111 Specialist neuro-oncology community therapy services: addressing inequalities and gaps in service provision

Abstract Introduction Patients with high-grade brain tumours experience rapid and unpredictable disease progression which comes with complex supportive care needs. Despite a specialist multi-disciplinary outpatient clinic at Velindre Cancer Centre, patients often have ongoing community-based needs. However no dedicated services exist with the specialist skills and knowledge required, resulting in inconsistent and inequitable service provision, increased risk of hospital admissions, and reduced quality of life (QoL). Methods A 4-week pilot was designed to provide specialist OT and physiotherapy for patients known to the existing outpatients service. A range of validated outcome measures were utilised to evidence pre and post QoL (EQ5D5L), function (AusTOMs) and falls risks (TUGS Cognitive). Patient experience information was also collected via a Likert Scale. Results A comparison of pre and post QoL data (EQ5D5L) demonstrated a percentage increase within all domains from 11% (usual activities) to 37.5% (pain). Percentage improvements in activity, participation and patient well-being were demonstrated with AusTOMs. Patient questionnaires rated experiences as excellent throughout with qualitative data highlighting the positive impact on both patients and carers. All patients (n = 6) were identified with AHP needs that would not have been identified without outreach assessment being completed. Conclusion The data from the pilot demonstrated improvements in both QoL and function. Very high falls risks were identified with all patients and the pilot enabled individualised, specialist interventions to avoid admission. The majority of referrals were needed at a later stage than anticipated, indicating the need to review current service provision which focuses on functional optimisation in preparation for and during treatment. All patients required onward referrals for equipment and services that would otherwise been missed, with further unmet needs identified for speech and language therapy and dietetics.