1324 The implementation of a home chemotherapy service—a collaborative project between hospital and community

The home chemotherapy service was initiated as the result of a Jomt project between Wandsworth Health Authority and the hospital based Oncology team. The aim of the project is to improve the quality of life for cancer patients by: (i) reducing time spent at the hospital, thus avoiding travelling and parking difficulties and preventing, long waiting times in outpatients and pharmacy, (ii) improving the quality of patient care through collaborative working with the primary health care teams (PHCT). The project is co-ordinated by the oncology specialist nurse. The post holder is based primarily at the hospital with the multidisciplinary oncology team whilst maintaining close links with the PCHT. Components of the role at home include assessment, pre-treatment blood counts, cannulation bolus or infusional chemotherapy and platelet transfusions. Community link nurses are being established and education sessions related to cancer topics are provided in the health centres. Detailed verbal explanations regarding disease and treatment are given which are reinforced using an individualised patient guide which includes details of the 24 hr on call telephone service. The General Practitioner is contacted prior to visiting the patient at home. Safety issues addressed include safe transport, handling and disposal of cytotoxic waste together with the management of extravasation and possible anaphylaxis. This collaborative working practice is a model demonstrating a seamless service for people with cancer and their families providing optimum access to expert care. The project is being audited by patients and the PHCT in order to assess the service and to make recommendations for the future.