Project Swallow: Living with Oesophageal Cancer

Problem

Centralisation of oesophageal cancer care improves outcomes and reduces healthcare costs but it can also affect the patient experience and increase the administrative burden on healthcare staff. Under a centralised care pathway, patients lose the continuity of care as they are transferred between different hospital trusts, traveling further whilst unwell.The aim of our project is to create digital health interventions (DHI), delivered through a computer software, to be used by healthcare staff, and a mobile phone app for patients and their carers. The three objectives of the DHIs are to:• Improve patient experience o Provide one source of reliable health and support information individualized to patientso Improve communication with their care team.• Improve health service efficiency. o Reduce the administrative burden on HCPs o Improve auditing across sites for adherence to pathway and cancer wait timeso Reduce DNA rates and A+E attendances• Improve health outcomeso More patient centered care decisions (quality vs quantity)o Standardise care across hospital trusts.

Approach

This project has emerged from observed challenges within the current NHS system, and is intended to have impact across the NHS in a relatively short time frame. It has strong patient and clinical input with a multi-disciplinary approach consisting of patients, Patient and Public Involvement (PPI), academic researchers, senior clinicians, chief medical officers, commercial company “Living with” who have expertise in smart condition management apps for the NHS and Macmillan cancer charity. There is patient involvement throughout the project to ensure that patients views are considered at each stage of design, implementation and evaluationThe project is divided into 4 main work packages. • Summarising the evidence base with a literature review • Determining using needs using qualitative methodology. • Designing the Digital health interventions using the principles of agile participatory design.• Refining the protype with a small non clinical pilot.

Findings

We are currently in the design phase having done a literature review on the needs of cancer patients and determined end user needs with interviews, focus groups and workshops. The results so far have highlighted the varied and complicated support needs of oesophageal cancer patients and the difficulties faced by their health care workers. The results of these findings are being used to inform on the design of the DHIs, to make sure the end user needs will be met.

Consequences

Our vision for the future is that every patient with cancer will have personalized support throughout their cancer journey provided by a digital health intervention. Different healthcare professionals including GPs will be able to see an overview of the cancer care in order to provide further support to patients in the community.