Implications of a needs assessment intervention for people with progressive cancer: Impact on clinical assessment, response and service utilisation yz Amy Waller 1Ã , Afaf Girgis 1 , Claire Johnson 1 , Christophe Lecathelinais 1 , David Sibbritt 2 , Michael Seldon 3 , Tony Bonaventura 3 and David Currow 4 on behalf of the Palliative Care Research Program team 1 Centre for Health Research and Psycho-oncology, School of Medicine and Public Health, The Cancer Council NSW, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia 2 School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia 3 Calvary Mater Newcastle Hospital, Newcastle, NSW, Australia 4 Discipline of Palliative and Supportive Services, Flinders University, Adelaide, Australia Abstract Objective: To assess the impact of the systematic use of the Palliative Care Needs Assessment Guidelines and Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C) on clinical assessment, response and service utilisation. Study setting: Three major oncology treatment centres in NSW, Australia. Study design: Between March 2007 and December 2009, 219 people with advanced cancer were recruited to complete bi-monthly telephone interviews. The intervention, introduced after at least two baseline interviews, involved training health professionals to complete the NAT: PD-C with patients approximately monthly. Data collection: Rates of service use and referrals were compared pre- and post-introduction of the NAT: PD-C. Rates of completion of the tool; its impact on consultation length; and the types of needs and follow-up care to address these were also assessed. Principal findings: The NAT: PD-C had a high rate of completion; identified needs consistent with those self-reported by patients in interviews; and did not alter consultation length. No changes in the number of health professionals seen by patients were found pre- and post- intervention. Conclusion: The NAT: PD-C is an efficient and acceptable strategy for supporting needs- based cancer care that can potentially be incorporated into standard routine care without increasing the burden on care providers. Copyright r 2011 John Wiley & Sons, Ltd. Keywords: cancer; oncology; NAT: PD-C; palliative care; service utilisation Introduction In Australia, deaths are often from chronic diseases [1] and, increasingly, the management of chronic diseases such as cancer is managed with finite resources [2] and the increasingly outmoded organi- sation of our health services [3]. Issues such as workforce shortages, increased out-of-pocket costs and the role of private and public funding have all impacted on the availability of health care [3,4], with access often based on ability to pay rather than complexity or magnitude of needs [3]. The ongoing challenge is to ensure that care of people with advanced cancer is delivered in an appropriate and equitable manner, across the illness trajectory. There has been a shift toward a more needs-based approach to the delivery of care of people with advanced cancer, with the complexity and severity of individual needs determining the type and level of care provided, as well as the setting in which it is delivered [5]. Accordingly, people with minimal needs may continue to be cared for by primary-care providers, while those with more com- plex needs may require consultative or continued involvement with specialist providers such as specialist palliative care services (SPCSs) [5]. In an attempt to link the unmet needs of indivi- duals to best practice standards and subsequently provide more appropriate and timely delivery of care [6], the Needs Assessment Tool: Progressive Disease—Cancer (NAT: PD-C) was developed. Along with the Palliative Care Needs Assessment * Correspondence to: Department of Psychosocial Resources, Cancer Care, Alberta Health Services, Tom Baker Cancer Centre–Holy Cross Site, 2202 2nd Street SW, Calgary, Canada T2S 3C1. E-mail: amy.waller@ albertahealthservices.ca y Supporting information may be found in the online version of this article. z The Palliative Care Research Program team also includes (in alphabetical order): Patricia Davidson, Emma Gorton, Brian Kelly, Linda Kristjanson, Geoff Mitchell, Martin Tattersall and Patsy Yates. Received: 20 August 2010 Revised: 16 December 2010 Accepted: 27 December 2010 Copyright r 2011 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology 21: 550– Published online 25 February 2011 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.1933 557 (2012)