Implementation of a referral pathway for cancer survivors to access allied health services in the community

Abstract

Abstract Background The growing demands for multidisciplinary cancer survivorship care require new approaches to address the needs of people living after a cancer diagnosis. Good Life–Cancer Survivorship is a self-management support survivorship program delivered by community allied health (AH) services for people diagnosed with cancer. A pilot study established the benefits of Good Life–Cancer Survivorship to help survivors manage their health and wellbeing in the community health setting. This study expanded the program to four community health services and evaluated the implementation outcomes of the survivorship program. Methods Eligible cancer survivors attending hospital oncology services were referred to the survivorship program. Data was collected between 19/02/2021-22/02/2022 and included allied health service utilisation, consumer surveys, and interviews to understand consumer experience with the survivorship program. Interviews and focus groups with hospital and community health professionals explored factors influencing the survivorship program uptake. Implementation outcomes included Adoption, Acceptability, Appropriateness, Feasibility, and Sustainability. Results Of 35 eligible survivors (mean age 65.5 years, SD=11.0; 56% women), 31 (89%) accepted the referral. Most survivors had two (n=14/31; 45%) or more (n=11/31; 35%) allied health needs. Of 162 AH appointments (median appointment per survivor=4; range=1-15; IQR:5), 142/162 (88%) were scheduled within the study period and 126/142 (89%) were attended. Consumers’ interviews (n=5) discussed the referral pathway; continuation of survivorship care in community health settings; opportunities for improvement of the survivorship program. Interviews with community health professionals (n=5) highlighted the impact of the survivorship program; cancer survivorship care in community health; sustainability of the survivorship program. Interviews (n=3) and focus groups (n=7) with hospital health professionals emphasised the importance of a trusted referral process; a holistic and complementary model of care; a person-driven process; the need for promoting the survivorship program. All evaluations favourably upheld the five implementation outcomes. Conclusions The Good Life–Cancer Survivorship program supported survivors in self-management strategies through accessible and tailored community allied health services. The survivorship program was well adopted and demonstrated acceptability, appropriateness, and feasibility by all parties involved. Findings support the delivery of cancer survivorship care in community health settings with recommendations from clinicians to sustain the referral pathway.