Table 4

Needs, barriers and solutions identified through consultation meetings

Themes 1–4NeedBarriersSolutionImpact on perception of care (Theme 5)
PeopleEarly 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
PurposeInformation 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
PlaceEase 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
ProcessJoined 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