{"entity":{"id":"idea-acc-nurse-led-follow-up-clinics","kind":"idea","name":"Nurse-led follow-up clinics for survivors, freeing oncologists for active treatment","aka":[],"tldr":"Most follow-up visits after successful treatment are routine. Nurse practitioners can run them well, giving survivors more time and oncologists more capacity for new patients.","summary":"Follow-up of treated patients consumes a large share of oncology clinic slots but rarely changes management. Nurse-led follow-up has shown equivalent outcomes and higher patient satisfaction in randomised trials in breast, lung, and colorectal cancer. Making this the default model, with explicit re-entry criteria and access to an oncologist, would free specialist time and improve survivorship care quality.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Not enough oncologists, nurses, pathologists, physicists): Yang et al., Projected supply of and demand for oncologists and radiation oncologists through 2025 (JOP 2014)","url":"https://doi.org/10.1200/JOP.2013.001319"}],"tags":[],"related":["idea-acc-risk-stratified-follow-up"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-workforce","b-survivorship"],"keyPapers":["paper-yang-j-oncol-pract"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Shifting routine follow-up to nurse-led clinics will free at least 20% of oncologist clinic capacity and will not delay detection of recurrence, measured by stage at recurrence and time from symptom to diagnosis.","rationale":"Randomised evidence already exists for equivalence; adoption is limited by payment models and professional custom, which are addressable.","test":"A pragmatic implementation across a regional network with capacity, recurrence detection, and patient-reported outcomes as endpoints.","maturity":"being-tested-at-scale","actor":"clinic","cost":"small","horizonYears":2},"route":"/ideas/idea-acc-nurse-led-follow-up-clinics/","neighbours":{"idea":[{"id":"idea-acc-risk-stratified-follow-up","kind":"idea","name":"Risk-stratified follow-up: low-risk survivors to primary care with fast re-entry","route":"/ideas/idea-acc-risk-stratified-follow-up/"}],"bottleneck":[{"id":"b-workforce","kind":"bottleneck","name":"Not enough oncologists, nurses, pathologists, physicists","route":"/bottlenecks/b-workforce/"},{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"}],"paper":[{"id":"paper-yang-j-oncol-pract","kind":"paper","name":"Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage","route":"/key-papers/paper-yang-j-oncol-pract/"}],"roadmap":[{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}