Delivery of Herceptin® at home saves £365k

Aim:
To develop a service model that enables Herceptin® (trastuzumab) to be given (where appropriate) to patients with breast cancer in their home environment rather than in the hospital day case unit. This work is with the teams at Heart of England NHS Foundation Trust, Sandwell and West Birmingham Hospitals NHS Trust and University Hospitals Birmingham NHS Foundation Trust with a view to testing the concept, acceptability and effectiveness of such a service.

Key areas of achievement:

• Patient choice is enhanced as they can now have receive their Herceptin® in their home.
• Patient feedback from those using the service stands at 100% satisfaction (March 2011).
• Greater understanding of reasons for some patients not wanting to have home therapy e.g.

1. Preferred the support of the unit
2. Children/ family at home
3. Concerns over venous access
4. Keep treatment and home life separate
5. Didn’t want neighbours to know they were having treatment
6. Gets them out of the house

• Good links and effective working relationships have been established between NHS and non-NHS organisations.

Enhancing patient choice by enabling patients to receive intravenous (IV) chemotherapy at home

Aim:

To develop a service model that delivers appropriate IV chemotherapy drugs to cancer patients in their own home or community setting via a private provider whilst maintaining close links to their oncologist.

Key areas of achievement:

• Formation of a list of appropriate drugs for home or community delivery agreed by consultants and pharmacists.
• Resolution of information governance issues that enabled sharing and secure transfer of patient identifiable information.
• Mapping of new pathway.
• Production of appropriate documentation that bridged the public and private providers (e.g. referral, patient information leaflet, pre-chemotherapy discussion, out of hours pathway, shared drug protocols).
• Tested new pathway with haematology and oncology patients.