The Macmillan Aftercare Rehabilitation Service
(“MARS”)
Providing a service for people who have, or have had, head and neck cancer
Who are the MARS Team?
A team of Allied Health Professionals (“AHP”) specialising in Head and Neck cancer (“HNC”), comprising:
Dietitians, Speech & Language Therapist, Nutrition Nurses, Care Co-ordinator
Based at the Royal Surrey County Hospital, (RSCH) Guildford, with outreach clinics at Frimley Park, East Surrey, St Peter’s and Basingstoke Hospitals
Working alongside the H&N Consultants Close liaison with the CNS
Why have we formed?
Lack of local specialist aftercare services in Surrey
Number of cancer survivors continues to grow; HNC rates ↑ by >20% past 30yrs, particularly in those <65years and both sexes (NICE, 2004)
Need for support & care may be greatest at treatment end (Roing et al, 2007, Semple et al, 2008)
Post-treatment HNC pts report high unmet supportive care needs, most vulnerable in the post-treatment phase + unprepared for lifestyle changes (Ziegler et al, 2004, Larsson et al , 2005, Chen et al, 2009)
Aims of the MARS team:
To provide a collaborative patient-centred specialist service to address the complex needs of this patient group, at a location close to the patients home
To help obtain optimal functioning after treatment (within limits of the disease + personal situation)
To promote self-care/management in a supportive environment + access to resources
To meet national and local policies & guidelines on cancer survivorship
To help more people survive cancer, all cancer pts to receive a recovery package of ongoing support after treatment. Aim for a seamless effective integrated discharge service (Department of Health: GB, 2013)
To improve Quality of Life as well as longevity; better outcomes/experience for ca survivors, unplanned +unnecessary hospital appts + admissions. (NCSI, 2011)(Healthy People, Department of Health: GB, 2010)
To provide a uniform high quality multidisciplinary local support service for HNC patients (Calmine Hine report, BAHNO, 1996) (IOG, 2004)
To encourage patients with long-term conditions towards self-empowerment to manage their own health (Cancer Workforce Development Strategy 2010-2015)
Compliance with National and Local policies & guidelines:
Benefits of service provision
One-stop MDT approach
Continuity of care
Frees up appointments at RSCH
Clinics local to patient homes
Enables patients to remain at home longer
Improved patient experience and satisfaction
MARS Dietetic Intervention
72% HNC pts on modified textured diets, supplements +/- tube feeds 1 yr post-treatment (Garcia-Peris et al, 2007)
Acute/chronic side-effects of HNC treatment
Regular assessment of tube feeds & supplement usage
Advice & support on all aspects of nutritional intake, weight management & healthy lifestyle choices following recovery from treatment
MARS Nutrition Nurse Intervention Advice and support post feeding
tube insertion Regular assessment of feeding
tubes Early detection of complications or
potential complication Timely removal of feeding tubes Prevention of unnecessary hospital
admissions
MARS Speech & Language Therapy Intervention
Advice, support and exercises to maximise speech and swallow function
Including providing diet/fluid modification advice & conducting bedside/instrumental swallow assessments
Without speech and swallowing intervention, 12 months post treatment the oral cancer patients speech and swalow function is no better than 3 months post treatment (Pauloski et al , 1994)
Advice and support for patients, carers and the MDT following laryngectomy
Including surgical voice restoration, stoma care, filtration/humidification, use of artificial larynx etc
Acute/in-patient visits
MARS Care Co-ordinator role
The Care Co-ordinator acts as the single point of access for acute and local Head and Neck teams
Closely liaising with the RSCH Head & Neck CNS Involves referral processing, telephone triage and patient
supportTasks include: Triage of patients, sign-posting and problem solving Providing individualised information Giving advice on:
Recurrence avoidance and recognition Long Term side effect management Finance- Macmillan healthcare grants, or Macmillan CAB Smoking cessation support Patient feedback projects
Where are we going?
Development: Resources Outcome measures Practical support
sessions: - smoking cessation
sessions, texture modification sessions, survivorship study days
Clinics at other outreach locations
Implementation of AHP clinics
Evolving roles
And…?
Thank you - Any Questions?
Contact details:[email protected]
01483 408379Claire Hanika – Macmillan DietitianAnna Clayton – Macmillan Dietitian
Kate Edwards – Macmillan Speech and Language Therapist
Emma Papworth – Macmillan Nutrition NurseElizabeth Seymour – Macmillan Care Co-ordinator
Top Related