Last year, incredible efforts were made from every corner of the NHS to maintain the essential service possible. Both clinical teams and individuals have been responsible for adapting pathways and transforming physical sites so that diagnostic services can be performed while keeping vulnerable patients as safe as possible.

One of these individuals is Tanya Gill, Macmillan Urology CNS (Clinic Nurse Specialist) Team Leader and Team Lead and Clinical Nurse Specialist at the Frimley Health NHS Foundation Trust, who provides the Trust’s Prostate Cancer Diagnostic Service from the course of the process. Outpatient setting while eliminating TRUS biopsy.

One-stop clinic

The Frimley Health NHS Foundation Trust provides NHS hospital services to approximately 900,000 people in Berkshire, Hampshire, Surrey and South Buckinghamshire. These services include the Trust’s three major hospitals, Frimley Park, Heatherwood, and Wexham Park, as well as outpatient clinics at Aldershot, Farnum, Fleet, Windsor, Maidenhead, Bracknell, and Chalfont St. Peter. It is provided by the diagnostic service.

The purpose of the trust is for the patient The highest quality health care possibleThe spirit reflected in the innovation of the prostate cancer diagnostic pathway by establishing the One-Stop Prostate Clinic in 2019, about two years ago.

“Our goal at the One-Stop Clinic was to provide one-touch points for men with suspected prostate cancer,” said Tanya Gil, clinical nurse specialist and clinic team leader at the Frimley Health NHS Foundation Trust. I will explain. “We found that men have multiple appointments with different clinicians. Delays were inevitable. This is ideal in terms of both the patient’s experience and the efficiency of the prostate cancer pathway. Was far from it. We wanted to change that. “

Under the guidance of Frimley Health’s urology consultant and urology cancer leader Marc Laniado, Tanya was responsible for establishing the one-stop clinic. Initially, this would triage the patient over the phone at the time of referral from the GP, reserve the appropriate patient for MRI and consultation, and biopsy that day for patients who may need further diagnosis. We held a slot. At that time, the biopsy method used was a transrectal (TRUS) combination. Transperineal (TP) biopsy using a grid template; La TP also uses the PrecisionPoint ™ transperineal access system. This is a new way to perform transperineal biopsy under local anesthesia in an outpatient setting, while improving the detection rate of cancer and reducing the risk of biopsy-related infections.

After that, COVID-19 was a hit.

Impact of COVID

Due to her intensive care background, Tanya was relocated from the one-stop clinic to the ICU during the first wave, and the one-stop clinic was suspended as the NHS worked on the influx of COVID patients. However, once selective service was resumed, it became easier and requested to change the clinic setup.

“Of our three hospitals, Wexam and Frimley have been designated as” red “and Heatherwood have been designated as” green, “explains Tanya. “This meant that diagnostic services could be resumed, but there was still a major challenge. The theater was no longer accessible for general anesthesia surgery and patients needed to be quarantined before one day of surgery. Because of this, one-stop clinics have become impossible. “

Still, Tanya decided to reopen the clinic and make sure the patient was still being examined. This required drastic measures on her part. “I went to Heatherwood one weekend with a colleague and basically cleaned up an unused room, or used for storage as part of a larger hospital renovation, a waiting room, a doctor’s office, and my own. Changed the biopsy room to our own outpatient setting, all in green. “

In parallel, the trust has decided to remove the TRUS biopsy altogether from its pathway because of the high risk of sepsis and biopsy-related infections and the patient’s potential for re-examination. “Before the pandemic, I was already training LATP using PrecisionPoint,” explains Tanya. “This was a huge speedup in 2020. It was supported by Laniado, who encouraged and taught me to develop the skills of the technique. This is what I am currently doing. This means that you are one of about 30 nurses in the UK who are fully performing this procedure. “

take responsibility

As of May 2021, Tanya is currently supporting the operation of Frimley Health’s one-stop prostate clinic and is conducting additional LATP prostate biopsies on a separate list.

She explains: “I will triage and identify suitable patients for a one-stop clinic. Book them, ensure everything you need on the day to turn your MRI review around, and if Laniado feels you need it. Will perform a biopsy.

“This has obvious benefits for patients as they can minimize the amount of time they spend in the hospital and make potential diagnoses and treatment plans in about 7-10 days after referral.” She adds. ..

Tanya has driven a lot of innovation on her own, but asserts that she couldn’t have achieved it without the support of Frimley Health’s broader team. “Obviously, I’m very lucky to have Mr. Raniad’s support for pushing and pushing,” she says. “Maybe there are a lot of nurses behind that level of support. Otherwise, I can accomplish something similar to mine.

“But in reality, it’s the work of the entire interdisciplinary team here that has made this possible from the radiology team, the service leaders who helped with the purchase of PrecisionPoint equipment, and the management team who helped with the reporting. Appointments – And Frimley Health’s external appointments that made them available to train me during these difficult times. I am in deep awe of what we have achieved to improve patient care. I have a feeling of. “


Recognize the tenacity and dedication of medical professionals such as Tanya, as well as men and their families who experience the psychological and physical side effects of living with cancer, as September 2021 is Prostate Cancer Awareness Month. Is important. A person who is committed to making the patient’s experience and results as good as possible.


Source link FRIMLEY HEALTH NHS FOUNDATION TRUST STREAMLINES Prostate Cancer Service, One Stop Prostate Clinic

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