Transcript Issues in systemic therapy

The Acute Oncology Project
Mrs Jenny Almond
Project Lead for Acute Oncology
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
Project Management Structure
• An Acute Oncology Project Steering Group
established with representation from MCCN
MCCN Clinical
Advisory Group
Chair: Ged Corcoran
Vision 2020 Steering
Group
Chair: Silas Nicholls
Acute Oncology
Project Steering
Group
Chair: Jenny Almond
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)
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
NA T C A N S A T
The National Cancer Services Analysis Team
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
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
Collaboration
• Acute oncology requires collaboration between:
– Oncology
– Palliative care
– Acute Medicine
– ED
– Haematology
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
Acute Oncology
Patient admitted via ED or AMU
Portfolio of
protocols /
pathways
‘Onco Alert’ to AOT
Oncologist / CNS review
Diagnostic & Treatment Plan
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
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
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)
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
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
Thank you for your attention
Any questions?
Further information:
[email protected]