Evaluation of the oncology physiotherapy service

1
Evaluation of the oncology physiotherapy service

• In part fulfilment of the BTEC level 3
  certificate in management

2
Introduction

• World Health Organisation (WHO) 1987
• Calman Hine Report (DOH) 1995
• NHS Cancer Plan (DOH) 2000
• Supportive and Palliative care guideline (NICE)
  2004

3
Background

• In-patient ward (41 beds)
• Dedicated oncology physiotherapy post 2003
• Macmillan physiotherapy post 2005

4
Current oncology physiotherapy service

• Implementation of rehabilitation onto the wards
• Number of oncology patients referred exceeds
  physiotherapy time available
• Other areas of work
• Macmillan objectives

5
Aim

• To evaluate the number of oncology patients
• currently being referred and treated against the
• number of hours of current dedicated
• physiotherapy in-put available on the
• oncology in-patient wards

6
Objectives

• To investigate whether the prioritisation
  standards are being met
• To investigate whether referrals are being seen
  within the standard of two working days
• To investigate whether there are still gaps in
  the oncology service provision and what is
  required to meet these gaps

7
Literature review

• Models of palliative care and curative care
• Evidence that people with cancer would benefit
  from rehabilitation
• Financial burdens
• Operational problems
• Knowledge base

8
Method

• Data collection
• Coding system
• Excel spreadsheet
• Colour coding
• Macro
• Verification
• Standards
• Charts

9
Findings

• Total number of patients peaked in Mid December
  2005 and January 2006
• Number of hours of treatment time peaked at nine
  and a half
• Deficiencies rose dramatically with reduced
  physiotherapy service

10
Results

• Deficiencies correlate with patient total
• Prioritisation standards not met
• Frequency of three deficiencies daily
• Referral standards being met
• Gaps in oncology physiotherapy service delivery
  remain

11
Discussion

• Different underpinning philosophies of MDT
• Rehabilitation vision
• Effective interagency working
• Patient-centred goal setting
• Appropriate funding
• Lack of support at strategic level
• Dorset cancer network rehabilitation plan (2005)

12
Conclusion

• Increased level of rehabilitation
• Provision of a more comprehensive and streamlined
  rehabilitation programme for SCC patients
• Development of the oncology physiotherapy service
• Provision of education on oncology rehabilitation
• Opportunity to assess community services
• Opportunity to attend the Dorset cancer network
  AHP rehabilitation sub-group meeting