What were we trying to do?

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

 

This study examined the cost consequences of the ADAPT scheme in primary and secondary care.

 

 

Why was 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 did we do it?
The study comprised 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 was assessed by examining the number of clinic appointments that had been opened to other uses as a result of patients being managed in primary care, and how these resources were 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 was also done – this informs 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 were unclear, the transfer to primary care could have resulted in better management of complications and resultant reductions in secondary care activity. Alternatively, if reviews were not conducted, there was the potential for greater complications and associated activity. This study used 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.

 

 

Findings

Findings from this study will be added in due course

 

 

Who did we work with?

• The Christie NHS Foundation Trust

 

 

More information
 

 

 

Programme Manager​​​​​​
Gill Rizzello
gill.rizzello@manchester.ac.uk