1. The Acute Oncology Project
Mrs Jenny Almond
Project Lead for Acute Oncology

2. Background
Recent reports from NCEPOD and NCAG recommend reform in the way acute oncology is structured and managed
Acute Oncology Team at each Trust with an Emergency Department
CCO is leading local design of acute oncology service in collaboration with MCCN

3. Project Management Structure
An Acute Oncology Project Steering Group established with representation from MCCN
Vision 2020 Steering Group
Chair: Silas Nicholls
Acute Oncology Project Steering Group
Chair: Jenny Almond
MCCN Clinical Advisory Group
Chair: Ged Corcoran

4. Acute Oncology Issues High level bed occupancy in acute Trusts
Acute oncology patients have complex medical needs and can be classified as:
Known cancer patients with complications of chemotherapy
Known cancer patients with complications of their disease
Patients with Unknown Primary disease (~5% of all cancer pts)

5. NatCanSAT Data Analysis
CCO & MCCN have jointly commissioned a detailed data analysis
Led by Brian Cottier
Understanding current and future ‘acute oncology’ workload
Better understanding of emergency admissions
                               N A  T  C  A  N  S  A  T The National Cancer Services Analysis Team

6. UKP Audit at St Helens & Knowsley
Focus on early referral to oncologist
Use of UKP pathway
Reduced time to diagnosis
Earlier planning and delivery of treatment
Reduced LOS from 22 to 11 days
Similar results seen at Sherwood Forest Hospitals NHS Trust

7. Aims of Acute Oncology Project
Establish an Acute Oncology Team at each Trust with an ED (7 Trusts)
This should lead to:
Faster and better care of patients with complications of chemotherapy
Faster and better care of patients with complications of cancer
Appropriate investigation of UKP patients

8. Collaboration Acute oncology requires collaboration between: Oncology
Palliative care
Acute Medicine ED
Haematology

9. Acute Oncology Clinical Model
Monday – Friday, 9-5 service
Consultant Oncologist to provide one clinical session per day at each Trust
Clinical Nurse Specialist support to level of 1 FTE per Trust
Secretarial support
AOT Office

10. Acute Oncology Patient admitted via ED or AMU ‘Onco Alert’ to AOT
Portfolio of protocols / pathways
Oncologist / CNS review
Diagnostic & Treatment Plan

11. Out of hours advice Initial contact with CCO’s triage service
Triage being redesigned to meet the needs of acute oncology
On-call oncologist available for telephone consultation

12. Acute Oncology -Peer review
NCAG has recommended:
Establishment of an acute oncology service with appropriate professional involvement
Numbers of patients presenting with cancer as emergencies
Interval between admission and oncological assessment
Time to referral to appropriate specialist team
Total length of stay for previously undiagnosed cancer patients

13. Local Implementation Plan
Subject to agreement by commissioners the service will be rolled out in 3 phases:
Two early implementer sites (2009/10)
Three further Trusts (2010/11)
Final two Trusts (2011/12)

14. Acute Oncology Progress
Draft case in need produced for review
Discussions are underway with RLBUHT and W&H NHS FT (EISs)
Information will be cascaded at both Trusts by Cancer Lead
Acute oncology meeting - April at RLH
Plan to have an AOT at RLH in October 2009

15. Acute Oncology Progress cont…
Re-design of triage service commenced (Kim Barrow / Mike Varey)
CCO Medical Director planning medical staffing
Develop CNS job descriptions / plans

16. Thank you for your attention Any questions?
Further information: