Cancer is a major cause of morbidity and mortality in Scotland. The Scottish Executive has responded to the challenge of cancer through its national strategy, Living and Dying Well and Building on Progress.
In Scotland three regional cancer networks co-ordinate and develop services for people with cancer across the country. The East of Scotland Cancer Network (SCAN) serves a population of approximately 1.4 million across four NHS Board areas.
Malignant spinal cord compression (MSCC) can affect any patient with cancer. It occurs in approximately 5 per cent to 10 per cent of cancer patients and is a major cause of morbidity. Early diagnosis when a patient is still ambulant is crucial and rapid referral and treatment lead to better outcomes. In addition, improvements in rehabilitation and aftercare improve patient experience and quality of life.
Patients with MSCC will often see a number of different healthcare professionals throughout their journey across SCAN, including their own home, local hospital, regional cancer centre and hospice. It is paramount that care is consistent, integrated and optimal throughout this time.
The first step to achieving this in the South East of Scotland has been the development of the regionally agreed guidelines developed during the MSCC project with funding from Macmillan Cancer Support, using research evidence, expert opinion and professional consensus. Other aspects of the project focused on changing practice within hospital to reduce delays and improve patient and staff education. The SCAN Audit conducted as part of the project has demonstrated real improvements in many of these areas.
Patients with MSCC will often see a number of different health care professionals throughout their journey across the South East of Scotland including their own home, local hospital, regional cancer centre and hospice. Early diagnosis whilst a patient is still ambulant is crucial 6. It is paramount that care is consistent, integrated and optimal throughout this time. Rapid referral and treatment lead to better outcomes 7.
The project strategy aimed to diagnose MSCC earlier, hypothesising that earlier diagnosis would ensure patients are placed on the correct treatment pathway sooner, therefore enhancing quality of life and redirecting service costs. The strategy included:
- Effective referral guidelines and management guidance.
- MSCC education for healthcare professionals.
- A minimum data set and development of quality standards.
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