A Florey allows you to send a questionnaire out to patients to gather data.

The Cancer Care Review Florey is used to help gather information prior to a Cancer Care Review. These questionnaire was developed in partnership with Macmillan Cancer Support.

The responses can be saved back as coded entries.


Content

Enrolment SMS

Hi/Dear NAME,


We will be inviting you in for a review with your doctor or nurse due to your cancer diagnosis. Please answer the following questions to make sure the review is as useful as possible.


SENDER ID

First page of questionnaire

Hi NAME,


Your practice will be inviting you in for a review with your doctor or nurse due to your cancer diagnosis. We would like to ask some questions in advance to ensure that the appointment is as useful as possible. Apologies if you feel we should have some of this information already but we want to make sure it is all up to date. This questionnaire will only take a few minutes.

Are you happy to proceed?

Powered by accuRx.

Questions

What is your date of birth?
Example 8 12 1988

  • DD MM YYYY

Which of the following treatments have you received?

Choose all that apply (you can select none)

  • Chemotherapy

  • Radiotherapy

  • Immunotherapy

  • Surgery

  • Hormone therapy

Are any of the following symptoms affecting your quality of life that you would like to discuss?

Choose all that apply (you can select none)

  • Bowel/Bladder problems

  • Tiredness

  • Pain/Discomfort

  • Sleep problems

  • Appetite weight problems

  • Sexual problems

  • Other

(If the patient selects "Other")

What other symptoms are affecting your quality of life that you would like to discuss?

  • Free text box

Are any of the following bothering you that you would like to discuss?

Choose all that apply (you can select none)

  • Anxiety or low mood

  • Concerns about work

  • Worry about your loved ones/family

  • Thinking about the future

  • Concerns about finance

Your GP or nurse can be useful to discuss planning for the future. Is this something you would like the opportunity to do?

  • Yes

  • No

What is your smoking status?

  • Current smoker

  • Ex-smoker

  • Never smoked

How much do you smoke? (only asked if patient selects current smoker)

  • < 1 cigarette or equivalent per day

  • 1-9 cigarettes or equivalent per day

  • 10-19 cigarettes or equivalent per day

  • 20-39 cigarettes or equivalent per day

  • 40+ cigarettes or equivalent per day

Do you drink alcohol?

  • Yes

  • No (questionnaire ends)

How often do you have a drink containing alcohol? (If selected "yes" to previous question only)

  • Never

  • Monthly or less

  • 2-4 times per month

  • 2-3 times per week

  • 4 or more times per week

When saved back to record - "Frequency of drinking alcohol: 2-4 times per month"

How many units containing alcohol do you drink on a typical day when you were drinking? (1 pint of beer is approximately two units, and one small glass of wine is 1 unit)

  • 1 or 2 units (Light drinker - 1-2u/day - 160575005)

  • 3 or 4 units (Moderate drinker - 3-6u/day - 160576006)

  • 5 or 6 units (Moderate drinker - 3-6u/day - 160576006)

  • 7 to 9 units (Heavy drinker - 7-9u/day - 160577002)

  • 10 or more units (Very heavy drinker - greater than 9 units/day - 160578007)

When saved back to record - "Units of alcohol drunk on a typical day: 3-4 units"

How often did you have 6 or more units if female, or 8 or more if male, on a single occasion in the past year?

  • Never

  • Less than monthly

  • Monthly

  • Weekly

  • Daily or almost daily

When saved back to record - "Drank greater than 6/8(F/M) units in the past year: Monthly"

What type and amount of activity is involved in your work?

  • I am not in employment (e.g. retired, retired for health reasons, unemployed etc.)

  • I spend most of my time at work sitting (such as in an office)

  • I spend most of my time at work standing or walking. However, my work does not require much intense physical effort (e.g. shop assistant, hairdresser, security guard, childminder etc.)

  • My work involves definite physical effort including the handling of heavy objects and use of tools (e.g. plumber, electrician, carpenter, cleaner, hospital nurse, gardener, postal delivery workers etc.)

  • My work involves vigorous physical activity including handling of very heavy objects (e.g. scaffolder, construction worker, refuse collector, etc.)

During the last week, how many hours did you spend on physical exercise such as swimming, jogging, aerobics, football, tennis, gym, workout etc.

  • None

  • Some but less than 1 hour

  • 1 hour but less than 3 hours

  • 3 hours or more

Is there anything else you would like to discuss in your Cancer Care Review?

  • Free text answer

Post-submission screen

Thank you for submitting your answers. 



What next?

Your practice will now review the information in the next 28 days and contact you to arrange your Cancer Care Review appointment.

Macmillan Cancer Support

The Macmilan website has many resources to support you: https:/www.macmillan.org.uk/

The Macmillan telephone support line is available to answer any questions you might have about your cancer or how it is affecting your life. This is available 7 days a week, 8am-8pm: 0808 808 00 00

The Macmillan Online Community:

https://community.macmillan.org.uk

How the patient response looks like in the accuRx Inbox

How the entry looks like saved into EMIS:

SNOMED Codes saved back to EMIS/SystmOne:


Chemotherapy 367336001
Radiotherapy 419815003
Immunotherapy 76334006
Hormone Therapy 169413002

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