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Managed local follow-up of long term cancer survivors: ADAPT

What are we trying to do?

An innovation in the management of long term cancer survivors has been implemented at The Christie NHS Foundation Trust,  in Greater Manchester (ADAPT). Under the previous way of working, patients had an annual review held at the hospital. Under the new ADAPT way General Practitioners (GPs) are encouraged to monitor patients in a primary care setting.


This study seeks to examine the cost consequences of the ADAPT scheme in primary and secondary care.


Why is it important?

Over 1.8 million people in England are living with and after a cancer diagnosis and the number of cancer survivors is increasing at a rate of 3% per year. One consequence of this is that the later effects of treatment (such as cardiovascular disease, musculoskeletal complications, endocrine effects and secondary cancers) are becoming more prevalent. These consequences require effective management to maximise quality and duration of survival after first cancer cure. However, traditional hospital follow-up for patients with curable cancers focuses on disease recurrence - which is rare beyond 5 years – with limited focus on the consequences of late treatment toxicity. 


How will we do it?
The study will comprise two work packages:


Work Package 1 Examining the impact of ADAPT on activity at the Christie hospital:

  • The impact of ADAPT on activity at the Christie hospital will be assessed by examining the number of clinic appointments that have been opened to other uses as a result of patients being managed in primary care, and how these resources have been otherwise utilised. Standard health economic approaches typically measure such impacts in terms of the benefits of the alternative use of resources. An assessment of activity from patients under the ADAPT scheme will also be conducted – this will inform the net impacts on the hospital. 


Work Package 2 – Estimating the consequences of the ADAPT scheme on overall primary and secondary health care costs:

  • The potential impacts of implementing ADAPT on the healthcare system are unclear, the transfer to primary care may result in better management of complications and resultant reductions in secondary care activity, alternatively, if reviews are not conducted, there is the potential for greater complications and associated activity. This study will use individual-level data on health care use and patient/provider characteristics from the integrated care record, a contact-level data source providing longitudinal information on a range of measures of health care use, and clinical and administrative information.


Who are we working with?


For more information:
If you woudl like to know more about this work, please contact Ross Atkinson (Programme Manager)