Improving care pathways for Immunotherapy patients in Hull
Introduction
Using Immunotherapy as a treatment is relatively new to Hull University Teaching Hospitals NHS Trust. Immunotherapy is a treatment that uses certain parts of a person’s immune system to fight diseases such as cancer. The service is run by two Clinical Nurse Specialists; Helen Carolan and Lynsey Wood and co-ordinator Jenna Holdsworth. We have around 200 patients on the treatment currently.
The potential benefits for patients
The Immunotherapy Team could see straight away the benefits of using PKB with their patients. They wanted to use a small cohort of 10 patients to begin with and following the success of this pilot the team have now recruited further patients. Sending the Treatment Questionnaire out to patients before and after their treatment, rather than telephoning them or bringing them into the Trust, has made it easier for the patient as they can complete the questionnaire in the comfort of their home and not attend unnecessary appointments.
The main features they wanted to use in PKB with their patients were:
- secure messaging and in particular the benefit of messages being sent to the team rather than individual clinicians.
- consultations (questionnaires) to improve their current, time-consuming process
- library to enable them to provide the most relevant and up-to-date resources and information for their patients
Disruption from a global pandemic
The team was in a difficult situation when COVID hit as they were not able to run clinics in the hospital but it was imperative that they were able to continue monitoring their patients’ symptoms. The patients were undergoing treatment for cancer and needed regular monitoring.
The questionnaire they created was the Immunotherapy Checklist which covered nine specific areas:-
- General Health
- Respiratory
- Gastrointestinal
- Skin
- Endocrine
- Eyes
- Neurology
- Rheumatology
- Cardiovascular
The Process
The team sends the questionnaire out a few days before treatment and the patient completes the consultation in PKB at regular intervals and sends it back through to the clinical team to assess. If there are any issues raised the co-ordinator passes them onto the patient’s clinical team to review. They will then contact the patient and review their medication and care.
The patients have also used PKB to query appointments and scans which has helped reduce the amount of phone calls to the service.
Not only did this eradicate the need to bring patients with low immunity into the hospital setting but it also saved time for both patient and clinician. They were able to communicate securely alongside their other health information which provided a much more holistic view of their overall health and care.
Seeing the benefits
Patients Know Best was designed to be a tool for patients to be more in control of their health and this case was a great example of this. Whilst patients in the first small cohort were using PKB in this way, two patients themselves spotted issues with their care which otherwise may have gone unnoticed. This enabled the patients to raise their concerns and get straight to the issue and resolve it at early onset.
Different types of immunotherapy can cause different side effects such as muscle aches, shortness of breath, swelling of legs etc and these need to be monitored closely to ensure the patient gets treatment as soon as possible. One particular patient whose main point of contact with the team has been through PKB stated that he feels like he is receiving excellent care and thanks them for their continued interest in his welfare.
PKB has greatly benefited our service and the care that we are able to provide. We are now much more accessible to our patients and they can be reviewed with minimal disruption to their day to day routine
Hull University Teaching Hospitals NHS Trust operates from two main hospital sites: Hull Royal Infirmary and Castle Hill Hospital but also has a number of additional services based across Hull.
They employ around 8,000 staff and welcome around one million patients through their doors every year.
