Enhancing cancer care in emergency settings

A new treatment pathway is helping to better care for patients diagnosed with cancer at Oxford University Hospitals NHS Foundation Trust's (OUH) two Emergency Departments (EDs).

The Acute Oncology Service (AOS) aims to address delays in patients receiving specialist support, confirming diagnoses, and starting treatment.

Previously, patients with suspected cancer who presented in ED were often signposted back to their GP for urgent referral to cancer services, often resulting in weeks of waiting without access to necessary support.

To improve care for these patients, a new pathway led by the Acute Oncology team was implemented at the Trust’s two EDs at the John Radcliffe Hospital in Oxford and Horton General Hospital in Banbury. This was launched as part of a quality improvement project in April 2023 with seed funding support from the Thames Valley Cancer Alliance (TVCA).

The team, made up of five nurses who are supported by four oncology consultants, facilitates onward treatment for patients who attend ED and are diagnosed with a likely cancer.

Data collected during the first year of implementation has shown improvement in care for patients who present in ED, with more patients receiving specialist support from the point of discharge from ED.

Kay McCallum, Consultant Nurse in Acute Oncology at OUH, said: “This pathway for patients with suspected cancer diagnosed in our Emergency Departments has multiple benefits for patients and families, and also for the Trust and wider health care services, such as GPs.

"AOS helps to enhance patient experience by providing timely and effective care; improve clinical outcomes through coordinated and specialised treatment; and ensure high-quality emergency care for all cancer patients."

The service receives between 15 and 20 referrals per month, and early support for this patient group is important.

Following a referral, the team contacts the patient within 24 hours and ensures timely investigations. Patients are under the care of an acute oncology consultant and have access to acute oncology nurses for telephone support.

Weekly meetings are held to discuss these patients, involving representatives from teams across the Trust, including acute oncology, radiology, acute medicine, and palliative care.

Felicity Taylor-Drewe, Chief Operating Officer at OUH, said: "I am delighted to see the positive impact of improvements to the Acute Oncology Service pathway on patient care.

"We are committed to providing timely and efficient care, ensuring that patients receive the support they need from the moment they are discharged from the ED. Well done to all those involved."

If you are concerned about any symptoms, you should contact your GP or primary care physician in the first instance.

Pictured: Emergency Department at the John Radcliffe Hospital