Patient experiences of the urgent cancer referral pathway-Can the NHS do better? Semi-structured interviews with patients with upper gastrointestinal cancer.
cancer
patient experience
qualitative
service evaluation
urgent pathway
Journal
Health expectations : an international journal of public participation in health care and health policy
ISSN: 1369-7625
Titre abrégé: Health Expect
Pays: England
ID NLM: 9815926
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
12
03
2020
revised:
28
07
2020
accepted:
08
09
2020
pubmed:
30
9
2020
medline:
10
8
2021
entrez:
29
9
2020
Statut:
ppublish
Résumé
Timeliness is viewed as a key feature of health-care quality. Internationally, this is challenging. In England, cancer waiting time targets are currently not being met. For example, between 2015 and 2018 only 71% of patients with upper gastrointestinal (UGI) cancer started treatment within the recommended 62 days of referral. We explored patients' experiences to identify areas for service improvement. Semi-structured interviews were conducted. Twenty patients who were referred through the urgent (two-week) GP referral route and were within six months of receiving first treatment were recruited. Data from the interviews were analysed thematically. Four themes were developed: organization of care; diagnosis; support; and views and expectations of the NHS. Patients described cross-cutting issues such as complex and varied pathways and uncertainty about what would happen next. They felt daunted by the intensity and speed of investigations. They were presented with a recommended course of action rather than options and had little involvement in decision making. They were grateful for care, reluctant to complain and resigned to the status quo. In order to meet patient needs, the NHS needs to improve communication and streamline pathways. Future cancer pathways also need to be designed to support shared decision making, be truly person-centred and informed by patient experience.
Sections du résumé
BACKGROUND
Timeliness is viewed as a key feature of health-care quality. Internationally, this is challenging. In England, cancer waiting time targets are currently not being met. For example, between 2015 and 2018 only 71% of patients with upper gastrointestinal (UGI) cancer started treatment within the recommended 62 days of referral.
OBJECTIVE
We explored patients' experiences to identify areas for service improvement.
DESIGN
Semi-structured interviews were conducted.
SETTING AND PARTICIPANTS
Twenty patients who were referred through the urgent (two-week) GP referral route and were within six months of receiving first treatment were recruited.
DATA ANALYSIS
Data from the interviews were analysed thematically.
RESULTS
Four themes were developed: organization of care; diagnosis; support; and views and expectations of the NHS. Patients described cross-cutting issues such as complex and varied pathways and uncertainty about what would happen next. They felt daunted by the intensity and speed of investigations. They were presented with a recommended course of action rather than options and had little involvement in decision making. They were grateful for care, reluctant to complain and resigned to the status quo.
DISCUSSION AND CONCLUSIONS
In order to meet patient needs, the NHS needs to improve communication and streamline pathways. Future cancer pathways also need to be designed to support shared decision making, be truly person-centred and informed by patient experience.
Identifiants
pubmed: 32989907
doi: 10.1111/hex.13136
pmc: PMC7752202
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1512-1522Informations de copyright
© 2020 The Authors Health Expectations published by John Wiley & Sons Ltd.
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