1. Acute Oncology Service (Insert relevant service name)

2. Northern England Strategic Clinical Network The Network serves a population of approximately 3 million and aims to offer the highest quality, equitable care to all patients in a seamless and accessible pathway. Regional Acute Oncology protocols and guidelines that underpin our regional and local services are available at: http://www.nescn.nhs.uk/group/net work-acute-oncology-group/ MSCC Centres NCCC, Freeman Hospital James Cook Hospital Radiotherapy Centres NCCC, Freeman Hospital James Cook Hospital

3. Key features of an Acute Oncology Service Early review by an oncologist or oncology nurse specialist (within 24 hours) 24/7 access to telephone advice from an oncologist Fast track clinic access from A&E Access to information on individual patients across the Trust Protocols for management of oncological emergencies and referral pathways from A&E and acute admissions unit Specific pathways for the investigation and treatment of malignant spinal cord compression The Acute Oncology Service is intended for ACUTE problems. It does not replace existing pathways for the diagnosis of new cancers or their planned treatment.

4. Key features of an Acute Oncology Service Patient Management Review within 24 hours oncology nurse specialist 24/7 access to telephone advice from an oncologist Protocols for management of oncological emergencies Investigation and treatment of malignant spinal cord compression Referral Guidelines During and after treatment, patients and GPs are advised to contact the treating hospital. Attend local A&E department with immediate life threatening complications Fast track outpatient clinics post A&E acute review via the site specific/acute oncology team.

5. 24 /7 patient advice line All patients are issued with an alert card with 24 hour helpline number (Insert number) The chemo unit will rehearse situations with patients to ensure that they understand when and who they should contact if they have a problem All calls are followed up by the acute oncology service

6. Management of suspected Neutropenic Sepsis Immediate Interventions Isolate patient, perform and record observations. Establish venous access, bloods for FBC, U&Es, LFTs, Coagulation, CRP, lactate and blood cultures IV fluids / oxygen if required Check for allergies Swabs for infection screen. Stools for culture & C Diff toxin if has diarrhoea. Urine for culture if indicated. Empiric antibiotics immediately Do NOT wait for the neutrophil count before starting antibiotics Piperacillin/Tazobactum 4.5mg given IV stat. Penicillin allergy – rash only Meropenam 1gm IV. Penicillin allergy – anaphylaxis Ciprofloxacin 400mg IV plus Teicoplanin 40mg

7. In normal hours Monday – Friday (add in the details of how to contact your service

8. Add in details of how to contact your out of hours service

9. The Acute Oncology Assessment and Consultant on call service Available (add in details of local service) Acute oncology specialist nurse bleep (add in local contact) Access to consultant oncologist advice and assessment if needed Telephone advice is available from an on call specialist registrar or consultant oncologist, 24 hours a day, seven days a week via the NCCC at FRH 0191 233 6161 or JCUH (delete as appropriate) 24 hour advice from (add in local information)