Background
The NCIS Breast Cancer (BC) Survivorship Programme was developed to streamline multi-disciplinary care. Low risk BC survivors will be seen in the Advanced Practice Nurse (APN) Clinic from Year 3 of diagnosis and transited to Primary Care Provider (PCP) from Year 5 if they were no longer on active treatment.
Aim
Evaluate the perception of BCSP by hospital specialists.
Methods
46 specialists across Breast Surgery, Medical and Radiation Oncology were surveyed on their awareness, satisfaction and support for the BCSP via an online survey using a 5-point Likert Scale.
Results
Of 36 respondents, 100% were aware of the BCSP, with majority Supportive/Strongly Supportive of APN-led care (88.8%), and transition to PCP (97.2%). 86.1% expressed they were Likely/Very Likely to refer patients to the APN, but 27.8% (n=10) reported reservations for patients who were at risk of hereditary cancer (n=8), preferred specialist care (n=2) or had multiple comorbidities (n=2). 88.9% stated they were Confident/Very Confident in PCP’s ability to provide stepdown care, but 13.9% (n=5) stated they were hesitant for patients who were anxious (n=3), had hereditary cancer (n=1), or required anti-resorptive injections (n=1). Patients’ unfamiliarity with another doctor (80.6%) and perceived PCP’s lack of specialty knowledge (58.3%) were cited as barriers for accepting transition. 97.2% agreed that the BCSP benefited patients with right siting of care. Specialists opined that the BCSP reduced duplicative visits (94.4%), eased specialist workload (91.7%), improved efficiency (83.3%) and provided time and monetary savings (74.4%). Specialists suggested increasing the capacity of the APN clinic, and having a system to ensure BC survivors transit successfully to PCP, for further improvement.
Conclusion
Hospital specialists are highly supportive of the NCIS BCSP and see benefits to both patient and system. Efforts are required to improve patient perception for shared care and upskilling of PCP to improve uptake.