Pioneers in patient care: consultants leading change
North East
Innovation: Provision of a Hickman line service for cancer patients needing chemotherapy at a regional oncology centre
Dr Andy Bodenham
Leeds General Infirmary/Cookridge Oncology Centre
Job title: Consultant in anaesthesia and intensive care medicine
Specialty: Anaesthesia and intensive care medicine
For cancer patients, the treatment of their disease can be a long and exhausting experience. To help people during this difficult time, consultant anaesthetist Dr Andy Bodenham has streamlined a service so that cancer patients can receive an essential part of their chemotherapy treatment at a regional oncology centre – without having to go back to their original referral hospital.
Dr Bodenham has a weekly list in a regional oncology centre where he can insert the Hickman line device for 6-7 patients who may need it. A Hickman line is a long-term central venous access catheter inserted via the subclavian or jugular vein, which is then used for the infusion of chemotherapy and to take blood over the weeks or months of treatment.
Dr Bodenham says: “Oncologists and their patients were fed up with the traditional requirement to send patients back to the referring hospital for, what was at times, a poorly performed procedure by inadequately trained junior practitioners. Our method supercedes this process. It provides a dedicated operating list at the oncology centre, with skilled personnel available to insert these devices.”
He says: “The majority of the procedures are carried out under local anaesthetic with supplemental intravenous sedation. Patients tolerate the procedure very well, which is important, as it often has to be repeated. A current audit of 500 patients has produced very good results.”
The service, introduced in May 1999, is funded by existing resources in the oncology department and has helped take pressure off other referring hospitals. Dr Bodenham says: “The service takes some pressure off district hospitals. Patients have procedures in a timely fashion as day cases or when they are already inpatients at the oncology centre.
“The procedure is usually carried out under local anaesthetic, complication rates are low and the procedures are done quickly. All this helps meet treatment deadlines for chemotherapy and saves money and time.”
An increase in time and resources would allow Dr Bodenham to extend this service to more patients and also include Hickman line removals which require a small, surgical procedure.