The advent of novel targeted treatments with strict monitoring requirements for men with metastatic hormone-relapsed prostate cancer resulted in a 51% increase in outpatient appointments from 2013 to 2014 at Clatterbridge Cancer Centre. Since September 2014, a weekly nurse-led clinic has been held to ease pressure on consultants and outpatients and to improve patient experience.

Considerable benefits have been observed in terms of patient experience with wider benefits to the NHS. The results of a patient survey were positive. All patients who expressed a preference were either very satisfied or satisfied with nurse-led treatment, most thought that continuity of care was very important or important and that waiting times were short. Despite a 43% increase in patient numbers, personnel costs only increased by £325 a month between September 2014 and September 2015. This relatively simple service redesign has enabled more patients to be managed in an environment in which they are satisfied, in a cost-constrained NHS.