Delivering Patient-Centric Cancer Care in Rural West Yorkshire.

Posted on by Hope for Tomorrow

Airedale NHS Foundation Trust – a case study for the use of Mobile Cancer Care Units

When Airedale NHS Foundation Trust needed a way to better serve their wide catchment area of cancer patients, they reached out to Hope for Tomorrow. Securing the use of a mobile cancer care unit delivered far more than they had originally anticipated:

  • Improved patient experience
  • Better staff engagement
  • A solution to the impact of the Covid-19 pandemic

Accessible cancer care in a rural community

Airedale NHS Foundation Trust covers a wide patient catchment area including North and West Yorkshire. Prior to 2018 cancer treatments were delivered in hospital settings, primarily at a specialist chemotherapy day unit at Airedale General Hospital. Receiving treatment at the haematology and oncology day unit (HODU) meant that patients were regularly travelling to hospital for treatment. In a large catchment area with many remote and rural communities, some patients faced an entire day of travel to and from hospital, even for a treatment that might take very little time to administer.

In 2011 the trust began to investigate ways in which they could improve things for their patients. A pilot was launched at a small, rural hospital. Specialist oncology nurses travelled to the site and a patient group from the area were able to receive chemotherapy in a location far nearer to their homes. The option of receiving treatment within their community was extremely well received by patients but the project only solved the problem for a small number of them and in only one location. Expansion would require a significant investment from the Trust.

The Trust began to investigate other options for improving the way cancer care was delivered in their region. Their relationship with Hope for Tomorrow began in 2015 when the concept of mobile cancer care was introduced to the Trust and the solution fit their operational needs perfectly.

Introducing Mobile Cancer Care

The charity Hope for Tomorrow has been providing NHS trusts with mobile cancer care units since 2007. The mission is simple: to improve the lives of patients with cancer by allowing them to receive treatments outside of the hospital setting and closer to their homes and work and life commitments.

Once presented with a proven concept Airedale set about creating a business plan, detailing how they would get the maximum benefit should they secure a unit from Hope for Tomorrow. Engaging the staff and patients at the outset of the project was vital. Airedale surveyed their day unit patients to make sure their needs were met and their concerns addressed. Staff were consulted to ensure they were comfortable with a potential new routine and working environment. In November 2018 the mobile cancer care unit was delivered.

Immediate benefits

The project team at Airedale made immediate use of the new unit and it has operated at full capacity since its launch. The unit travels to rural locations in Skipton, Ilkley, Settle and Bingley up to five days a week. There are four treatment chairs on board allowing an average of 20 patients to be treated each day. The benefits to the patients are clear; they receive treatment delivered by specialist cancer care teams in a convenient and accessible location. This means often vastly reduced travel time and costs, shorter waiting times and less disruption to patients’ lives on treatment days. Their care fits into their lives.

The NHS trust has seen significant benefits to using a mobile cancer care unit too. The nursing team (11 at time of writing) are fully engaged in the service and two nurses are able to deliver more treatments per day on board the mobile unit than they could in the hospital day unit. Staff retention is the highest in the area and the trust attributes this to the positivity associated with providing care out of the mobile unit.

Delivering a wide range of treatments and supportive therapies

Mobile cancer care units facilitate a variety of treatments including blood transfusions, PICC line flushing, injections and oral and intravenous chemotherapy.

In addition to traditional cancer care, the Airedale unit is also providing a range of supportive and therapeutic treatments to patients.

In May 2019, the Trust began a trial of the Paxman scalp cooling system on board the unit, which replicates the service that is available in the hospital setting. The Paxman system helps patients to keep their hair through chemotherapy, allowing them to retain a sense of self and normalcy during a stressful cancer journey. These innovative machines can be used with all solid tumour cancers, depending on the specific chemotherapy drugs being administered.

In September 2019 it was announced that patients in Skipton will be offered free oncology massage therapy on board the unit once a month, helping patients to relax during and after treatment.

Mobile cancer care during Covid-19

During the Covid-19 pandemic the trust approached Hope for Tomorrow to investigate if anything could be done to reduce the impact of Covid-19 on their cancer patients. Hope for Tomorrow were able to provide a second loan unit to assist with the Trust’s response. With two units now operational and after extending their hours of operation, in May 2020 the Airedale NHS Foundation Trust treated 97.7% of the number of patients treated in the same period in 2019. This was the highest rate of continued treatment across the West Yorkshire and Harrogate Cancer Alliance. Then, in June 2020, the Trust treated more patients with cancer than in June 2019, which was only achieved by one other trust in the region.

Conclusions

The success of this project means that the Trust now delivers up to 60% of its cancer care on board a mobile cancer care unit and away from the hospital setting.

The use of two mobile cancer care units has contributed strongly to allowing the Trust to continue delivering treatment safely to a high proportion of patients with cancer throughout the Covid-19 pandemic. As a firm advocate for the benefits of mobile cancer care to both patients and the NHS, the Trust submitted an application for a second unit on permanent loan from Hope for Tomorrow and was successful in its case.

“Providing care for cancer patients that wherever possible reduces the impact on their lives and ensures treatment is as accessible and flexible has never been more important, especially to the diverse and rural communities our Trust serves.  Working in partnership with Hope for Tomorrow and preparing for an additional mobile cancer care unit realises our commitment to our patients and their families, and has been a real morale boost to our staff. I do not underestimate the tremendous amount of work involved in this, and am grateful to Hope for Tomorrow for their continued forward thinking and innovative approach, which truly is transformative for patients and their families.”

Professor Brendan Brown, Chief executive at Airedale NHS Foundation Trust

To find out more email info@hopefortomorrow.org.uk or call our Partnership Manager on 01666 505055.