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D. Borthwick
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ORAL 43 - Enhancing Physical Wellbeing in Lung Cancer (ID 168)
- Event: WCLC 2015
- Type: Oral Session
- Track: Nursing and Allied Professionals
- Presentations: 1
- Moderators:G. Bates, M. Hesdorffer
- Coordinates: 9/09/2015, 18:30 - 20:00, 102+104+106
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ORAL43.02 - Which Patients Are Assessed by a Lung Cancer Nurse Specialist: A UK National Lung Cancer Audit Study (ID 1258)
18:41 - 18:52 | Author(s): D. Borthwick
- Abstract
- Presentation
Background:
Lung cancer nurse specialists (LCNS) are an integral part of the multidisciplinary team, supporting, managing and coordinating of care for people with lung cancer. In the UK the National Institute of Health and Care Excellence (NICE) recommends that all patients have access to a LCNS in a trust, but recent National Lung Cancer Audit (NLCA) reports show that LCNS access varies across England. The aim of this study was to examine how access to a LCNS varies by patient and National Health Service (NHS) trust characteristics.
Methods:
We used data on all lung cancer patients in the NLCA first presenting to 150 English NHS trusts between January 1[st] 2007 and December 31[st] 2011. NHS trusts are health care organisations typically 1-3 hospitals collectively covering regional catchment populations. The NLCA collects key clinical information, including LCNS assessment on all individuals with a diagnosis of lung cancer presenting to NHS trusts. Data from 146/150 trusts were successfully linked with the National Cancer Action Team (NCAT) census of the LCNS workforce (number, salary grades) for 2011. Multinomial logistic regression was used to calculate the likelihood of being assessed by a LCNS by patients clinical and LCNS workforce at each trust.
Results:
Across 146 NHS trusts there were128,124 patients and 321 LCNSs. LCNS assessment records showed80,113 (62%) patients were assessed, 7,544 (6%) were not assessed, and 40,467 (32%) had missing information on assessment. Missing assessment information was random and not biased to certain types of patients or trust and data completeness increased over the years. Patients (>75 years old), those with poor performance status (i.e. PS 4) and those with comorbidities were less likely to be assessed (adjusted relative risk ratios (RRR) (95% confidence interval) 0.84 (0.75 – 0.93), 0.34 (0.24 – 0.47) & 0.71 (0.63 – 0.79) respectively). There was no difference in assessment rates by socioeconomic groups. Patients who received anti-cancer treatment (surgery, chemotherapy with radiotherapy or chemotherapy alone) were over twice likely to have been assessed by a LCNS compared with those who did not receive treatment 2.09 (1.75 – 2.50), 3.96 (3.11 – 5.04) & 3.45(2.71 – 4.38). Annual LCNS patient caseload did not appear to impact access, but there was an association between assessment and a higher salary grade of the LCNS workforce in a trust (RRR 1.59 (0.86 – 2.92) for trusts with LCNS salary band 7 & 8).
Conclusion:
We found variations in access to LCNSs by both patient and trust a feature, which indicates an unmet need for people with lung cancer in England. To meet the needs of all people with lung cancer and the clear targets set out by NICE, we need to expand the current LCNS workforce and ensure that we retain experienced nurses as LCNS are an integral part of the lung cancer team and provide help to people with lung cancer.
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