P-OGC63 Care Close to Home in the Era of Centralisation

Background With increasingly centralised services for people diagnosed with OG Cancer we wanted to ensure our local service was maintained to provide the appropriate care and management by collaborating with the Specialist Sites and raising the profile of local services. Most patients remain local due to their disease stage, performance status or through choice. We wanted those patients who have tests and treatment on other sites to be able to have their care managed locally as much as possible and therefore only have to travel when absolutely necessary. We aim to facilitate and deliver a streamlined service. Methods Weekly Local MDT triages patients to Specialist MDT once appropriate information is available. Established local outreach clinic for specialist service. Ensures patients are known to specialist service from diagnosis. Patients will be diagnosed and managed locally unless input required elsewhere. Local CNS attends both Local/Specialist MDT as patient advocate and provides cross site communication and care planning. Local User Involvement- contributes to service development and feedback both locally and beyond. Local HNA at point of diagnosis to establish a bench mark. Ongoing emotional support is integral to the local service and continues wherever the patient is in their care pathway. Results Streamlined care with local and specialist team contacts. Improved communication between professionals. Identifiable contact for patients Rapid referral process - timely and appropriate discussions. Improved patient satisfaction. Direct access to specialist site from point of diagnosis. Improved patient advocacy across sites Effective use of clinic time. The right patient being seen at the right time in the right hospital with the right information. Local follow up enables integration of additional local services/teams into patient care More inclusion for local teams in wider service development. Local leadership within the network has ensured investment in local services and raised the profile. Conclusions Care is more streamlined Patients are assessed by the right person at the right time enabling more open communication Avoids unnecessary referrals Less travelling between sites Reduces patient anxiety Encourages user involvement- more personalised care. Promotes continuity of patient care Allows inclusion of local teams in decision making at specialist level Promotes collaboration and team working with flexible leadership amongst team members Improved job satisfaction by establishing a shared vision Upper GI Cancer delivery will continue to go through changes but with a motivated team who work together these changes can be implemented efficiently and effectively.