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Eur J Surg Oncol. 2019 May 7. pii: S0748-7983(19)30397-X. doi: 10.1016/j.ejso.2019.04.005. [Epub ahead of print]

Making an IMPACT: A priority setting consultation exercise to improve outcomes in patients with locally advanced, recurrent and metastatic colorectal cancer.

Author information

1
Clinical Effectiveness Unit, Royal College of Surgeons of England, 35-43 Lincolns Inn Fields, London, WC2A 3PE, UK. Electronic address: a.e.vallance@gmail.com.
2
Newcastle Centre for Bowel Disease, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK. Electronic address: deena_harji@hotmail.com.
3
Colorectal Unit, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK. Electronic address: nicola.fearnhead@cambridgecolorectal.org.
4
Nottingham University Hospital, Nottingham, UK.
5
King's College Hospital NHS Foundation Trust, London, UK.
6
Cardiff University, Cardiff, UK.
7
Bowel Cancer, UK.
8
St. Mark's Hospital, London, UK.
9
Bowel Diseases Research Foundation, UK.
10
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
11
University Hospital Southampton NHS Foundation Trust, Basingstoke, UK.
12
University of Birmingham, Birmingham, UK.
13
University Hospitals of Derby and Burton NHS Foundation Trust, Oxford, UK.
14
University Hospitals of Derby and Burton NHS Foundation Trust, Burton, UK.
15
Leicester Royal Infirmary, Leicester, UK.
16
Association of Coloproctology Nurses, UK.
17
The Christie NHS Foundation Trust, Edinburgh, UK.
18
Western General Hospital, Edinburgh, UK.
19
Royal Marsden Hospital, Dundee, UK.
20
St Mark's Hospital, Dundee, UK.
21
Nottingham University Hospital, Dundee, UK.
22
Ninewell Hospital, Dundee, UK.
23
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
24
Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
25
Heart of England Foundation Trust, Birmingham, UK.
26
Leeds Teaching Hospitals NHS Trust, Leeds, UK.
27
Glasgow Royal Infirmary, Glasgow, UK.
28
Pelican Foundation, UK.
29
Royal Devon & Exeter NHS Foundation Trust, Exeter, UK.
30
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
31
Cardiff & Vale University Health Board, Cardiff, UK.
32
Singleton and Morriston Hospital, Swansea, UK.
33
Beating Bowel Cancer, UK.
34
Chelsea and Westminster Foundation NHS Trust, Windsor, UK.
35
Western General Hospital Edinburgh, Edinburgh, UK.
36
IA (The Ileostomy and Internal Pouch Support Group), UK.
37
Patient Representative, UK.
38
British Society of Gastroenterology, UK.
39
Aintree University Hospital in Liverpool, Aintree, UK.
40
Cambridge University Hospitals, Cambridge, UK.
41
Queen Elizabeth Hospital, Birmingham, UK.
42
Bowel & Cancer Research, UK.
43
Manchester Royal Infirmary, Manchester, UK.
44
Oxford University Hospitals NHS Trust, Oxford, UK.
45
Cambridge University Hospitals NHS Foundation Trust, Bury St. Edmunds, UK.
46
Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
47
Heart of England NHS Foundation Trust, Birmingham, UK.
48
Ashford and St. Peter's Hospitals NHS Foundation Trust, Chertsey, UK.
49
University Hospitals Birmingham, Birmingham, UK.
50
Raigmore Hospital, Raigmore, UK.
51
Inside Out, UK.
52
Monklands Hospital, Airdrie, UK.
53
Whipps Cross University Hospital, London, UK.
54
The Royal Free London Hospitals NHS Foundation Trust, Barnet, UK.
55
University Hospital Southampton NHS Foundation Trust, Southampton, UK.
56
Lancashire Teaching Hospitals, Preston, UK.
57
Imperial College Healthcare NHS Trust, London, UK.
58
University Hospitals of Leicester NHS Trust, Leicester, UK.
59
The Christie NHS Foundation Trust, Manchester, UK.
60
Basingstoke and North Hampshire Hospital, Cambridge, UK.
61
Wirral University Hospitals NHS Foundation Trust, Liverpool, UK.
62
Aberdeen Royal Infirmary, Aberdeen, UK.
63
Norfolk and Norwich University Hospital, Norwich, UK.
64
Aintree University Hospital, Liverpool, UK.
65
Lynch Syndrome, UK.
66
University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK.
67
Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
68
Manchester University NHS Foundation Trust, Manchester, UK.
69
University of Liverpool, Liverpool, UK.
70
The Royal Gwent Hospital, Newport, UK.
71
Frimley Health NHS Foundation Trust, Isle of Man.
72
University of East Anglia, East Anglia, UK.
73
Countess of Chester NHS Trust, Chester, UK.
74
National Bowel Cancer Audit, UK.
75
Chelsea and Westminster Hospital, London, UK.
76
St Vincent's University Hospital, Dublin, UK.

Abstract

AIM:

The IMPACT (Improving the Management of Patients with Advanced Colorectal Tumours) initiative was established by the Association of Coloproctology of Great Britain and Ireland in 2017 as a consortium of surgeons (colorectal, hepatobiliary, thoracic), oncologists, radiologists, pathologists, palliative care physicians, patients, carers and charity stakeholders who will work together to improve outcomes in patients with advanced and metastatic colorectal cancer. To establish this initiative, better information is required to establish how further intervention is focused. This paper details the approaches used, and outcomes generated, from a priority setting exercise to inform the design of the IMPACT initiative.

METHODS:

A mixed method approach was employed to set the priorities of patients, clinicians and other key stakeholders in the delivery of optimal care. This consisted of two patient centered consultation events and a questionnaire.

RESULTS:

A total of 128 participants took part in the consultation exercise; 15 patients, 5 carers/family members, 5 charity representatives and 113 healthcare professionals. Nine key themes for focus were identified, these were: current service provision, specialist services, communication, education, access to care, definitions and standardisation, research and audit, outcome measures, and funding of specialist care.

CONCLUSION:

These future priorities will be developed with collaborative engagement in a systematic manner to produce an overall cohesive programme which will deliver a sustainable and efficient clinical and academic service to improving the management of patients with advanced colorectal tumours.

KEYWORDS:

Colorectal cancer; Metastatic cancer; Multidisciplinary team

PMID:
31097310
DOI:
10.1016/j.ejso.2019.04.005

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