Follow-up and aftercare in oncology is an important workingfield of oncology, receiving extra stimulation since 2007 by the Health Council report ‘Follow-up in oncology' ('Nacontrole in de oncologie' ). The points of departure for this report were distinguishing objectives and establishing a foundation for the content.
The ACCC has taken the initiative at the end of 2007 to convert this report to a guideline in collaboration with professional associations, patients and other parties involved.
This guideline now lies before you. On the one hand, the guideline commission has chosen to translate the results of the report by the Health Council to practice. On the other hand, we have developed an aftercare plan with a group of experts.
In developing the guideline, we asked patients for their opinions and ideas about cancer aftercare. The responses have been incorporated in the guideline.
During development of the guideline, the guideline commission entered into discussion with general practitioners about their role in cancer aftercare. The commission has taken cognisance of developments in care standards in relation to other disorders, such as diabetes and COPD, but has also realised that it is not yet possible to translate the report of the Health Council to a care standard and, as such, to make the position of the general practitioner more recognisable.
Subsequent to this guideline, the guideline commission would like the step to an improved oncological care chain between primary and second health care to be made visible in a care standard.
The results from a study on the application of care standards in oncology, initiated by the NPK (National Cancer Programme), could then be used. A signalling report ‘Cancer aftercare in primary health care', focused on the aftercare phase, is also being released in June 2010; a report by SCK (a commission who inventises oncological care in the Netherlands) as part of the KWF (Dutch Cancer Society).
The guideline is therefore largely limited to recommendations on providing aftercare in the hospital in the first year after completion of treatment. Using an individual aftercare plan, choices are made in consultation with the patient for further guidance, aimed at limiting physical and psychosocial damage as a result of the illness.
This requires a change in the way hospitals are organised.
Limited attention is given to intensification of the collaboration between professionals in hospitals and the first-line in this guideline. When the recommendations in this guideline are specifically elaborated for the different tumour types and implemented in hospitals, it is possible to make the next step in collaboration in integrated care in oncology.
The guideline commission expresses the wish for this step to be made rapidly.
ACCC Programme Manager Cancer survivorship care, chair guideline commission