Neuro-Oncology Prehabilitation Service Update Summary Nov 2022-April 2023
Neuro-Oncology Prehabilitation Service saw 73 new patients between Nov 2022-April 2023. Patients with high-grade gliomas, low-grade gliomas, and brain metastases received tailored interventions pre and post-surgery. Patient feedback was positive, indicating a very good overall experience. The service's impact on reducing length of stay and improving patient outcomes was noted.
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Neuro-Oncology Prehabilitation Service Update November 2022-April 2023 Charly Moran Clinical Specialist Physiotherapist Eleanor Guiney - Clinical Specialist Speech and Language Therapist Rosie Humphreys- Clinical Specialist Occupational Therapist
Prehabilitation Patient Pathway ENHANCED RECOVERY: HIGH GRADE GLIOMAS 1 week post discharge Offer 1-2 sessions to bridge gap before community services / continue interventions started prior to surgery 1-2 sessions prior to surgery First Appointment: Referral to Neurosurgery at North Bristol Trust Discharge Onward referrals completed Patient questionnaire sent out (PREM) -Seen at Consultant clinic face to face appointment -Can be contacted via phone / virtual appointment if missed at this time Follow up post- surgery (phone /virtual) Follow up outcome measures completed (PROMs) Diagnosis of Low grade glioma, High grade glioma, Metastases in brain METASTESES 1-2 sessions prior to surgery Baseline Measures completed (PROMs) : EQ 5D EORTC-30 GENERAL: ( Specific functional outcome measures as required) 3-4 weeks after surgery 1 session Review of recovery and any ongoing needs LOW GRADE GLIOMAS Notes uploaded to Careflow for inpatient team / Handover 3-4 sessions prior to surgery Follow up outcome measures completed (PROMs)
PATIENT DATA New patients seen in prehab (1st November 2022- 5th may 2023): 73 Average no. new patients per week: 2.7 Predicted no. new patients per week: 6 Tumour types: 43 HGG (57% of patients seen) 14 LGG (18% of patients seen) 18 METS (24% of patients seen) 1 other ( neurocytoma) Appointment types: 73 % initial appointments face to face 23% initial appointments telephone 4% initial appointments virtual Length of stay AHP BNSSG Evaluation dashboard to go live in next month Impact on LoS and readmission data will be available.
Patient Experience Data Patients rated their overall experience of the Neuro- oncology Prehabilitation service between 9/10 out of 10 (Very good). Inpatient therapy feedback Reduced length of stay as patient didn t have to wait for a foot-up orthotic to arrive on the ward, as well as then waiting for a 2nd physio review to assess his mobility with the foot-up. ' (Inpatient physiotherapist) A plan of action was good to have at a time of uncertainty- came away knowing what would happen. Leaflet was very useful to read afterwards if I didn t take everything in (Metasteses patient) It was really helpful to have an in-depth Prehabilitation assessment including social history, baseline mobility, and a balance outcome measure. It made the initial assessment much easier and quicker for both patient and therapist, particularly when the patient was so fatigued. It allowed me to quickly identify what was new post-op and helped identify flatness in mood that hadn t been present pre-op. -Inpatient physiotherapist Excellent Caring Patient orientated
Next Steps: Next Steps: Actions Risk RAG rating 6/52 regular meeting with Consultants and General manager to business case for acute provider to permanently fund service Service closes in September 2024 Red Weekly caseload reviews Close links with CNS team Operational Clinic Space Number of referrals Amber Data collection Cancer Lead AHP liaising BNSSG for dashboard NBT to form cancer patient experience group Admin support Support from Patient Experience team Amber
