Once you have completed treatment for cancer at UCLH you will enter a period of follow-up care. Follow-up is an important way of monitoring your health. It allows us to identify any signs that the cancer may have returned or progressed, and it also supports you in addressing any ongoing side effects of your cancer or its treatment.
Follow-up will vary depending on your cancer and the treatment you have received, and will often include a combination of face-to-face or telephone appointments with your doctor or a clinical nurse specialist. You may also need to have some tests, such as CT scans, endoscopies or blood tests, depending on the type of cancer.
There is a growing recognition both within the UK and internationally that the traditional follow-up model of face-to-face appointments at set times does not meet the needs of patients. As the number of cancer survivors in the UK is predicted to double in the next 15 years, it is important that new models of follow-up are developed. These models need to reflect the cultural shift to a greater focus on empowering people to take control of their own health and wellbeing (known as supported self-management). Implementing supported self-management pathways (sometimes referred to as stratified follow-up pathways) is supported at a national level by both the Department of Health and Macmillan Cancer Support, and is now happening at cancer centres across the country.
Supported self-management pathways offer an alternative to traditional follow-up appointments after treatment for cancer within certain groups of patients. We know that some people find routine clinic appointments to be a source of anxiety, and others put off reporting worrying signs and symptoms if a routine clinic appointment is ‘not too far away.’ Evidence also suggests that cancer recurrence is unlikely to be picked up at these appointments, and is generally identified by patients themselves, in between routine check-ups.
Supported self-management follow-up pathways after treatment for cancer are now being set up at UCLH, with some patients being offered additional information and support at ‘end of treatment’ clinic appointments and health and wellbeing days to increase their confidence to monitor their own wellbeing. This approach to follow-up replaces routine clinical appointments, which means that patients do not have to come to hospital when they are feeling well and are not experiencing any symptoms. Instead, they can contact their specialist team as and when they need to. Any necessary tests, such as CT scans or blood tests will carry on as normal, and results given to patients and their GPs either over the phone or in a letter.
It is important to note that supported self-management pathways are not for everyone. If you have specific concerns or health-related issues that make supported self-management follow-up unsuitable, then you will continue to have traditional follow-up appointments in the cancer outpatient clinic.
You can also read the report of the Independent Cancer Taskforce, which sets out recommendations for a new cancer strategy for England (including the development of supported self-management follow-up) on the Cancer Research UK website.