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Enhanced quality and productivity of long-term aftercare of cancer in young people
  1. Adam Glaser1,2,
  2. Gill Levitt3,4,
  3. Patricia Morris4,
  4. Judi Tapp4,
  5. Faith Gibson5,6,
  6. On behalf of the Children and Young People workstream of the National Cancer Survivor Initiative (NCSI), UK
  1. 1Department of Paediatric and Adolescent Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2Cancer Policy team, Department of Health, London, UK
  3. 3Department of Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  4. 4NHS Improvement, Leicester, UK
  5. 5Great Ormond Street Hospital for Children NHS Foundation Trust and London South Bank University, London, UK
  6. 6Children and Young People's Workstream, National Cancer Survivor Initiative, London, UK
  1. Correspondence to Dr Adam Glaser, Department Paediatric Oncology, D Floor Offices, Martin Wing, Leeds General Infirmary, Leeds LS1 3EX, UK; adam.glaser{at}


Introduction Long-term morbidity associated with survival from childhood cancer is well defined. Traditional models of hospital-based long-term aftercare are not sustainable and may not be necessary for all. A programme to support development and implementation of redesigned care pathways is reported.

Method Application of service improvement methodologies to identify the case for change, to evidence development of, and test, new aftercare pathways.

Results Four models of aftercare were identified; traditional cancer centre-delivered medical follow-up, shared care with local hospitals or primary care, specialist nurse-led supported management and self-management. Key components required for successful implementation of risk-stratified care included; comprehensive information transfer with treatment summaries and care plans, provision of care coordinators, effective transition across services, remote monitoring systems, educating professionals, maintaining patient choice.

Conclusions Adoption of risk-stratified evidence-based aftercare pathways, generated through application of service improvement methodologies, can result in the delivery of enhanced quality and productivity.

  • Oncology
  • late effects
  • models of care
  • service improvement

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