Treatment Record Summary â User Guide - National Cancer ...

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Advise entry onto palliative or supportivecare registerDS 1500 status and prescriptionexemptionAlert symptoms that require referral backto specialist teamContact for re referrals or queries in andout of hoursSecondary Care On-going ManagementplanReferrals to other servicesInclusion of the patient on the palliative care register ensures that theprimary health care teams are made aware that a patient is nearing end oflife and that increased input maybe required to support patient and carers.The register is shared with all relevant OOH doctors, ambulance service,community district nursing teams, Macmillan support team, social care,hospice as appropriate. Patients can then receive the appropriate support,information and benefits in a timely manner.If no DS 1500 completed the GP will be prompted to arrange. Also ensuresthat exemption charges are waived for any cancer treatment - anentitlement for all patients with a diagnosis of cancerThis should include only those symptoms where immediate re-referral tosecondary care specialist is required e.g. acute breathlessness requiring apleural tap, as opposed to the expected side effects of treatment that canbe managed by the GP or community team. Improved information to thepatient will also enable better patient choice especially related to End ofLife Care.Confirms contact details for the patient or GP for advice on care ortreatment or to arrange urgent review. The out of hours contact could be award, the acute oncology team or relevant on call teamInclude any planned outpatient reviews and surveillance tests dates (orapproximated timescales). This provides a framework for GPs. If indicated,further tests can be scheduled prior to the further outpatient visits. Patientswill be better informed about follow up plans and what to expect. It isreassuring to patients and carers to see the planned care, surveillance andsupport, they then know what to expect and when.Helps avoid duplication of referral if the patient visits the GP betweenappointments and is unsure of who is involved in their care. Particularlyuseful in respect social care referrals and whether the patient is known toother agencies. Can help to reinforce the importance of attendingappointments with other agencies. Useful to also include details related tothird sector support and centres such as Maggie’s if available.DDEEED
Required GP actions including medicationetc<strong>Cancer</strong> Care Review<strong>Summary</strong> of information given to thepatient about their cancer and futureprognosisAdditional Information given includingissues relating to lifestyle and supportneedsREAD CodesTo provide clarity on the expectation of GPs in respect of the patients ongoingcare and how they can support them. Also provides prompts e.g. toadd patients to routine screening programmes to help mitigate late effectsof treatment. Patients will be more empowered to approach GPs if theyrequire further advice and support. Can give specific request to GPs toensure continuity of care and avoid ambiguity. Provides GPs with guidanceand advice on which drugs if any need stopping and when and whetherany adjusting between follow up appointments or following discharge. Mayavoid inappropriate prescriptions, overdose or misuse. Particularlyimportant if the GP is going to continue to prescribe long term i.e.endocrine manipulation. Patients will also know what to expect from GP.Inclusion of this reminder helps ensure the patient is entered onto theregister and that they are formally reviewed by the GP within 6 months ofdiagnosis. This is a requirement for QOF points within all general practicesSharing information on what has been discussed with the patient and theircarer improves the quality and openness of the discussion that the GP canhave with the patient.To confirm which lifestyle advice has been given or signposted and detailsof local support groups and psychosocial support, complementarytherapies, returning to work advice etcGP READ codes are similar to hospital HRG codes and used to identifydiagnosis, tests and treatments. Both are complex systems and requiremanual input. Inclusion of the READ codes in the TS prompts andencourages GPs to accurately code patients. This helps improve patientsafety in terms of surveillance, disease tracking and audit. It is theresponsibility of the GPs to assign the appropriate codes and enter on theirsystems. Note Codes may differ depending on GP IT system in useEDE*DD
Page 6 and 7: GP READ CODES - CANCER (For GP Use
Page 10 and 11: Treatment Summary Example Appendix

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