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P85 Virtual lung cancer clinic: early experience and feasibility
  1. JF Faccenda,
  2. LD Calvert,
  3. SO Brij
  1. Peterborough City Hospital, Peterborough, UK

Abstract

Background With increased public awareness, cough campaigns and incidental nodules on computed tomography (CT), referrals on a Lung Cancer Pathway (LC) have risen significantly. Safe and effective methods to transfer patients to Respiratory Pathways (RP) are essential.

Aims to evaluate a chose and book, virtual Lung Cancer Clinic (VLCC) to facilitate non-face-to-face “blind” rapid patient assessment, next investigation and appropriate out-patient review.

Methods A retrospective review of all referrals during the period March–May 2016 was undertaken to assess whether blind clinical decision-making at point of referral was sufficient to plan on-going management.

Results 60 referrals were reviewed in VLCC by a Lung Cancer Consultant Physician (average time from referral 2 days, range 0–4 days) as their first 2 week wait appointment. 17 (28%) patients had a final diagnosis of Lung Cancer (histological 12, radiological 5).

Only 29/60 (48%) were of an acceptable quality for blind decision making. 16 (27%) referrals did not have sufficient information provided to allow any decision to be made and further information from the GP was requested.

26 referrals (43%) were removed from CP onto RP at VLCC review: 14 did not require a CT; 12 scans were undertaken (7 high resolution CT, 1 CT pulmonary angiogram, 4 staging CT), 8 prior to clinic attendance.

34 referrals (57%) remained on CP: 30 (88%) proceeded to staging CT with average wait 12 days (range 3–17 days) from referral, all performed prior to clinic attendance. 1/34 died prior to clinic attendance. 3/34 were scanned before VLCC. A further 8 referrals were removed from CP after imaging.

Thus, only 36/60 (60%) referrals were seen in the Lung Cancer Clinic. There was appropriate pathway change in 30% of referrals to General Respiratory (25%) and Pleural Clinic (5%).

Conclusion The VLCC can effectively assess and plan next investigation with appropriate clinic follow-up for suspected Lung Cancer patients. However, blind decision-making relies upon good clinical information from the referrer and administrative time can be wasted chasing this. Our data confirms that the VLCC facilitates efficient use of Out-patient and Radiology Services.

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