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Kidney Pre-hab pilot at NBT

A pilot project aiming to deliver preventative rehabilitation to cancer patients before treatment to reduce future needs and healthcare costs. The project involves baseline measurements, surgery, and post-op assessments to improve patient outcomes and experience. Successes and challenges are discussed, with plans for future expansion.

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Kidney Pre-hab pilot at NBT

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  1. Kidney Pre-hab pilot at NBT Urology CNS TeamOctober 2015

  2. Background • Preventative rehabilitation delivered before and during cancer treatment has the potential to reduce the future clinical and non clinical needs of a person with cancer • This could in turn reduce the cost to the health and social care system associated with later stage and more serious interventions Achieving World Class Outcomes – A Strategy for England 2015-2020

  3. Kidney Prehab Pathway Patient advised about Prehab clinic/ POAC by CNS and/or medical team WLC books patient into theatre slot, Prehab clinic & POAC Patient attends Prehab clinic (alt Tues mornings NGS Macmillan Wellbeing Centre) Baseline measures of Sit to Stand 60, FACT-G & nutritional screening NB: POAC appointment will be ideally on same day in the afternoon Patient has surgery as per ERP (approx 4-6 weeks after Prehab clinic) Patient contacted by CNS (6-8/52 post-op) Repeat measures of STS60 & FACT-G Holistic Needs Assessment and Care Plan

  4. Results to date • 32 patients have attended Prehab clinic between April and Oct 2015 • Approx 3-6 patients have attended each session • Completed data for 9 patients • Trend towards increased physical function (sit to stand 60) and improved QOL (FACT-G) • Physical and emotional wellbeing sections of FACT-G show largest improvements

  5. Successes • Positive engagement from CNS, ERP teams and Cancer Support Workers • Support from kidney MDT, Cancer Services and AHP’s • Use of NGS Macmillan Wellbeing Centre space/ environment • Positive patient feedback – ‘I recovered much quicker from this operation’ (Previous partial nephrectomy patient)

  6. Issues • Engagement with WLC’s has been challenging – resulting in patients not routinely booked into the pre-hab clinic • Still not capturing all patients – further work required with WLC’s • Initially unable to align Prehab clinic with POAC but now improving

  7. Future • Review of data in November • Poster to be placed in outpatients to prompt patients to ask about Prehab clinic • Follow up appointment at 6-8 weeks post-op with Macmillan Cancer Support Worker to undertake post-op assessment and offer holistic needs assessment • Plan roll-out to all urology patients in Jan 2016 and run weekly clinic

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