ideasIdea
Nurse-led follow-up clinics for survivors, freeing oncologists for active treatment
Most follow-up visits after successful treatment are routine. Nurse practitioners can run them well, giving survivors more time and oncologists more capacity for new patients.
Follow-up of treated patients consumes a large share of oncology clinic slots but rarely changes management. Nurse-led follow-up has shown equivalent outcomes and higher patient satisfaction in randomised trials in breast, lung, and colorectal cancer. Making this the default model, with explicit re-entry criteria and access to an oncologist, would free specialist time and improve survivorship care quality.
Hypothesis
Shifting routine follow-up to nurse-led clinics will free at least 20% of oncologist clinic capacity and will not delay detection of recurrence, measured by stage at recurrence and time from symptom to diagnosis.
Rationale
Randomised evidence already exists for equivalence; adoption is limited by payment models and professional custom, which are addressable.
What would test it
A pragmatic implementation across a regional network with capacity, recurrence detection, and patient-reported outcomes as endpoints.
Maturity
being tested at scale
Who has to act
clinic
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.
- Survivorship and late effects are neglected · Tens of millions of people live after cancer with heart damage, infertility, second cancers and fear, and few services.