A nurse-led holistic clinic with MyPos

Alison Pugh, Myeloma Clinical Nurse Specialist at Royal Gwent and Nevill Hall hospitals, talks us through starting a nurse-led clinic using the Myeloma-Specific Quality of Life Questionnaire (MyPOS), and how it supports holistic care for myeloma patients.

Could you explain how the MyPOS clinic started and what prompted it?

I started the clinic in July 2023 to reintroduce use of a myeloma-specific holistic needs assessment (HNA). I had previously used other types of HNAs but did not feel they met the particular needs of our myeloma patient cohort. Starting the clinic was prompted by not having enough time in clinic to complete a HNA with every patient, and I was conscious only patients starting chemotherapy were having HNAs done. I did a quality of life audit and chose MyPOS as a result. Patients now complete the survey at three, six and nine months after a treatment cycle.

What resources and staffing are required to run the clinic?

Patients receive a reminder text and access the survey online via the NHS DrDoctor Patient Engagement Platform. Aside from the booking service, I am the only member of staff involved in the clinic. I run the clinic on a quieter day for the haematology department, so I can spend more time with each patient. I led a similar clinic before COVID-19 and offered patients laptops to use in the clinic to ensure the needs of those who are digitally excluded were captured. I’m hoping to secure administration support to help these patients complete the survey, and to reassess the need for laptops.

What impact has the service had on patients, families/carers and colleagues?

Filling in the questionnaire at home, often with family support, seems to enable patients to be more honest. They have more time to think, plus the questionnaire is myeloma specific. Family members also telephone me for support themselves if they’ve helped with the questionnaire. Patients like to know when I’ve read their answers, so it gives reassurance that I’m aware of their needs beyond any treatment they are receiving. The clinic reduces strain on the consultant clinics, and also reduces telephone calls about symptoms to the triage team.

Can you offer any advice for other hospitals wanting to provide a similar service?

Getting infrastructure and paperwork set up can take longer than expected. Until I started using the paperwork designed for the clinic, I didn’t realise what tweaks were needed.

Alison Pugh
Myeloma Clinical Nurse Specialist
Royal Gwent and Nevill Hall Hospitals