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December 2011
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Chemotherapy delivery: challenges for the future
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Current chemotherapy pathways
The exact details of how individuals progress through an outpatient chemotherapy clinic depend on the specific treatments being administered, but there are some distinct steps in the typical patient pathway (Figure 1).
The pathway summarised in Figure 1 is time-consuming and requires patients and their families to be in the hospital for up to 8 hours.
Many cancer services rely on outdated systems that do not address issues of current pressing concern, such as capacity, delays in starting potentially curative treatments or meeting patients’ wishes for treatment delivery closer to their homes.
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Scheduling of chemotherapy
Staff and patients in our clinics say that problems with the scheduling of chemotherapy are a major contributory factor to poor service delivery. Indeed, many of the systems designed to enable nurses to schedule chemotherapy are prone to error, awkward to use and limited in the information they display.4
More efficient scheduling of chemotherapy appointments is one of the aims of the Chemotherapy Oncology Planning Resource Tool (C-PORT), which has been designed by the Pharmaceutical Oncology Initiative Partnership (POIP) in association with the Cancer Action Team and the NHS.5 The benefits of C-PORT became clear when it was piloted in a small number of cancer networks in 2005, and the system is now being rolled out to 34 other cancer networks throughout the UK. C-PORT is a simulator that allows networks to model how different drug regimens, patient flows, resource levels and unit organisation can affect the chemotherapy unit. For example, it can forecast how each individual patient will experience care, how long they will wait and how much care they will receive. It can be used to recreate real life situations such as equipment breakdown or absenteeism to see how they will affect treatment. It can also be used to compare differences at local, regional and national level allowing comparisons between NHS trusts.
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