A Triggers Service is:
- Collaborative relationship between oncology and Symptom Control and Palliative Care teams (SCPCT)
- Adopting co-productive strategies to shape service delivery
- Early identification of patient need using the Triggers Tool
Our Aims are
- To improve patients symptom burden at the start of their journey
- Access to Advance Care Planning
- Demystifying SCPC to our patients
The Triggers Tool
- Symptoms not present - TRIGGERS NEGATIVE - No intervention required
- One or more symptoms present - TRIGGERS POSITIVE - Triggering:- Service introduction, Holistic needs assessment Intervention, Future review
Metastatic cancer progressing after 1st line treatment:
- Performance status ECOG2 and deteriorating
- Acute oncology or unplanned admission
- Severe of overwhelming symptoms
- Anorexia, hypercalaemia, or any effusion
- Moderate or severe psychological or existential distress
- Complex social issues
How would the service operate in clinic?
What happens after a review?
- The service will carry out a holistic needs assessment and discuss what is most important to you.
- If any medications are suggested, we discuss with your oncology team first and document it in your medical notes
- We will contact you again, either by phone or when you next attend clinic and check if there has been an improvement in your symptoms.
- The Triggers Service will continue to review, until your symptoms have resolved
- The Triggers Service will also discuss patients in our Triggers MDT (oncology staff are invited to attend) and document this on the patient record any further recommendations to management of symptoms
- Take a step back when symptoms have resolved
- Discuss future planning with the medical oncology team
How would you inform your patient population about the service?
When is the right time to introduce the Triggers service?
- The right support
- At the right time
- In the right place
- By the right people