Ambulatory care for teenagers and young adults (TYA) was introduced at University College London Hospital as an alternative, mobile approach to the delivery of cancer treatments that would traditionally be undertaken within the inpatient setting, including high dose chemotherapy and stem cell transplantation. This model of care is facilitated by portable infusion pumps and features family self-monitoring facilities alongside overnight stays in a residential setting or a patient’s own home. Ambulatory care in this context aims to normalise daily life during cancer treatment as much as possible and care is shaped around the TYA and their family.
An ambulatory care (AC) service for adult cancer patients launched in London 10 years ago. This new initiative, the first of its kind in the UK for young people with cancer, was driven by a commitment to normalise lengthy cancer treatment within a family-centred context. This is the largest teen and young adult (TYA) cancer service in the UK, supported by the Teenage Cancer Trust.
Prior to AC, TYA patients were treated in an age-appropriate inpatient ward. The idea of AC was to encourage the TYAs to be involved in the decision making about their own treatment, to meet their own health care requirements and receive their treatment in an environment where independence, an essential adolescent development task, is promoted.
The project has three main objectives.
Firstly, the operational development of the AC model. This was the immediate priority, as the service had to provide safe mobile cancer treatment. The existing adult AC model was therefore adapted to meet the needs of the TYA population, with the input of patients and their families.
Secondly, the development of a participatory action research group to facilitate the growth and development of the service, to document learning undertaken and generate evidence for practice.
The final objective was to explore the impact of ambulatory care on the TYA lifestyle and sense of wellbeing, by allowing patients and families to work collaboratively with health professionals to discuss the important aspects of care and treatment.
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