Patient Discharge Letter Template Nhs The History Of Patient Discharge Letter Template Nhs

A blight nursing aggregation has advised pathways, roles and responsibilities to advance a added patient-centred service. This action won the Blight Nursing chic in the 2019 Nursing Times Awards



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The bounded urology blight centre at Wirral University Teaching Hospital NHS Foundation Assurance was award barometer numbers and circuitous pathways fabricated allocation challenging, consistent in poor accommodating experience. In 2017, the advance blight assistant and urology nursing aggregation advised pathways, roles and responsibilities to advance a patient-centred service. They alien a new staffing anatomy and replaced acceptable aftereffect with self-supportive administration workshops. Investigations are tracked, and alien surveillance is managed via a accommodating portal.



Citation: Miller D (2020) Developing a patient-centred blight alleyway to abutment self-management. Nursing Times [online]; 116: 2, 42-43.

Author: Dawn Miller is Macmillan advance blight nurse, Wirral University Teaching Hospital NHS Foundation Trust.



Due to the abundant aggregate of patients actuality referred to the account the Macmillan urology analytic assistant specialists (CNSs) at Wirral University Teaching Hospital NHS Foundation Assurance were disturbing to accommodate a account that was candid and met the needs of all patients. The urology administration was additionally challenged by the blight achievement standards (NHS England, 2019a).

The CNSs were agog to redesign their account in a way that would advance the lives of bodies active with urological cancer. The advance blight assistant at the assurance encouraged and accurate the CNSs to admission change.

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The team’s aims with the intiative were to redesign the accommodating alleyway for urological cancers; ensure all patients beyond the arena had admission to appropriate admonition and support; and liaise with added astute trusts in the arena to ambit assets accessible to patients. They additionally capital to advance accommodating experience, accouter technology to account patients, abate delays at diagnosis, and advance achievement to blight standards.

The aggregation recognised the charge to appoint with key stakeholders in redesigning the service. They accustomed a council accumulation involving key stakeholders, including doctors and nurses, the informatics abstracts manager, Macmillan Blight Support, the bounded analytic allotment group, bounded leisure casework and Blight Alliance.

The advance blight assistant wrote a business plan with the abutment of the nursing aggregation and assurance business manager. The bounded administrator provided Macmillan Blight Abutment allotment for an added two bandage 5 nurses and a blight affliction coordinator for two years to accredit the aggregation to acquaint the alleyway redesign.

Once recruited in 2018, the new agents fabricated links with bounded analytic teams and charities, including Maggie’s, Merseyside Prostate Blight Abutment Group, Wirral Holistic Centre, Macmillan Blight Admonition Centres to abode the needs of all patients beyond the region.

The analytic assistant specialist advised and facilitated Self-supportive Administration (SSM) workshops, which aim to brainwash patients and accommodate them with the aplomb to self-manage and be independent. It provides admonition on abiding side-effects of their action and treatment, advantageous affairs choices, and admonition on signs and affection of recurrence. They are additionally accustomed admission to the accommodating portal, which enables them to bulletin bloom professionals at a time acceptable to them. The workshops accommodate admonition tailored to patients’ bounded area, including a chargeless 12-week canyon to any of the eight bounded leisure centres. The canyon provides admission to gym, pond and cancer-specific classes.

The workshops are abounding by patients who accept undergone prostate surgery. A ambit of bloom professionals, including a Macmillan Blight Abutment admonition manager, a physiotherapist and agents from the Macmillan Community Wellbeing Programme accommodate admonition on accommodation such as signs and affection of ache ceremony and side-effects to analysis for patients to accredit them to backpack out SSM. Anniversary branch is evaluated to accredit us to advance approaching content.

We alien Macmillan Blight Support’s Cyberbanking Holistic Needs Assessment (eHNA) and use the admonition it provides to ensure patients’ apropos are addressed. Patients can complete the eHNA at any allotment of their adventure from analysis to abiding follow-up. Those from alfresco the arena no best accept the aggravation of accepting to biking to the assurance for accustomed aftereffect appointments. They can acquaintance the aggregation or appearance their analytic addendum and after-effects online via a accommodating aperture that additionally provides admonition on accustomed bloom and wellbeing.

“This innovative, person-centred action enabled bodies with blight to alive activity as absolutely as they can” (Judges’ feedback)

Our aggregation has created a programme tailored to patients’ needs, and has broke into bounded and bounded adeptness to abutment the admonition needs of bodies afflicted by cancer. Benefits for patients accommodate the adeptness to appearance accustomed appointments, acquittal belletrist and after-effects via the accommodating aperture – acceptance for added compassionate of and assurance in their own healthcare, and the adeptness to use cyberbanking messaging to acquaint with a appointed team. In the best term, we additionally achievement that ante of blight ceremony will abate as a aftereffect of patients authoritative affairs changes.

We captivated a alert accident with patients who accept abounding the workshops to arm-twist their angle and the programme was able-bodied evaluated. All comments from accommodating achievement questionnaires completed afterwards anniversary branch are acted upon, for archetype we now accept a pre-surgery pelvic attic exercise chic to advice patients advance continence.

We currently accept 203 patients registered to accept alien monitoring, and 197 of these accept abounding a branch back April 2018. Best accept additionally accustomed the befalling to be registered on the accommodating portal. Anniversary accommodating accepting alien ecology would ahead accept up to four contiguous outpatient accessories annually, and delay two weeks to accept their after-effects anniversary time rather than 24 hours.

Patients accept no added accustomed follow-ups with us unless they acquaint us of affection of recurrence. The prostate specific antigen (PSA) claret analysis after-effects can be taken at the hospital, and are accessible on the aperture aural 24 hours. If they are taken at their bounded hospital, again the affliction co-ordinator obtains these after-effects and uploads them assimilate the portal.

Documentation has improved: in September 2019 we articular that 79% of urology patients had an eHNA and affliction plan and 69% of those commutual analysis had end-of-treatment summaries completed by the CNS – ahead no patients accustomed either of these.Benefits for the assurance accommodate bargain charge for aftereffect appointments, bigger aftereffect ratios, and accommodation actuality appear to access new appointments. Telephone calls from patients enquiring about accessories and requesting accustomed admonition accept bargain back the accommodating aperture was introduced, absolution CNS time to acknowledgment added circuitous queries.

Patients are acceptable to become added affianced and booty added albatross for their healthcare, consistent in bigger analytic outcomes. Achievement adjoin blight standards has bigger – there are beneath delays at analysis due to the change in the affliction pathway, and there is added job achievement and agents retention.

Overall, we apperceive the trust’s achievement in The Civic Blight Accommodating Acquaintance (NCPE) Survey has bigger (NHS England, 2019b). The 2017 NCPE Survey (sample from 2016), in affiliation to prostate cancer, begin that back patients were asked if they were accustomed the name of a CNS who would abutment them, 92% said they were. In 2018 (sample from 2017), 99% of respondents said they had a called CNS compared to the civic boilerplate of 90%.

In 2017, back asked whether prostate patients were accustomed barefaced answers to important questions from their CNS, 80% appear yes, compared to the civic boilerplate of 88%. However, in 2018 in acknowledgment to the aforementioned question, 94% appear accepting answers best or all of the time compared to the civic boilerplate of 87%.

The accident stratified aftereffect alleyway is now actuality formed out to patients who accept had renal cancer, and a bespoke SSM programme is actuality devised by the nursing aggregation and the blight affliction coordinator.

The affection advance action has been aggregate internally with added divisions. For example, the gynaecology administration is attractive at apery the urology archetypal with the addition of nurse-led SSM workshops and alien surveillance.

All the abstracts and improvements are actuality aggregate with the Blight Alliance and comparisons beyond the Merseyside and Cheshire arena are actuality made. The assurance is actuality showcased as an archetype of best practice, for instance, the SSM access is actuality aggregate with Wirral GPs. The new alleyway has been agreed by the analytic allotment group.

Patient Discharge Letter Template Nhs The History Of Patient Discharge Letter Template Nhs – patient discharge letter template nhs
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