised.

No abstract

No abstract

Aims Key governing guidelines recognise that the holistic and complex needs of neuro-oncology patients are best served by a cohesive multidisciplinary team (MDT). Achieving a joint Clinical Nurse Specialist (CNS) and Allied Healthcare Professional (AHP) clinic (including Speech and Language Therapy, Physiotherapy, Dietetics and Occupational Therapy) for neuro-oncology patients has been a longstanding vision at Velindre Cancer Centre (VCC) in Cardiff. A successful funding application to Welsh Government in July 2020 allowed the establishment of a virtual “one stop shop” clinic with CNS and AHPs available along the care trajectory to improve patient and carer quality of life. The project reports on whether this innovative clinic model successfully achieved the desired coordinated, anticipatory and holistic care. Method The project utilised service improvement methodology principles with aims inherent within quarterly timeframes. This included robust data collection on patient attendances and interventions, improving patient education and self-management and wide patient, care and staff engagement by means of questionnaires and semi-structured interviews. The mixed methods approach yielded rich quantitative and qualitative data. Results The data demonstrates an increasing demand for the joint neuro-oncology clinic indicating that additional resources may be required. From triangulation of patient, carer and wider team engagement the key benefits were perceived to be having accessibility to the team in a convenient way, the provision of support and timely information and the overall perception of enhanced holistic care. Conclusion The data demonstrates the huge successes of the joint neuro-oncology clinic so far, including improvements to patient and carer quality of life, wider VCC benefits and cost saves. The persuasive case was presented to Welsh Government, and ongoing endorsement has been achieved for the next financial year.

No abstract