What I Do: A day in the life of the Community Head and Neck Cancer Team

CHANT (Community Head and Neck Cancer Team) work together to bring specialist care and rehabilitation closer to the patients’ homes. They share with us what a typical day is like for them.

Tuesday 9am the weekly CHANT multi-disciplinary team caseload meeting kicks off to discuss our current caseload and new patient referrals.

Last week we were made aware of a patient called Joe when we attended the ward discharge meeting at Guys. Joe was discharged home yesterday following a 3 week stay in hospital. As a result of his head and neck surgery Joe now breathes via tracheostomy tube in his neck; he has swallowing difficulties and requires supplementary feeding via a tube in his stomach.

Nipa our physio and Hannah our speech and language therapist agree to visit Joe en route to one of the 9 CHANT community clinics, to ensure he has all the appropriate airway management equipment and he is confident and competent in using them and thus safe in his own home.

Nipa texts Joe to let him know of our arrival time (he is unable to speak because of his tracheostomy).

Meanwhile the caseload meeting is interrupted by Erica our administrator. She has picked up a call from a distressed patient reporting that her nasogastric feeding tube has been dislodged for the 5th time. She feels too exhausted to go to her local A&E department to have this replaced. Erica has reassured the patient that Mary one of our dietitians will phone her back this morning with a management plan. Mary leaves the meeting to investigate.

The meeting highlighted two new patients completing six weeks of chemoradiation on Friday. They are booked into next week’s post treatment clinic at Guys hospital to see our Dietitian and a Clinical Nurse Specialist (CNS), to provide early intervention of acute treatment related toxicities thus preventing admission to hospital.

Nipa and Hannah drive the 8 miles, almost an hour in London traffic to see Joe at home. All equipment is checked and the suction machine is found to be broken. Nipa calls the District Nurse who agrees to provide a new suction machine later today.

After a lunchtime pit stop Nipa and Hannah arrive at the Clinic which is in a GP Surgery and therefore allows closer to home care.

Patients are often unwell after treatment so they value not having to travel so far to the main Centre.

It’s a jam packed afternoon with a good mixture of patients at different points throughout their rehabilitation. Lets talk about two of them.

Yvonne our dietitian is waiting to see the first patient. He highlighted in his previous Holistic Needs Assessment that he is feeling isolated because he can’t go out to eat with his friends and feels a sense of loss because of this. He also reports feeling weak and fatigued and increasingly reluctant to leave the house. Nipa focuses on mobility and fatigue management — helping Chris to come up with his own SMART goals and providing written information. Yvonne and Hannah focus on optimising nutritional intake and swallow ability. They also provide suggestions for suitable food choices and food preparation techniques which may help his eating. They suggest that he may like to attend one of our Food Groups at a later date (these focus on food choice, restaurant menu choices, and social interaction around food and other patients) along with a referral to our CNS who may discuss psychosocial issues and coping mechanisms.

The next patient has met all his goals and is ready for discharge.

He is referred to our next Living with and Beyond Cancer Day which promotes a healthy lifestyle, self-management and early identification/prevention of further disease to empower the patient.

In between patients they have phone calls, emails, case discussion, with regular communication between the admin team back to base.

The South East London Community Head and Neck Cancer Team (CHANT) is a unique multidisciplinary community specialist rehabilitation team supporting patients with head and neck cancer.

Launched in 2010, this Lewisham and Greenwich NHS Trust service working as a partnership arrangement with Guys and St Thomas’ NHS Trust, prides its self in providing seamless care from hospital to home and optimising rehabilitation potential for those who are living with and beyond head and neck cancer.

Patients are seen in local clinics, or at home (depending on clinical need) to help them reach their potential in recovery.

CHANT utilise the holistic needs assessment tool to facilitate patient led care and offer a health and wellbeing event at the end of their rehabilitation.

Hannah is a Speech and Language Therapist, Mary and Yvonne are Dietitians and Nipa is a physiotherapist who along with other allied health professionals, assistants and administrators in the team provides multidisciplinary support, symptom control, advice and specialist rehabilitation for patients who have undergone treatment for head and neck cancer.

CHANT is the only comprehensive service of its kind in the UK, bringing specialist care and rehabilitation closer to the patients’ home.

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