Author Archives: Caitriona Higgins

Prof Niall Davis discusses robotic partial nephrectomy in Beaumont Hospital and the benefits for patients

The ‘‘gold standard’’ treatment for surgical management of small kidney cancers has shifted from radical nephrectomy (i.e. total nephrectomy) to robotic partial nephrectomy (RPN). RPN is designed to provide minimally invasive nephron sparing surgery and is technically feasible with the Da Vinci robotic platform. Wristed instrumentation and three-dimensional vision facilitate excellent ergonomics for resection and renorrhaphy; decreased warm ischemia time while preserving oncologic outcomes.

Robotic kidney surgery was introduced to Beaumont in 2020 and approximately 125 robotic kidney cases have been performed to date. Most of these cases are robotic partial nephrectomy for kidney cancer. Given its comparable oncologic outcomes to open surgery and improved patient safety; robotic assisted partial nephrectomy is an exciting innovation that will benefit kidney cancer patients attending Beaumont Hospital for the foreseeable future.

Key Roles in the management of Upper Gastro Intestinal cancer at Beaumont RCSI Cancer Centre

With the spotlight on Upper Gastro Intestinal (UGI) cancers this month we focus on some of the key roles in our expert service at Beaumont RCSI Cancer Centre. Our patients  have access to experts in advanced endoscopic techniques, minimally invasive surgery and structured enhanced recovery programmes and our team of experts continues to grow.

My name is Wendy Hickey. I have recently started working in the role of Registered Advanced Nurse Practitioner (RANP) within the Upper Gastrointestinal (GI) Surgical service here in Beaumont Hospital after completing my MSc in Advanced Nursing Practice in UCD. My role focuses on surveillance and survivorship of for upper GI cancer patients who have completed the active phase of their cancer treatments. I bring my experience of working in Medical Oncology, in St Anne’s ENT/Head and Neck oncology and as an Upper GI CNS for over 12 years to the service. Optimising these patients quality of life and encouraging them to live well beyond their cancer diagnosis is the essence of my new role! I look forward to bringing my experience and knowledge into this new role having worked as the Upper GI CNS for over 12 years within the surgical service.

We are the two Upper GI Cancer Clinical Nurse Specialists (CNS) in Beaumont Hospital, Claire Coleman and Julie Anne Pereras. Within our role we act as the patient’s core link and aim to provide a seamless service for patients diagnosed with Upper GI Cancers. We co-ordinate appointments for all relevant out-patient clinics. We also provide support, guidance and advice to patients and their families both in person and via the phone. We encourage patients and their families to contact us directly in the event of any problems or concerns which we can address directly with the team as necessary. We strive to provide an efficient, effective high quality service whilst representing the needs of the patient. Over recent years we and our ANP Wendy have been involved in many improvements to the service. A significant advancement was the implementation of the Enhanced Recovery After Surgery (ERAS) Pathway for Oesophagectomy and Gastrectomy patients. ERAS is an evidence based multidisciplinary approach designed to decrease the time it takes to recover after surgery, reducing complications along with improving the surgical experience.

The dietetic team specialising in Upper GI Cancer in Beaumont Hospital is growing.  2023 saw our new Senior Dietitian Lynn Fagan join the team, working alongside Linda Moore, Senior Dietitian and Cathy White Clinical Specialist Dietitian.  The newly expanded dietetic service to patients with oesophageal or gastric cancer in Beaumont Hospital now spans from diagnosis, throughout oncological and surgical treatment and into survivorship.  Patients have access to a dietitian in both the outpatient and inpatient setting.  Our role involves providing evidenced based nutritional interventions: we help patients to maximise their nutritional status before treatment, support them with advice and nutritional interventions during treatment and surgery and advise on best dietary strategies to use to adjust to life after surgery and into the longer term. The dietetic team work closely with the other members of the Upper GI Multidisciplinary Team to develop the service and improve patient experiences and outcomes.  In 2023 Cathy was a key speaker at an Oesophageal Cancer Fund (OCF) Patient Support Meeting and the dietetic team have led research and audit presented both nationally and internationally on nutrition and Upper GI cancer over the last number of years.

My name is Orla Brett and I am a Physician Associate in Beaumont Hospital. I commenced this role as part of the upper GI surgical team in 2019, having completed my MSc in Physician Associate Studies in RCSI, Dublin. I have been working in this specialty for almost 5 years, which has absolutely flown by. My role has established and evolved over the years involving a variety of tasks and responsibilities. I am trained as a robotic first assistant for major UGI surgeries including oesophagectomy and gastrectomy for our cancer patients. I assess, manage and follow up patients in our surgical outpatient department with support from my supervising consultant, Mr Robb. I liaise with patients in their peri-operative phase, communicating with GPs and other necessary hospital specialties. I believe I have become an integral part of upper GI team and a point of contact for staff, students and patients. I enjoy being a familiar face to our patient’s who are often seen by our service for over 5 years for cancer surveillance. I take pride in helping our new team during NCHD changeover by providing continuity of care within our service. Navigating a new role in the healthcare system can have it’s challenges, however, I am delighted with how my role has evolved as a physician associate on the upper GI team and hope I continue to provide continuity going forward. 

Advanced Endoscopic Techniques improve Patient Outcomes

My name is Professor Danny Cheriyan, and I’m a Consultant Gastroenterologist in Beaumont Hospital. I work in all areas of gastroenterology but I have a special interest in advanced endoscopy. One of the procedures that I’m particularly interested in is Endoscopic Submucosal Dissection (ESD).

ESD is a minimally invasive endoscopic procedure that is performed under general anaesthesia. I use a flexible tube called an endoscope to see and treat early cancers of the upper gastrointestinal tract (oesophagus and stomach). This procedure allows for a lesion to be removed in one piece, without the need for removing a large part of the oesophagus or stomach. This results in a much shorter procedure, shorter length of stay in hospital (typically 1 day), and a much easier recovery for the patient (compared to major surgery, which involves a 12 to 14 inpatient stay). Most importantly, patients have their natural anatomy intact after the procedure.

Beaumont Hospital is currently the only hospital in the country performing ESD. We began this procedure 2 years ago and have performed it successfully on over 30 patients. To further advance our skills and patient care, I will be undertaking a short sabbatical in Japan this year, to train further and gain more experience with this advanced technique.

 

The Cancer Patient Partnership Working Group visit with RCSI Researchers

Cancer Research covers a broad spectrum from prevention to treatment and beyond. Making sure patient perspectives and experience guide the research agenda means that it has more value and relevance for patients as well as making it more meaningful for researchers. Members of the The Cancer Patient Partnership Working Group (CPPWG) joined researchers in the RCSI lab in St Stephens Green who are looking into treatments for metastatic breast cancer,  It was an very informative and enjoyable visit allowing us to see how lab based research is carried out and to ask questions and to exchange ideas with the researchers. 

Anne Mynes – Patient Partner and Co-Chair of the CPPWG, “For me, the visit to the lab was a mixture of nostalgia for my early days in research in the 1980s, pride in seeing our young women actively investing their time in science and research , and hope that this investment will lead to better outcomes for all cancer patients.”

Vicky Lunt – Principal Clinical Psychologist – “I left the lab feeling reassured that there are world class trials ongoing in Ireland.  I am not sure how many people are aware of just how much passion and focus goes into the work of these researchers.” Vanessa Fay- Patient Partner. “My experience was that I was amazed by the level of research that was going on behind the scenes. As a former patient it was very comforting seeing that there were teams of people working on potential treatments right here in Dublin. It was fascinating to see the imagery on screen. Cancer treatment is simplified from doctor to patient. Take this medicine and you will get better… maybe… But seeing this gave me more faith in the treatments we are prescribed.” 

Victoria and Vanessa

Dr Petra Jagušt PhD, Irish Cancer Society Research Fellow – “The Endocrine Oncology Research Group puts patients at the centre of the research and it was our pleasure to host the Cancer Patient Partner Working Group (CPPWG) at RCSI. This visit was a great opportunity to hear patients’ experiences and insights which I am looking forward to including in my future research. The CPPWG visit has given me a new sense of perspective and reinforced my drive to make a difference. I am looking forward to our future collaborations.”

Louise, Aobhinn, Petra

 Louise Watson and Aoibhin Powell, PhD Students: “We really enjoyed the visit. It was a great opportunity to demonstrate some of the research we do in the lab. We had some very engaging discussions about our research and the impact that it can have. It was a privilege to gain a deeper insight into the vital role of patients in research and the importance of the connection between researchers and patients. “

 

 

Investigating the need for a Nurse led Pre Treatment Clinic for Blood Cancer Patients

My name is Laura Kiernan and I work as a Clinical Nurse Specialist (CNS) in Haematology. The main focus of my CNS role is to provide support and education for patients with a new diagnosis or relapsed haematological malignancy (blood cancer), such as Multiple Myeloma, Leukaemia or Lymphoma.

Throughout 2023, I reviewed 205 patients who were commencing treatment in the Haematology Oncology Ward. Some I met with their family before commencing treatment, others I managed to meet on the day of starting treatment – with or without their family. I provide patients with both verbal and written education about their diagnosis, planned treatment schedule and side effects. I also provide them with information about support services within the hospital and in the community and made any relevant referrals at this time.

In September 2023 I decided to ask patients about their experience of how they received information, to find out if attending a pre treatment clinic with a specialist nurse would be of benefit to them. I presented my idea to the Cancer Patient Partnership Working Group. This is a group of patient partners and staff who work together on various on projects. They gave me great advice on the type of questions to ask  in my survey and on changes I should make so it was easier to read and understand.

I sent out 30 surveys and received 19 back. The feedback was very positive, with an overwhelming agreement that meeting a CNS at the beginning of treatment alleviated anxiety and allowed time for questions. Most agreed that a dedicated, separate appointment to meet a CNS before treatment begins would be beneficial. There were also some other suggestions that I had not considered, and this has helped me to plan other improvements of the service I provide. These include:

  • Develop a pre-treatment nurse specialist clinic – This clinic will be held on a date before treatment and will be used to provide education about the drugs, side effects and support services available for patients and their family. Referrals to appropriate teams members will be made. Ideally at this appointment, patients could have any outstanding tests performed, and any prescriptions provided to them, to minimize stress on the first treatment day.
  • Develop an End of treatment summary – This is something that came up as part of the feedback. Patients said that when they finish treatment it can be hard to remember all the details of the treatment they had. I plan to develop a treatment summary’ document that can be given to patients.
  • Add a follow up call to the patient plan of care – The majority of patients were in agreement that a follow up phone call with the CNS they had met, either 1 week, or 1 month after commencing treatment would be of benefit. It is at these times that new questions are formed, that weren’t asked at the beginning, or even new symptoms appear, and patients need additional advice and support. Referrals that were declined at the initial stages might actually be relevant at this stage also.

You can read a copy of the results from the survey by Click Here

Dr Daniel Ryan updates us on Innovative Endoscopic interventions for Lung Cancer Patients

The Lung Cancer Service offers swift access for patients with a suspicion of lung Cancer via the Rapid Access Lung Cancer Clinic and see 96% of referrals within 10 working days. However having swift access to diagnostics is just as important for our patients. The Beaumont Hospital Endoscopy Suite has 15 slots for Bronchoscopy and up to 8 for Endobronchial Ultrasound (EBUS) weekly, which means that our patients can have these diagnostic procedures done within 7 to 10 working days of booking them.

 

Dr Daniel Ryan, Respiratory Consultant in Beaumont RCSI Cancer Centre tells us a bit about some of the innovative endoscopic techniques used for diagnosis and treatment in Lung Cancer.

In 2023 a technique called Radial Probe EBUS was introduced. This now means that more peripheral lung lesions located beyond the reach of normal bronchoscopy or EBUS, can be sampled reducing the need for Percutaneous Biopsy.

Another procedure performed in the endoscopy unit, that benefits our cancer patients, are Indwelling Pleural Catheters (IPCs). Over 50% of patients with advanced lung cancer suffer the discomfort of pleural effusions. Management of this often requires prolonged inpatient stay.  With this procedure, we now insert indwelling pleural catheters as outpatients in the Endoscopy to alleviate symptoms, improve overall quality of life and allow patients to spend more time at home independently

We continually monitor and review the timelines from referral to diagnosis and treatment and the diagnostic and treatment interventions we carry to make sure we can provide the best service for our Lung Cancer patients.

Rozanna Hardie highlights the important role of the Laboratory in the Cancer Patient’s Journey

 

The laboratory in the Beaumont RCSI Cancer Centre is made up of many different departments, all of which at some point have a part to play in helping Cancer Patients through their journey from diagnosis, to treatment.

Rozanna Hardie, Business Manager in the Laboratory gives us an insight into how.

“Laboratories are made up of many different departments and look after blood, fluid and tissue samples. Here are some examples of where we are involved in with our Cancer patients.

Phlebotomy: All Cancer patients will meet our phlebotomy staff on a regular basis. Skilled phlebotomists minimise any discomfort to patients.

Sample Receipt: Medical Lab Aides perform all the pre-analytical preparation of blood, fluid and tissue samples so they are ready for analysis by our scientists.

Chemical Pathology: Here we can provide levels of certain tumour markers in a patient’s blood, we also provide results on various organ functions that indicate any side effects from treatment e.g. liver and renal function tests. Specialist testing can detect underlying cancers

Haematology: Clinicians are provided with details on a range of blood cells including platelets and haemoglobin which will indicate if a cancer patient requires a blood transfusion. Scientists here also perform specialised testing to diagnose blood cancers.

Blood transfusion: Scientists here ensure that the correct blood and blood products are dispensed for much need blood transfusions.

Immunology: Specialist antibody testing is provided by this department that can support treatment plans. Clinical Immunology are also responsible for providing Immunogloblin therapy.

Microbiology:  Infection is always a concern for cancer patients as many treatments leave them with weak immune systems. Microbiology staff play a vital role in checking patient samples for infection and where they find it making recommendations on treatments that will work on these infections.

Histopathology: This is where tissue samples are analysed. These are sent to diagnose a cancer or to find out the extent of a cancer after surgery and our Histopathologists attend all multi-disciplinary meetings with a patient’s entire team of clinicians.

Molecular pathology: Next generation sequencing is one of the more advanced techniques and is used to look at the DNA of the tumour sample. This is an essential part of supporting targeted treatment. This laboratory also provides a national service for neurological tumour molecular testing.

Patients are at the centre of everything we do, so ensuring excellent quality of procedures as well as making sure the highest standard of accurate results are available in a timely manner are important to all the staff here. Laboratory services see ever increasing numbers of samples arriving for analysis every year. Last year alone we provided clinical teams with over 20 million test results. We couldn’t do this without our team of Consultants, Scientists, Lab Aides and Administrators and support from the wider hospital. We are a fully accredited lab and continue to strive for excellence for all our patients (This means we meet all the safety and quality conditions that are required for a centre of excellence)”

 

The ADEPPT Clinical Trial opens in Beaumont Hospital

My name is Professor Jarushka Naidoo. I am a medical oncologist working in the Beaumont RCSI Cancer Centre and I am excited to announce that on November 9th we opened the ADEPPT trial in Beaumont Hospital. This trial, which is being run by ETOP-IBCSG clinical trials group, and locally by Cancer Trials Ireland focuses on providing access to novel targeted therapies for lung cancer, and to patients who are normally not included in clinical trials- to expand their reach.

Patients who are elderly with NSCLC (age over 70) or those who are unwell to start with (PS2) are often excluded from trials, but make up >40% of the population with lung cancer. KRAS G12C-mutant NSCLC is a specific type of lung cancer. Currently there are no approved targeted treatments for patients with this type of lung cancer.

The patients that will be invited to take part in this trial which involves treatment with Adagrasib are:

  1. Patients with KRASG12C-mutant NSCLC, including patients aged ≥18 years who have a poor functional status (ECOG PS=2) [Cohort 1]
    OR
  2. Elderly (≥70 years) (ECOG PS=0-1) Cohort 2

Opening and running studies like this would not be possible without the collective efforts of all members of the lung team, the molecular lab, and being part of a cancer centre that is reaching high in terms of advancing availability and access to Clinical Trials for patients.

For more information about the ADEPPT Trial Click Here

 

 

 

 

 

Breast Cancer – It’s not always a lump!

Jane is a patient of the breast cancer service in Beaumont RCSI Cancer Centre. Jane was diagnosed with breast cancer in 2022 and here she shares her story and important message:

“My name is Jane, I was diagnosed with breast cancer aged 46 and I’m telling you my story because I want you to know that you should see your GP if you notice any changes to your breast. Breast Cancer does not always mean finding a lump or detection by mammogram. I first noticed a small rash near my right nipple in September 2022. My GP thought it could be eczema, I’ve never had any skin complaints and when it didn’t improve she promptly referred me to the Breast Cancer Rapid Access Clinic in Beaumont Hospital.

When I first came to the clinic I met Professor Hill’s team, I was examined and quickly had a mammogram and ultrasound on that same day. Nothing showed up on these, given my age and the fact that I had no other symptoms and have no family history of breast cancer I felt very reassured. However, the importance of following up was impressed upon me. I was prescribed a steroid cream and given a follow-up appointment. Even though the rash improved it didn’t go away and so, after a further observation period, the team advised me to have a biopsy. This made me feel confident that all avenues were being fully investigated, I felt assured that I was ‘in the system’ and the team would soon have an explanation for the rash.

I was given the results of my biopsy in clinic and I was shocked to learn that my diagnosis was Paget’s Disease (which I had never heard of) with Breast Cancer (Invasive Ductal Carcinoma ER+, PR+, HER2+). At that same appointment I was given a clear plan for the initial treatment based on the histopathology report.  I learned about the MDT meetings and it was helpful for me to know that I was already scheduled for an MRI, which was followed by wire guided ultrasound and then a wide local excision of the area.

I recovered quickly from the Wide Local Excision and removal of sentinel nodes, which were clear of cancer, but the results of this and further MDT discussion helped me understand that there was a very small focus of invasive breast cancer in 3 parts of my breast which had proven difficult to locate by imagery and ultimately I decided with my team the best treatment for me was to proceed with a double mastectomy with immediate DIEP flap reconstruction which was scheduled within weeks. At all stages I felt hugely supported by the team in Beaumont in learning about my own diagnosis and was well informed about all decisions and options before and after my surgery and results. I was encouraged to ask questions. I took a lot of notes and benefitted from the MDT process and in-person consultations with familiar and very kind faces. I felt that a team of highly experienced and specialised experts contributed to my diagnosis and treatment plan.

My mastectomy and reconstruction in May was very successful. I have since undergone a course of Chemotherapy under Professor Patrick Morris and will continue with Herceptin treatment for a further period of time. With the support of my employer I am back to full time work.

I’m a survivor of breast Cancer. My message to others is to prioritise your own well-being and contact your GP if you notice any changes to your breast. It really is the most important form of self-care. I had no lump or other symptoms, no family history and would not be called to BreastCheck until 2026, yet I had breast cancer.

I have benefitted hugely from the knowledge and experience of Professor Hill’s team and will always be grateful to them and also to my husband Dan who encouraged me to see the GP initially and is always in my corner”

Breast Cancer Nursing Team

Anne Staunton, Breast Care Nurse: “I was Jane’s Breast Care Nurse, I am one of the six clinical Nurse Specialists in Breast Care and we meet our patients in the Triple Assessment clinics (TAC) and the review clinics.  My role was to be there for Jane at the time of her diagnosis and throughout her patient journey in Beaumont.  As with all my patients I provided Jane with my contact details so she could phone me directly with any questions about her diagnosis and treatment plan I could make sure she had all the information and support she needed”.

“All patients with cancer have their case discussed at a multidisciplinary meeting, these are held every week with Surgeons, Medical and Radiation Oncologists, Pathology and Radiology Consultants and the Nursing Team. Results of scans and pathology are discussed so that the best possible diagnostic or treatment options for patients can be made by the whole team. The results of these meetings were explained to Jane in clinic to help her make decisions about her treatment”

Beaumont RCSI Cancer Centre Breast Cancer Team

 

 

 

 

 

 

Meet the Nurse Specialists in Haematology

The Haematology Department in Beaumont looks after patients with blood cancers and other blood disorders. There is one Advanced Nurse Practitioner and five Clinical Nurse Specialists and we work with seven Haematology Consultants, their non consultant hospital doctors and a wide multidisciplinary team to support patients that come to our service either in St Teresa’s Haematology Inpatient Unit and the Coleman K. Byrne Haematology Day Unit.

St Teresa’s has fourteen individual isolation HEPA- filtered rooms and the Coleman K. Byrne Day unit has three consultation/procedure rooms and nine treatment chairs. We see and treat up to 45 patients every day and also have five outpatient clinics every week.

Throughout these areas, our team diagnose, manage, monitor and support haematology patients with a range of conditions by providing chemotherapy, immunotherapies, transplants and supportive treatments.

Particular areas of focus for Haematology CNS include:

  • Transplant (autologous and allogeneic)
  • Patient education regarding diagnosis and treatment
  • Linking patients with other members of the multidisciplinary team where this is needed e.g. social work, physiotherapy.
  • Support our patients throughout their diagnosis and treatment
  • Teaching other staff
  • Being a link for patients that need help and advice through the Telephone Triage service

A Bit About Us!

 

                  Aoife Mc Cormack                                                                     Frances Martin

We are Clinical Nurse Specialists and our role is to coordinate bone marrow transplants. The cell treatments that are available to our patients at present are autologous stem cell, allogeneic stem cell and CAR T cell therapies.

Autologous stem cell transplants are used as treatment in patients with multiple myeloma, amyloidosis and lymphoma. It is a process where once the patient’s condition is under control, we stimulate their bone marrow to produce stem cells and harvest them peripherally. The patient then receives these cells back as a form of rescue following high doses of chemotherapy with the aim of achieving a deeper/prolonged remission.

Allogenic stem cell transplants are used as treatment for various forms of leukaemia and lymphoma. This involves the patient receiving high doses of chemotherapy with or without radiation therapy to weaken their bone marrow, following that they receive stem cells which have been harvested from a matched donor. The aim is to replace the patient’s defective marrow with the donor cells to achieve remission.

Car T cell therapies are a relatively new form of treatment for the past 2 years in Ireland, where in the patients T cells are harvested, modified in a laboratory to make the patients cancer cell their new target, and then reinfused to the patient following chemotherapy. Currently it is available to particular lymphoma and leukaemia groups in Ireland but is being used to treat a variety of haematological conditions worldwide. We liaise with external referring hospitals, notably Our lady of Lourdes hospital, Connolly hospital and Blackrock Health at the Hermitage Clinic, to facilitate these treatments in conjunction with St James hospital stem cell transplantation service

 

Laura Mc Kiernan

I am a Clinical Nurse Specialist and I support and educate patients with a newly diagnosed or relapsed blood cancer. I meet patients after receiving their diagnosis and before they start treatment in the inpatient or outpatient setting. I help my patients to understand their medications, prepare them for treatment side effects and provide advice on symptom management.

I also make sure they are aware of all the support resources available here in the hospital and in the community, ensuring they are appropriately referred from the beginning of their  cancer journey.

Cancer information can be extremely overwhelming to take in, and it is difficult to retain all of the information during such an uncertain time. Therefore, it is so important that family members or loved ones are involved in the continual education and information process. I am learning a lot about what is important to patients on diagnosis. I am developing a patient experience survey in order to get feedback that I will use to improve my practice and to plan for the future of this service, ensuring the development of a sustainable patient focused service.

Marie Clare Mc Evoy

I am a Clinical Nurse Specialist and my role is to manage the Telephone Triage service which is for Haematology patients on active Systemic Anti-Cancer Therapy (SACT) and other haematology patients. I started in this role, which was set up in response to the COVID-19 pandemic to decrease hospital/ED attendance for our patients, in 2020. We have successfully introduced the UK Oncology Nurses Society (UKONS) telephone triage tool to grade symptoms and side effects of treatment, and direct the care of patients who are unwell at home. Advice is then given to patients on how to proceed. This may just be general advice and support or to go to their GP or local Emergency Department. All patients receive education regarding the importance of reporting disease symptoms and side effects of treatment to the contact numbers. The service is available 24/7 365 days a year. Out of hours is provided by St. Teresa’s haematology inpatient ward and CKB haematology day unit alongside the Haematology and Oncology medical on-call team. I follow up all calls the next working day either by phone or in person if the patient has been admitted.

Avril Furey

The main focus of my role as Haematology CNS is on early detection and survivorship in patients with haematological malignancies. Early detection of blood cancers leads to improved patient survival and access to services for diagnosis within Beaumont Hospital. This role will improve the patient journey from the community to cancer diagnosis, and facilitate the early detection of new cancers and relapsed cancers. It will also facilitate the development of a survivorship service to meet the increasing needs of patients who live longer on novel therapies. An important aspect of survivorship is effective patient education which lays the foundation for a better patient journey.

Rachel Fox

I have been in post as an Advanced Nurse Practitioner (ANP) in haematology since 2018, and provide a complete episode of care to patients’ with Myeloproliferative Neoplasms (MPN’s) and many other blood cancers attending CKB haematology day unit and the outpatient haematology service.  As an ANP I provide an outpatient service for patients’ with stable blood cancers to facilitate comprehensive review, assessment, diagnosis, investigation and treatment, as well as striving to meet social and psychological care needs. This service is delivered with the oversight of the Consultant Haematology team, considering international best practice guidelines and evidence based research applied to the patient review process, whilst providing a timely, safe and effective service. I work autonomously with medical and nursing teams, with focus on improving patient care and patient satisfaction, contributing to the continuous improvement of the quality of care experienced by patients and their families.

I believe promoting patient centered care, educating patients’ locally and nationally on disease specific issues, and linking with appropriate patient advocacy groups and community services, are core to effective chronic disease self-management for patients at home with haematological malignancy.