Table 4

Needs, barriers and solutions identified through consultation meetings

Themes 1–4	Need	Barriers	Solution	Impact on perception of care (Theme 5)
People	Early access to mesothelioma specialist team Continuity of care and integrated respiratory and follow-up pathways	Lack of resources Existing organisational structures and referral processes Lack of patient knowledge of pathway	Invest in mesothelioma specialist nurses Introduce mesothelioma specialist consultants Train lung CNSs Shared care approach with respiratory led follow-up	High
Purpose	Information about range of treatment options and pathways Clear and responsive follow-up schedule	Lack of consistency in range of treatments available Lack of knowledge of options available (patients and healthcare professionals)	Mesothelioma nurses and consultants should provide specialised information Provision of additional resources to patients Clear signposting to specialist support available Regular follow-up based on patient need	High
Place	Ease of access	Geographical barriers Transport/parking Differing levels of support at home Limited understanding of entitlements	Signposting to increase awareness of options with regard to access and support services Flexibility when arranging appointments	Low
Process	Joined up service provision between secondary, community and palliative care Clear communication processes within Trusts Continuity of care when transferring in and out of different services	Differences in referral pathways and accessing palliative care/community services Lack of resources Patient awareness of services available at different trusts Administrative issues	Mesothelioma specialist nurse primary point of contact between secondary, palliative and community care Patients provided with options for contact and communication Continuous contact with mesothelioma specialist nurse throughout pathway	Medium