The district nursing team at this Scottish practice launched a clinic for cancer patients who were believed to have unmet needs following treatment.
The clinic was started as a result of discussions at the practice's monthly Gold Standard Framework meeting, and the experiences of nurses.
District nurse Phyllis Hutchison said she had visited a cancer patient who was comparatively well but terrified because 'you only get a district nurse when you are dying'.
The new clinic was devised to review patients who had completed, or nearly completed cancer treatment, to ensure their general health and welfare needs were addressed.
All such patients not regularly seen in primary or secondary care were invited to attend, where their medication and nutritional status was reviewed. Of the seven patients invited, all attended the clinic.
GP partner Dr Samantha Ross said: 'The patients saw the district nurses first and then me. They often brought family members with them and seemed grateful they had been called in to a clinic rather than presenting themselves.'
Ms Hutchison said having a GP at the nurse-led clinic enabled a one-stop approach.
Some patients needed nutritional input, others were helped to increase their welfare benefits, and some were found to have been neglecting pre-existing conditions.
Ms Hutchison said: 'Some had let other conditions get out of control because the cancer diagnosis had taken over. '
The team hopes to bring in a dietician and podiatrist for the next clinic.
Dr Ross said: 'We believe there is a lack of a uniform service in this area. Our clinic also allowed forward planning: if a patient was to deteriorate the team would already know about them, and the carers and patient would already have met the nursing and GP teams.'
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