Cancer after-care 'shake-up' could reduce NHS costs

Cancer survivors say they may be happy to receive after-care from medical professionals that are not cancer specialists provided they receive follow up care for longer and are compensated by some additional services, such as dietary advice and counselling.

Changing follow-up care in line with survivor's preferences services could lead to more efficient personalized care which could also cut costs for the NHS.

As more people survive cancer, specialist-led cancer follow-up is becoming increasingly expensive and is failing to meet many survivors' needs.

It is generally accepted that alternative methods of providing this after-care, informed by survivors' preferences, are urgently needed.

A study by experts at the University of Aberdeen gathered information from 668 adults in North-east Scotland who had survived melanoma, breast, prostate or colorectal cancer via a postal questionnaire. The results have been published in the British Journal of Cancer.

Cancer survivors surveyed had a strong preference to see a consultant during a face-to-face appointment when receiving cancer follow-up but appeared willing to accept follow-up from specialist nurses, registrars or GPs provided that they are compensated by increased continuity of care, dietary advice and one-to-one counselling.

The survey also revealed that survivors valued longer appointments but telephone and web-based follow-up and group counselling, were not considered desirable.

Survivors of colorectal cancer and melanoma said they would accept after-care delivered by registrars, specialist nurses or GPs, instead of a consultant as long as they saw the same person each time and their after-care went on for longer. Breast cancer survivors wished to see a registrar or specialist nurse, and prostate cancer survivors, a GP.

"Cancer after-care is a hugely important but increasingly expensive patient service," said Dr Peter Murchie, who led the research team.

"Naturally most survivors' preference would be to see the most specialised cancer expert available but our survey shows that they are prepared to accept after-care from other qualified healthcare professionals as long as they receive other benefits – such as greater continuity of care, accessible dietary advice and counselling services.

"Given the practicalities, costs and the potential to develop continuous care, specialist nurse-led cancer follow-up may be an attractive alternative to the current setup."