Does Limiting Long-Term Follow-Up for Breast Cancer Allow All Referrals to be Seen in 2 Weeks?
Identifieur interne : 003994 ( Pmc/Checkpoint ); précédent : 003993; suivant : 003995Does Limiting Long-Term Follow-Up for Breast Cancer Allow All Referrals to be Seen in 2 Weeks?
Auteurs : S. Potter ; S. Govindarajulu ; M. Shere ; F. Braddon ; J. Turner ; Ak Sahu ; Sj CawthornSource :
- Annals of The Royal College of Surgeons of England [ 0035-8843 ] ; 2008.
Abstract
The UK National Institute for Health and Clinical Excellence (NICE) recommends that breast cancer follow-up should be limited to 2–3 years stating this will ‘release resources’ making it ‘possible for all women with breast symptoms to be seen within 2 weeks’. In 2000, breast cancer follow-up services in North Bristol were redesigned to reflect evidence-based best practice. The aim of this paper is to assess the impact of this policy on numbers of follow-ups, clinic capacity and waiting times.
Data regarding the numbers of new and follow-up patients seen in breast clinic between January 2000 and December 2005 were collected from the hospital Patient Administration System. New patients were categorised as either ‘routine’ or ‘urgent’ according to ‘2-week wait’ rule guidelines. Median waiting times were calculated for each group and nominal appointment times assigned in an attempt to assess the effect of any changes on clinic capacity.
The number of follow-ups decreased by 33% as a result of the new policy. Numbers of referrals over the same period, however, increased by 14%. Routine referrals declined, but there was a 27% increase in ‘2-week wait’ patients. Waiting times for routine appointments initially decreased in response to reduced follow-up, but then rose as the number of ‘2-week wait’ referrals increased.
Reducing long-term follow-up is a simple and effective method of increasing clinic capacity but its effects are inadequate and transient in the face of increasing service demand. Additional innovative and creative strategies will be required if all breast patients are to be seen within 2 weeks.
Url:
DOI: 10.1308/003588408X301181
PubMed: 18634731
PubMed Central: 2645738
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Turner</name></author><author><name sortKey="Sahu, Ak" sort="Sahu, Ak" uniqKey="Sahu A" first="Ak" last="Sahu">Ak Sahu</name></author><author><name sortKey="Cawthorn, Sj" sort="Cawthorn, Sj" uniqKey="Cawthorn S" first="Sj" last="Cawthorn">Sj Cawthorn</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18634731</idno><idno type="pmc">2645738</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645738</idno><idno type="RBID">PMC:2645738</idno><idno type="doi">10.1308/003588408X301181</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">002713</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002713</idno><idno type="wicri:Area/Pmc/Curation">002712</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002712</idno><idno type="wicri:Area/Pmc/Checkpoint">003994</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003994</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Does Limiting Long-Term Follow-Up for Breast Cancer Allow All Referrals to be Seen in 2 Weeks?</title><author><name sortKey="Potter, S" sort="Potter, S" uniqKey="Potter S" first="S" last="Potter">S. Potter</name></author><author><name sortKey="Govindarajulu, S" sort="Govindarajulu, S" uniqKey="Govindarajulu S" first="S" last="Govindarajulu">S. Govindarajulu</name></author><author><name sortKey="Shere, M" sort="Shere, M" uniqKey="Shere M" first="M" last="Shere">M. Shere</name></author><author><name sortKey="Braddon, F" sort="Braddon, F" uniqKey="Braddon F" first="F" last="Braddon">F. Braddon</name></author><author><name sortKey="Turner, J" sort="Turner, J" uniqKey="Turner J" first="J" last="Turner">J. Turner</name></author><author><name sortKey="Sahu, Ak" sort="Sahu, Ak" uniqKey="Sahu A" first="Ak" last="Sahu">Ak Sahu</name></author><author><name sortKey="Cawthorn, Sj" sort="Cawthorn, Sj" uniqKey="Cawthorn S" first="Sj" last="Cawthorn">Sj Cawthorn</name></author></analytic><series><title level="j">Annals of The Royal College of Surgeons of England</title><idno type="ISSN">0035-8843</idno><idno type="eISSN">1478-7083</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>INTRODUCTION</title><p>The UK National Institute for Health and Clinical Excellence (NICE) recommends that breast cancer follow-up should be limited to 2–3 years stating this will ‘release resources’ making it ‘possible for all women with breast symptoms to be seen within 2 weeks’. In 2000, breast cancer follow-up services in North Bristol were redesigned to reflect evidence-based best practice. The aim of this paper is to assess the impact of this policy on numbers of follow-ups, clinic capacity and waiting times.</p></sec><sec sec-type="methods"><title>PATIENTS AND METHODS</title><p>Data regarding the numbers of new and follow-up patients seen in breast clinic between January 2000 and December 2005 were collected from the hospital Patient Administration System. New patients were categorised as either ‘routine’ or ‘urgent’ according to ‘2-week wait’ rule guidelines. Median waiting times were calculated for each group and nominal appointment times assigned in an attempt to assess the effect of any changes on clinic capacity.</p></sec><sec><title>RESULTS</title><p>The number of follow-ups decreased by 33% as a result of the new policy. Numbers of referrals over the same period, however, increased by 14%. Routine referrals declined, but there was a 27% increase in ‘2-week wait’ patients. Waiting times for routine appointments initially decreased in response to reduced follow-up, but then rose as the number of ‘2-week wait’ referrals increased.</p></sec><sec><title>CONCLUSIONS</title><p>Reducing long-term follow-up is a simple and effective method of increasing clinic capacity but its effects are inadequate and transient in the face of increasing service demand. Additional innovative and creative strategies will be required if all breast patients are to be seen within 2 weeks.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann R Coll Surg Engl</journal-id><journal-id journal-id-type="publisher-id">rcse</journal-id><journal-title>Annals of The Royal College of Surgeons of England</journal-title><issn pub-type="ppub">0035-8843</issn><issn pub-type="epub">1478-7083</issn><publisher><publisher-name>The Royal College of Surgeons of England</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18634731</article-id><article-id pub-id-type="pmc">2645738</article-id><article-id pub-id-type="doi">10.1308/003588408X301181</article-id><article-categories><subj-group subj-group-type="heading"><subject>Oncology</subject></subj-group></article-categories><title-group><article-title>Does Limiting Long-Term Follow-Up for Breast Cancer Allow All Referrals to be Seen in 2 Weeks?</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Potter</surname><given-names>S</given-names></name></contrib><contrib contrib-type="author"><name><surname>Govindarajulu</surname><given-names>S</given-names></name></contrib><contrib contrib-type="author"><name><surname>Shere</surname><given-names>M</given-names></name></contrib><contrib contrib-type="author"><name><surname>Braddon</surname><given-names>F</given-names></name></contrib><contrib contrib-type="author"><name><surname>Turner</surname><given-names>J</given-names></name></contrib><contrib contrib-type="author"><name><surname>Sahu</surname><given-names>AK</given-names></name></contrib><contrib contrib-type="author"><name><surname>Cawthorn</surname><given-names>SJ</given-names></name></contrib><aff><institution>Breast Care Centre, Frenchay Hospital</institution><addr-line>Bristol, UK</addr-line></aff></contrib-group><author-notes><corresp>Correspondence to SJ Cawthorn, Consultant Surgeon, Breast Care Centre, Frenchay Hospital, Beckspool Road, Frenchay, Bristol BS16 1JE, UK T: +44 (0)117 970 1212; E: <email>simon.cawthorn@nbt.nhs.uk</email></corresp></author-notes><pub-date pub-type="ppub"><month>7</month><year>2008</year></pub-date><volume>90</volume><issue>5</issue><fpage>381</fpage><lpage>385</lpage><copyright-statement>Copyright © 2008 by the Annals of The Royal College of Surgeons of England</copyright-statement><copyright-year>2008</copyright-year><abstract><sec><title>INTRODUCTION</title><p>The UK National Institute for Health and Clinical Excellence (NICE) recommends that breast cancer follow-up should be limited to 2–3 years stating this will ‘release resources’ making it ‘possible for all women with breast symptoms to be seen within 2 weeks’. In 2000, breast cancer follow-up services in North Bristol were redesigned to reflect evidence-based best practice. The aim of this paper is to assess the impact of this policy on numbers of follow-ups, clinic capacity and waiting times.</p></sec><sec sec-type="methods"><title>PATIENTS AND METHODS</title><p>Data regarding the numbers of new and follow-up patients seen in breast clinic between January 2000 and December 2005 were collected from the hospital Patient Administration System. New patients were categorised as either ‘routine’ or ‘urgent’ according to ‘2-week wait’ rule guidelines. Median waiting times were calculated for each group and nominal appointment times assigned in an attempt to assess the effect of any changes on clinic capacity.</p></sec><sec><title>RESULTS</title><p>The number of follow-ups decreased by 33% as a result of the new policy. Numbers of referrals over the same period, however, increased by 14%. Routine referrals declined, but there was a 27% increase in ‘2-week wait’ patients. Waiting times for routine appointments initially decreased in response to reduced follow-up, but then rose as the number of ‘2-week wait’ referrals increased.</p></sec><sec><title>CONCLUSIONS</title><p>Reducing long-term follow-up is a simple and effective method of increasing clinic capacity but its effects are inadequate and transient in the face of increasing service demand. Additional innovative and creative strategies will be required if all breast patients are to be seen within 2 weeks.</p></sec></abstract><kwd-group><kwd>Breast cancer</kwd><kwd>Follow up</kwd><kwd>Guidelines</kwd><kwd>Capacity</kwd></kwd-group></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Braddon, F" sort="Braddon, F" uniqKey="Braddon F" first="F" last="Braddon">F. Braddon</name><name sortKey="Cawthorn, Sj" sort="Cawthorn, Sj" uniqKey="Cawthorn S" first="Sj" last="Cawthorn">Sj Cawthorn</name><name sortKey="Govindarajulu, S" sort="Govindarajulu, S" uniqKey="Govindarajulu S" first="S" last="Govindarajulu">S. Govindarajulu</name><name sortKey="Potter, S" sort="Potter, S" uniqKey="Potter S" first="S" last="Potter">S. Potter</name><name sortKey="Sahu, Ak" sort="Sahu, Ak" uniqKey="Sahu A" first="Ak" last="Sahu">Ak Sahu</name><name sortKey="Shere, M" sort="Shere, M" uniqKey="Shere M" first="M" last="Shere">M. Shere</name><name sortKey="Turner, J" sort="Turner, J" uniqKey="Turner J" first="J" last="Turner">J. Turner</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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