RESOLVE aims to improve the health status and symptom experience for those people living with advanced cancer across Yorkshire.
The University of Hull, in partnership with the University of Leeds, has gained funding from Yorkshire Cancer Research for the RESOLVE research programme to help address these symptoms better.
Our research looks at how people with advanced cancer needing support to address symptoms access the help they need, and how this access can be improved so they receive appropriate expert help.
The RESOLVE project is made up of three workstreams:
Workstream 1: Recognise patients early that need help
Lead: University of Leeds
Workstream 1 will examine ways to identify early patients with advanced cancer that need support from palliative care services and address limited or late access to palliative care in primary care.
We will devise, implement and evaluate an algorithm-based approach within primary care electronic record systems to alert GPs to patients with cancer who may benefit from palliative care approach. This will include a performance evaluation of the model as well as qualitative evaluation of the implementation process in primary care.
The workstream also comprises of an analysis of 5-year data from the national survey of bereaved people (VOICES) to examine factors associated with access to community palliative care services; and a systematic review of screening tools to support timely identification for palliative care.
For more information on this workstream, please contact Yousuf El-Mokhallalati (Y.ElMokhallalati@leeds.ac.uk)
Workstream 2: Implement regular assessment and monitoring of symptoms and other concerns
Lead: Hull York Medical School / University of Hull
In workstream 2, we will work with healthcare professionals across Yorkshire hospices and palliative care providers to understand what does and does not work when using outcome measures in routine palliative care practice.
Based on these conversations, we will provide tailored interventions and support to each site to assist with the implementation of outcome measures. Outcome measures are brief, simple questionnaires which we know help improve recognition and management of symptoms.
We will then build a Yorkshire-Wide Outcomes Registry – which sites will be able to voluntarily submit their outcomes data to – in order to drive quality improvement in the delivery of palliative care across the region. This will involve working with sites to develop benchmarks and then provide feedback about how they are performing in relation to these.
In doing this, we can ensure close corroboration between palliative care services through recognising leaders in particular areas who can then share practices to others in the hospice community. Based on this work, we will then conduct a process evaluation to understand if, how, and why patient-centred outcome measures can be used to improve patient care within palliative care.
Workstream 3: Provide better management of the most challenging symptoms
Lead: Hull York Medical School / University of Hull, University of Leeds
In workstream 3 we will work with staff at Yorkshire hospices to develop brief interventions for management of the challenging symptoms of pain, breathlessness and fatigue-exhaustion and implement these in routine care in ways that facilitate staff to intervene more effectively.
We will develop and evaluate resources to help patients cope better with their symptoms, reduce interference in daily activities, and be better able to engage with healthcare services.
We will determine the impact of these resources. This will include uptake and use by patients, qualitative interviews on how patients and carers use them to support their own management, and how well these resources are supported by palliative care staff in terms of promotion to patients and regular use in clinical encounters.
As part of this workstream, we would like hospice pharmacists to provide medicines optimisation consultations for patients with pain, breathlessness or fatigue from cancer. These will take the form of two, telephone delivered consultations and will be based on a current NHS community pharmacy service called the New Medicine Service. The pharmacist will discuss medicines with the patients, how to get the best use from them and goals will be set between the two consultations. A patient resource will also be developed to use alongside the consultations.
For more information on this workstream, please contact Dr Emma Chapman (E.J.Chapman@leeds.ac.uk)