1. Acute Oncology Hotline. The Christie NHS Foundation Trust
Jason Nicholas Simons
Advanced Care Practitioner
Thursday 3rd October 2019

2. What is Acute Oncology Hotline Service ?
Ensuring that patients with proven or suspected cancer have access to specialist advice, opinion and treatment in an appropriate time frame.

3. Why is Acute Oncology needed?
2004 to 2007
1st Round of National Peer Review appraisals:
Showed that only around one half of chemotherapy services had Cancer Network-wide lists of agreed acceptable regimens and guidelines/protocols for chemotherapy service delivery
January 2008
Over 400 reported instances of adverse events linked to oral anti-cancer medicines highlighting a lack of understanding of patients in regards to their treatment.
National Patient Safety Agency (NPSA) (2008) Rapid Response Report NPSA/2008/RRR001. Risk of Incorrect Dosing of Oral Anticancer Medicines. London.

4. Why is Acute Oncology needed?
November 2008
1044 cases of patients dying within 30 days following systemic anti cancer therapy from 659 hospitals analysed by a multi-professional expert group.
In only 35% of cases was care judged to have been good by the advisors, with 49% having room for improvement and 8%
receiving less than satisfactory care.
National Confidential Enquiry into Patient Outcomes and Death report ‘For Better, for Worse? A review of the care of patients who died within 30 days of receiving systemic anti-cancer therapy. November

5. Why is Acute Oncology needed?
The National chemotherapy advisory group report 2009 Chemotherapy Services in England, ensuring quality and safety.
This report emphasises the need for teamwork and for teams to work together within hospitals and across Networks.
The careful provision of care by teams who communicate well is central to this.

6. NCAG report 2009
Acute oncology encompasses both the management of patients who develop severe complications following chemotherapy or as a consequence of their previously diagnosed cancer, as well as the management of patients who present as emergencies with previously undiagnosed cancer. Acute Oncology therefore necessarily involves clinicians working in emergency departments and in acute medicine, as well as in oncology and related disciplines. Provision of AOS will save the NHS money and resources.

7. The Christie response Formation of Acute Oncology Team (MDT) – 2011
Trust Lead Acute Oncology – Dr Tim Cooksley, Dr Tam Al-Sayed
Acute Oncology Nurse Clinicians
Gerry Egan : ACP (OAU)
Lauren Mott: Hotline Team Leader
Jason Simons: Trainee ACP
Richard Beebee ACP: Duncan Lindsay ACP

8. Acute Oncology Assessment & Management Service
The Christie response
Acute Oncology Assessment & Management Service
21 Bedded Inpatient Assessment Unit
10 patient Ambulatory Facility 8-9pm Monday- Friday.
Nurse- Led service utilising telephone triage assessment.
Currently patients receiving Systematic Anti- Cancer Treatments (SACT)

9. The Christie hotline

10. Who is using the service?

11. How many calls do we receive?
1755 hotline calls in Feb 2019 – averages to 65 calls per day. Does not include ones put through via switch etc.

14. Triage and Hotline Proforma
Acute Oncology Nurse Advisor
Following assessment – Advice on appropriate care location/service e.g. GP, 111 service
Advice &
Reassurance
Attend the Christie or A&E as appropriate

15. The Christie response Clinic Access (known Cancer Patients)
Rapid Access established for all oncology patients
Establishment of Enhanced Supportive Care and AOS Team working. Monday- Thursday's

16. What Acute Oncology Does?
Provides a single 24 hour focal point of contact for cancer patients who have treatment or disease related concerns.
Toxicity Assessment Tool.
Provides an assessment service to determine the level of intervention required to address a patient’s concern.
Provides a further line of communication to the tumour specific teams of their patient’s status and condition.

17. What Acute Oncology Does Not do?
Does not replace the tumour specific team in the management of a patient’s condition.
Does not replace or substitute the patient’s GP.
Does not provide a treatment facility for the Non Acute needs of the patient.

18. Optimising AOS Communication
Identification of communication pathways between the tumour specific team and the AOS service. Not reliant on individuals.
The use of consistent accepted best practice protocols for treatment and disease related toxicities.
Ensuring patient understanding (& Staff understanding) of when, where and how to get advice and treatment.

19. The Future is bright