A summary report of findings and recommendations to government will be coming in the new year on how to best enhance cancer care services for Yarmouth and southwest N.S. residents through the Nova Scotia Health Authority’s (NSHA) Yarmouth Cancer Services Review project.
The review was initiated in 2017 in response to requests from the community, health professionals and local politicians to have radiation services offered at the Yarmouth Regional Hospital. At the conclusion of that review it was determined a radiation unit – due to staffing, state-of-the-art technology upgrade restrictions, and other factors – was not the best treatment option, given that patients would receive more advanced, up-to-date treatment in Halifax. The majority of the review committee, which included Yarmouth representation, came to this conclusion.
Instead, the cancer care review identified other areas to focus on for improvement and enhancement.
According to the latest community update – released during the last week of November – next steps include drafting a summary report of findings and recommendations; implementation of working groups to fine-tune and move the recommendations forward; and developing a business case for each recommendation submitted to government for consideration. This includes identifying the costs of any new resources needed for each recommendation and providing a rationale for the need.
The review is being led by a steering committee, established last winter and supported by three working groups: transportation and travel burden; service delivery and communication and engagement.
Already, there have been some improvements and stability in service delivery, says the update.
The temporary withdrawal of monthly medical oncology consultation visits in Yarmouth as a result of a shortage of medical oncologists was diverted with the NSHA approval to recruit two additional medical oncologists earlier this fall. As a result, medical oncology consultation and follow-up clinics continued in Yarmouth and patients did not have to travel to Halifax.
The radiation oncology team is working to shorten the length of treatment time for some cancers. For patients who have to travel a distance for radiation treatment in Halifax, this will mean fewer days away from home and fewer trips to Halifax.
The radiation oncology team has also:
• Set up a rapid response clinic, which enables consultation, simulation and treatment on the same day. Initially, this treatment option was provided one day each week. It has recently been expanded to twice a week. In the future, if there is demand, this program could expand to several times a week.
• Successfully implemented a supportive care clinic, which currently operates four times a week. In the near future, the clinic will be available daily. The clinic helps patients manage their side effects from radiation and lowers the chances of a patient needing to be admitted to hospital or going to the emergency department.
• Welcomed the introduction of a new virtual health (video) system and is committed to expanding its use to minimize the number of times a patient has to travel to see a radiation oncologist. This system can be used for initial consultation, teaching and learning in preparation for radiation therapy as well as follow-up after completion of radiation therapy.
Cancer Care Program leaders and a few members from the service delivery working group held an engagement session in Yarmouth on Nov. 13 and 14 with community and patient family advisors to discuss information collected and help prioritize the work going forward.
The input provided by community and patient family advisors included:
• An understanding that travelling to Halifax is sometimes necessary.
• A request for better coordination of care so that all in-person appointments possible can be scheduledduring a single visit and to ensure thought is given to travel time and costs such as accommodation.
• A request, whenever possible, that video technology be used for appointments so consultation and follow-up appointments can occur at Yarmouth Regional Hospital.
• Early referral to the cancer patient navigator.
• Recommendations for fine-tuning and implementation include adding a new coordinator role in Halifax to work with the Yarmouth team to improve coordination of care; increasing virtual care (cancer care appointments using video and adding any necessary resources to support its success (equipment, nursing staff, etc.); and exploring ways to improve staffing and scheduling to make clinics as efficient as possible. This may include implementing the same booking/scheduling system used in Halifax.
Government is also looking at ways to increase awareness of the Boarding Transportation and Ostomy Program and the Drug Assistance Program for Cancer Patients and exploring how to make it easier for cancer patients and families to register for them.
The steering committee will be exploring the best way to move the work forward at a meeting planned for early in the new year with working group members.
