Our lung cancer service had experienced pressure in the past, so the team was redesigned to ensure that patients receive timely, high-quality care.
This resulted in two major developments to the service:
Improved access for 2ww patients
The service has introduced daily access for patients on the two-week wait referral pathway so that they can be triaged into clinics.
In practice, this means that most patients will now receive initial contact from the service in a day or two and be booked in for any diagnostic tests or scans that may be necessary prior to seeing a respiratory consultant.
In turn, their first appointment within the two-week window will enable the clinician to discuss the patient’s case in detail as results from initial inquiries will be available. Patients benefit from moving down their pathway much more quickly as well as reducing the amount of uncertainty and anxiety while they wait for test results.
For the 12-month period from November 2023 to October 2024, 615 patients have benefited from the service with an average waiting time of 2 days to first appointment.
Lung oncology virtual ward
Northumbria Healthcare set up the country’s first lung oncology virtual ward – bringing the benefits and rationale of virtual wards to the lung cancer pathway.
As with other virtual wards, it supports patients to remain in their own homes, but still receive the acute clinical care they need.
This helps to reduce admissions to hospital, reducing the pressure on beds, as well as supporting timely discharge from hospital. The lung oncology virtual ward covers both North Tyneside and Northumberland.
Data shows between 40 and 73 patients being treated on the lung oncology virtual ward per month between April and August this year, with most common length of stay being a single day.
An example of how the virtual ward works can be seen in the case of a 79-year-old female patient with a new diagnosis of lung cancer, who was waiting to be seen by the oncology team to discuss treatment options.
She contacted the lung cancer nurse specialist team as she was experiencing increased breathlessness and a cough, while also feeling lethargic. She had last been seen in the lung cancer outpatient clinic two weeks before and she felt that things were getting worse while her cancer treatment was due to start.
A full assessment over the phone identified a chest infection. She was prescribed antibiotics and some dexamethasone tablets to improve her energy levels so she would be feeling better before meeting the oncologists to progress cancer treatment.
Psychological support was also given as she was struggling to cope with the diagnosis. A face-to-face visit was offered; however, the patient was satisfied with the contact she had. She spent four days in total on the virtual ward, and by the end felt much better, with her chest infection symptoms and lethargy both much improved.
An additional benefit brought about by the creation of the lung oncology virtual ward is enhanced support in the emergency department and ambulatory care at the Northumbria Specialist Emergency Care Hospital (NSECH) in Cramlington.
It means patients can have immediate support from a lung cancer nurse if there are concerns during an attendance for another issue.
From April to August 2024, there were 280 patient admission to the lung oncology virtual ward across Northumberland and North Tyneside.
These projects were recognised with a Bright Ideas in Health Award 2024. Read more here.
Additional initiatives
In 2022, Northumbria Healthcare introduced a screening pilot to detect lung cancer in its early stages after data showed that patients with certain risk factors and living in more deprived areas of North Tyneside and Northumberland were more likely to develop lung cancer.
The trust initially worked with five GP practices in Wallsend to invite patients most at risk for early screening. 420 patients accepted the offer and the team found 18 cancers, 17 of which were in the early stages and able to receive curative treatment.
There were plans to expand the pilot further, but this has now been rolled into the targeted lung health check screening programme. Through this, the trust will be offering a lung health check to everyone in Northumberland and North Tyneside aged 55-74 with a history of smoking across the coming years.