UK Clinician update: Friday 8th May

Friday May 8th

As the country is entering a period of restoration in cancer services, our teams at GenesisCare are here to support you and your patients with fast access to cancer diagnostic pathways for urology and breast cancer, clean and seamless pathways to radiotherapy and chemotherapy, including our MR Linac and SRS service. The safety of staff, doctors and patients is our number one priority at GenesisCare and for that reason we have been running weekly swab testing for staff and doctors onsite, which we will extent to all patients from next week.

Our centres are equipped with appropriate PPE to cover all settings and procedures and you should feel its necessary, face to face clinics and procedures are safe to do on site. We encourage our staff and our doctors to take advantage of the video consultation platform, Telehealth, which we have introduced for consultation and MDTs in order to minimise patient footfall in the centres to protect vulnerable patients and staff. Our research and clinical trial team have put together a proposal for the gradual re-introduction of essential clinical trials, following government guidance.

Resources

Click here; NEW Doctor Hub

Access to our latest innovations, protocols and governance and our business and clinical updates.

Click here; NEW Podcast – COVID-19 and the future of healthcare

James McArthur, UK General Manager chats with Australian – UK Chamber of Commerce.

Looking into the future

  • Our Horizon portal will shortly be introducedfor Clinical Oncologists which will enable you to easily and securely book patients for treatment by selecting existing evidence-based clinical protocols in a script format
  • The Doctor Hub,hosted on our website has gone live this week, giving you access to our latest innovations, protocols and governance and our business and clinical updates
  • On the 11th of May, we are going live with the first breast cancer eMDT, this is a fantastic step forward to improve our patient quality of care, thanks to all of you, our expert clinical reference groups and the service development teams who have supported the project

Updates on SACT treatments endorsed by NHS England 

NHS England has approved some amendments to the systemic anticancer chemotherapy regimens and delivery of those, whilst we are still in the phase of patient shielding for the next 12 weeks. You can find the guidance in the link below.

It is important that you incorporate Covid-19 into your discussions with patients when you consent them for treatment. The general patient risk for catching Covid-19 in the community (around 3%) will apply to any patient who is coming to our centres, due to travelling involved and other environmental exposures. The risk to individual patients may be higher than that depending on their condition and treatment they are receiving.

SACT interim options during Covid-19 

Radiotherapy at GenesisCare

We continue to offer the standard GenesisCare protocols as well as hypofractionated protocols, guided by clinicians. We have incorporated the 26Gy/5# breast protocol ahead of the publication of the Fast Forward trial results and as directed by the RCR.

You can view the Fast Forward trial results paper here

Staff and patient testing for SARS-CoV-2

We’re committed to keeping our teams and patients safe during SARS-CoV-2 pandemic and beyond, by delivering systematic rapid access testing for our clinical teams and patients.

The testing program approach started on the 23rd April for asymptomatic staff and doctors who work in our centres. We’ll also test asymptomatic patients from 15th May. In the meantime, we test all patients and staff who present to our centres with symptoms (on-demand testing) using:

  • The laboratory-based reverse transcriptase Polymerase Chain Reaction (RT-PCR)
  • Nasal and throat swabs are taken in centre for PCR testing or kits can be sent home and we will arrange courier service to the lab at our cost

Asymptomatic patients

  • On chemotherapy– testing will be done no longer than 6 days prior to each chemotherapy cycle. Patients will get tested weekly or 3-weekly or depending on the chemotherapy schedule
  • Radiotherapy– patients will get tested prior to fraction 1 and midway through patient treatment if the radiotherapy schedule is ≥3 weeks
  • Haematology patients– testing follows the same principles as with chemotherapy patients
  • Diagnostic patients – will be screened through questionnaires and temperature checks as per our standard procedures

Symptomatic patients

PCR swab testing will take place for patients who are symptomatic. Ideal testing time is around 5 days from symptoms but could be anytime the patients are presented with symptoms. Patients should self-isolate until the PCR swab tests are back and the decision to continue or postpone treatment will be determined in consultation with their referring clinician.

Any patient with positive PCR swab test results will be required to isolate for a minimum of 7 days. During this time the GenesisCare Chief Medical Officer will discuss options with their consultant, including carrying out a virtual MDT to determine best course of treatment.

A further PCR swab test will be carried out after 7 days. Depending on the results, the patient may be treated or is required to continue isolating.

Antibody (Ab) testing

A validated antibody testing will soon be introduced to the above protocol for (a)symptomatic staff and patients, to complement the PCR swab test. The protocol for testing is currently subject to ethics approval and will be shared once it is approved.

Clinical evaluation of CT scans: recognition and escalation of incidental findings suspicious of Covid-19 infection

All patients who attend for a diagnostic CT scan that includes the thorax and base of lungs and all patients on treatment for breast cancer, lung and mediastinal cancer, oesophago-gastric, liver and pancreatic cancers who receive CBCTs during treatment (or on MRL), will be informed at CT consent or prior to fraction 1 of radiotherapy, that incidental findings suggestive of Covid-19 infection may be found on lungs/lung bases and appropriate steps will be taken as follows.

When reviewing the images radiographers look for characteristic appearances: peripheral or patchy ground glass opacification. If these appearances are seen the radiographer must consult a radiologist while the patient is still on the scanner and essential steps will be taken.

Recognition and escalation of incidental findings suspicious of Covid-19 infection policy

UrologyHub and One Stop Breast Clinic 

This week we’ve launched further diagnostic services across the network that use world-class clinical protocols and are designed around rapid access pathways that cover every stage, from diagnosis to survivorship. Gold standard feedback has been received from patients – thank you and amazing work to the teams that have been involved in the launch’s of the services.

The diagnostic services are also being supported by a range of marketing activities including digital and social media advertising campaigns, a GP email campaign, a range of new printed and digital content plus other channels to be added soon! See some of the creatives below.

“I think the fact you see patients so quickly is absolutely fantastic – I didn’t even have time to worry about my upcoming appointment as it was booked in so quickly. I’ll definitely be recommending GenesisCare to anyone who may need the service.” Patient, Milton Keynes

One Stop Breast Clinic will enable patients to receive same-day diagnostic testing for breast cancer followed by seamless progression to comprehensive breast cancer treatment if needed.

  • Symptoms; lumps, swelling, redness, change in size or shape the breast, nipple changes including inversion, discharge, a rash or crusting, skin puckering or dimpling and persistent pain in the breast or armpit
  • Family history
  • Further testing outside of routine mammograms

Appointments can be made within 24 hours at Maidstone, Milton Keynes and Cambridge, in may cases results will be received on the same day.

Coming in May to…
Windsor and Oxford

Payment options
A call may be required to the insurer for authorisation or a GP referral letter may need to be issued, depending on the provider. Self-pay options are also available.

  • Bilateral mammography from £210
  • Ultrasound from £290

UrologyHub offers fast and easy access, to expert urologists and diagnostic services for a wide range of urological health conditions for men and women, including:

  • Cancers
  • Chronic cystitis
  • Enlarged prostate
  • Erectile dysfunction
  • Kidney and urinary stones
  • Lower urinary tract symptoms – such as urinating more often or at night, weak urine flow or urine retention
  • Urinary incontinence
  • Vasectomy pain or reversal

Appointments can be made within 24 hours at Windsor, Oxford and Cambridge, in many cases results will be received on the same day.

Coming in May to…
Maidstone and Milton Keynes

Payment options
A call may be required to the insurer for authorisation or a GP referral letter may need to be issued, depending on the provider. Self-pay options are also available.

  • Consultation from £225
  • Ultrasound from £290
  • CT scan from £400
  • MRI from £450

As always, any questions or comments don’t hesitate to contact me personally.

James McArthur

General Manager – UK

Penny Kechagioglou 

Chief Medical Officer – UK


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