1. MACMILLAN AFTERCARE REHABILITATION TEAM (MARS) Anne Hope Head and Neck CNS.

3. Background to MARS Lack of local specialist aftercare services in Surrey/Hampshire/Sussex Non- compliant with National /local policies and guidelines, e.g. (NICE, 2004) Post treatment HNC patients lacked local support in rehabilitation and support following treatment. Number of cancer survivors growing Inconsistent access to support services and specialist follow up across cancer alliance.

4. AIMS OF THE MARS TEAM To provide a multi-disciplinary, holistic specialist service to HNC patients and their families throughout follow up. To provide follow up closer to patients home. To promote self management in a supportive environment and facilitate/sign post to local support services. To meet national and local policies and guidelines on cancer survivorship and rehabilitation.

5. MARS OBJECTIVES Improve patient and career experience. Facilitates patient choice. Reduce avoidable / inappropriate hospital admissions. Reduce post surgical treatment complications, e.g. chest infections/tube site infections. Reduce oral and enteral nutritional supplementation through SALT/dietetic. Proactive support for laryngectomy patients reducing emergency laryngectomy replacements and support self management of laryngectomy and stoma.

6. Planning of MARS Discussions with local PCT’S Time line devised on clinical activity and need. Models of potential teams devised Support and funding obtained from Macmillan Cancer Support Steering group commenced. Discussions with commissioners.

8. NEW PATIENTS REFERRED FOR TREATMENT TO CANCER CENTRE (Surgery/Radiotherapy/Chemo-radiation /palliative care) Palliative Care Surgery @RSCH RT/CRT Followed up at centre 3/12 PORT/CRT Palliative Treatment @RSCH No further treatment – refer to MARS Disease recurrence –refer to MDT @RSCH On completion of palliative treatment refer to MARS / Local Palliative care services

9. Benefits of MARS More effective clinics at Cancer Centre. Improved patient/carer experience. Multi-disciplinary team approach for rehabilitation and cancer survivorship locally. Reduced admissions for SVR emergencies. Reduce rate of feeding tube infections. Reduction in the cost nutritional supplements in the community.

10. CHALLENGES  Funding  Fixed term contracts  Band 4 role  Referral to MARS  Clinic space  Continuity/productivity of clinics in locality

11. What would we do differently? Team leader ? Avoid fixed term contracts Tariff based? Include nurses in team. Include admin role.

12. THANK YOU Any Questions ?