A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic.

A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic. [PubMed]

Ann R Coll Surg Engl. 2019 Jan;101(1):30-34.

• Clinical, financial and environmental benefits of  virtual urology clinic at Charing Cross Hospital, London.

Abstract

NUH and Macmillan pilot new ‘virtual clinic’ for tumour patients

NUH and Macmillan pilot new ‘virtual clinic’ for tumour patients
Digital Health 10 December 2018

Nottingham University Hospitals Pioneers Innovative Virtual Clinics in Partnership with Macmillan, Involve 10 December 2018

• Nottingham University Hospitals NHS Trust and Macmillan Cancer Support have piloted a new service that offers patients with brain metastases the option to have their consultation from home via video.
• Virtual Clinic was trialled as part of efforts to help improve care for patients with brain tumours across the East Midlands. After booking an appointment via an online booking system, patients receive a link that enables them to connect to a video meeting with their clinician at the scheduled time.
• Over a seven-month period, 37% of appointments in the brain metastases unit were held via Virtual Clinic. 

Pan-London Guideline for In Utero Transfer

Pan-London Guideline for In Utero Transfer
NHS London Clinical Senate 7 November 2018

• This guideline provides information on key areas of the in utero pathway and will help inform both the content and structure of local guidelines. The goal of the guideline is to better inform clinicians, support their decision-making process and reduce inappropriate variation in practice.

Trustedoctor to facilitate virtual consultations for cancer patients

New Digital Health Tech Accelerator Opens Up NHS To Cancer Specialists
Forbes 18 September 2018

• Trustedoctor, one of the most recent additions to the NHS DigitalHealth accelerator program, a cloud-based, open platform that allows specialist physicians to quickly assess patients and consult with expert colleagues in a virtual setting. DigitalHealth.London will be supporting Trustedoctor in deploying a solution that could help alleviate the complexities that surround ongoing cancer care and support.
• According to Professor Karol Sikora, Professor of Oncology and Dean of Medicine at the University of Buckingham. “Trustedoctor’s technology could help to improve connectivity between patients, clinicians and NHS Trusts, speeding up diagnosis. It could also ensure the right expertise can be brought to the patient more speedily and effectively, even to those living at some distance from a cancer centre.”
• According to Paul Grundy, Consultant Neurosurgeon, Southampton Hospital, Chair of NHS England Clinical Reference Group for CNS Tumours and Secretary of the British Neuro-Oncology Society "Trustedoctor could be a great asset to the NHS by facilitating virtual consultations, allowing patients the benefits of being seen in the comfort and convenience of their own home and freeing up valuable clinic space in hospitals for those patients that do require an on-site appointment."

Ortus-iHealth app trial at St Bartholomew's Hospital

Virtual advice app trialled at St Bartholomew’s Hospital
Digital Health 8 August 2018

• A new app, Ortus-iHealth, that provides care advice for heart and cancer patients is being trialled at St Bartholomew’s Hospital. 
• The app helps patients and their clinicians connect through virtual appointments by computer or mobile phone, rather than requiring them to travel in for a face-to-face consultation.
• See also Virtual clinic app underway at St Bartholomew’s Hospital

Vanguards are improving patient experience

Improving the experiences of people who use services
NHS Providers 7 March 2018
Sharing learning around patient experience from vanguards including:

• Specialist care closer to home - integrated neurology nurse at the Neuro Network vanguard at Walton Centre, Liverpool.
• Reducing the need to travel - epilepsy specialist nurse providing support and practical care to children treated at Evelina London Children's Hospital closer to home.

Impact of travelling times to cancer treatment centres

A cancer geography paradox? Poorer cancer outcomes with longer travelling times to healthcare facilities despite prompter diagnosis and treatment: a data-linkage study.
British Journal of Cancer 117, 439-449 (25 July 2017) | doi:10.1038/bjc.2017.180

• Bottom line - the longer you have to travel to a cancer treatment centre the faster your diagnosis and treatment, but poorer your survival rate.

Abstract
Background: Rurality and distance from cancer treatment centres have been shown to negatively impact cancer outcomes, but the mechanisms remain obscure.
Methods: We analysed the impact of travel time to key healthcare facilities and mainland/island residency on the cancer diagnostic pathway (treatment within 62 days of referral, and within 31 days of diagnosis) and 1-year mortality using a data-linkage study with 12 339 patients.
Results: After controlling for important confounders, mainland patients with more than 60 min of travelling time to their cancer treatment centre ((OR 1.42; 95% CI 1.25–1.61) and island dwellers (OR 1.32; 95% CI 1.09–1.59) were more likely to commence cancer treatment within 62 days of general practitioner (GP) referral and within 31 days of their cancer diagnosis compared with those living within 15 min. Island-dweller patients were more likely to have their diagnosis and treatment started on the same or next day (OR 1.72; 95% CI 1.31–2.25). Increased travelling time to a cancer treatment centre was associated with increased mortality to 1 year (30–59 min (HR 1.21; 95% CI 1.05–1.41), >60 min (HR 1.18; 95% CI 1.03–1.36), island dweller (HR 1.17; 95% CI 0.97–1.41).
Conclusions: Island dwelling and greater mainland travel burden was associated with more rapid cancer diagnosis and treatment following GP referral even after adjustment for advanced disease; however, these patients also experienced a survival disadvantage compared with those living nearer. Cancer services may need to be better configured to suit the different needs of dispersed populations.