Acute Lymphoblastic Leukaemia is the most common type of childhood cancer, accounting for 25% of all childhood malignancies. GOSH manages up to 150 children at any one time who are in the maintenance phase of this chemotherapy treatment. The majority of this therapy is delivered in the shared care centre, which is the patient‘s local paediatric unit, and GOSH must liaise with each centre in a time-sensitive fashion, in order to ensure uniform, excellent care is delivered to the patient locally. We ‘share care’ with up to 30 units, posing some challenges in ensuring uniform and equitable service delivery and ensuring ease of access to our haematology department for ongoing advice and support during this complex phase of therapy.
We have developed an innovative approach to coordinate treatment with our shared care centres, by setting up a regular monthly ‘virtual’ multi-disciplinary team meeting by teleconference, between ourselves and the shared care centre. The meeting is attended by medical and nursing representatives from GOSH, and the lead consultant for the service at the shared care unit, and other members of the team, including paediatric oncology and local community nurses representation. We discuss the management of each child currently receiving treatment for Acute Leukaemia, and send an electronic record of the meeting to each unit involved.
This has been very positively received, not only as a tool to ensure excellent care is coordinated and documented across multiple sites, but is also very time efficient, being able to discuss all patients in one meeting. It has built excellent relationships between GOSH team members and local paediatric teams and provided an excellent forum for ongoing education, teaching and general discussion on the management of these patients. and is very reassuring for families to know we are all in regular communication about their child’s treatment.
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