Supporting regional patients

Regional cancer patients often need to travel from the comfort of their familiar and tight-knit community to attend appointments and undertake cancer treatment in the city – sometimes for weeks or months on end. 

Here are some of the financial, social, emotional, cultural and practical issues your regional patients may face, to help you understand and support them:

There are some important considerations metropolitan-based health professionals must make when it comes to treating rural and regional patients. 

You can make specialist appointments and treatments as manageable as possible for your regional patients by remembering: 

• For many regional patients, both arriving in and finding their way around the city can be very stressful.
• Staff in small rural and regional hospitals are often familiar with their patients. Therefore, these patients can find the anonymity of large metropolitan hospitals overwhelming, impersonal and difficult to navigate.
• Being away from family, friends and usual support networks during their cancer treatment adds to the levels of distress.
• As travelling long distances is tiring, difficult and often costly, scheduling appointments together and not changing them at the last minute is essential. Most regional patients also appreciate the acknowledgement that they have travelled from their rural homes for the appointment.
• Ask your patient, “what do I need to know about you that will help me to help you?” This helps build rapport and gives them an opportunity to raise preferences about how their treatment can be structured to accommodate their work and family commitments.
• Where possible, suggest making arrangements for tests (e.g. blood tests prior to chemotherapy) to be done close to the patient’s home to minimise the amount of time spent away from home. If possible, check that this will not cost the patient any extra.
• Stigma and regional values, such as reluctance to complain or ask for help, can make it difficult for rural patients to access support services and hesitant to report any difficulties they face, such as side effects or emotional issues. It is helpful to explain that psychosocial support is recommended as a standard part of treatment for all cancer patients. It may also help to ask your patient directly about what sorts of difficulties they have experienced so far to help broach this subject.
• Clear communication between regional GPs and metropolitan specialists is a necessity. Regional patients may experience feelings of anxiety upon leaving urban-based treatment facilities, particularly if these patients are concerned that their local GP does not have a good understanding of their medical situation.
• Discharge planning is very important. Be familiar with exactly what services are available in regional communities to support patients on their return home.
• Make a referral to psychosocial services in metropolitan treatment centres and/or inform regional patients about relevant support services available in their local area.
• When explaining medical jargon, including the diagnosis, and treatment plans to your patient and their family members, use simple, easy to understand language.
• Encourage patients and their supporters to take notes, ask questions and report any side effects.
• Try to demonstrate a personal interest in the person beyond their illness by asking about what they do for work and what their favourite hobbies are.
• Ask patients if they need assistance with completing a Patient Assistance Transport Scheme (PATS) form.

There are 15 chemotherapy units in hospitals across regional South Australia. Each are classified as low or medium risk, depending on the complexity of the treatment they offer. Each unit has between one and six chemotherapy chairs. 

Staff at these units are trained and accredited to administer chemotherapy treatment and also offer supportive services for cancer patients, such as chemotherapy education and central venous access device maintenance. These units are also equipped with Digital Telehealth Network facilities. 

Contact details for each health service are available below: 

Medium risk

• Whyalla
• Port Lincoln
• Port Pirie
• Riverland
• Mount Gambier
• Victor Harbor

Low risk

• Ceduna
• Clare
• Gawler
• Kangaroo Island
• Mount Barker
• Murray Bridge
• Naracoorte
• Port Augusta
• Wallaroo

There is increasing evidence that regional patients may be more likely to experience poor mental health, reduced treatment outcomes and unmet psychosocial needs, compared to metropolitan patients.

Therefore, a focussed effort in linking regional cancer patients with psychosocial services is important. 

Regional patients can access this support through:

• Cancer Council SA’s 13 11 20 Information and Support Service: connecting patients with a qualified health professional Monday to Friday, 9.00 am to 5.00 pm – our team can answer questions, provide emotional support and connect patients with a range of services including counselling and peer support
• general practitioners
• psychology services: available through your Cancer Treatment Centre or find a psychologist at Australian Psychological Society
• Rural and Remote Mental Health Triage Service on 13 14 65: This service provides 24/7 emergency mental health information and assistance for health professionals and their clients, families and carers.

You can also consider a Mental Health Care Plan to provide access to subsidised psychological support. 

The Patient Assistance Transport Scheme is a financial support subsidy available to eligible patients who live regionally and need to travel into the city for appointments and specialist treatment.

Your patient can assess the eligibility for the scheme using the online calculator.