Acute Oncology in Northumbria Healthcare NHS TrustDr. Ian Neilly, Acute Oncology Clinical Lead.

3 District General Hospitals;• North Tyneside• Wansbeck• Hexham

6 Community Hospitals;• Alnwick Infirmary• Berwick Infirmary• Morpeth Cottage • Blyth Community• Rothbury Cottage• Haltwhistle War Memorial

Existing Resources in Oncology:

Chemotherapy day units:

Wansbeck General Hospital A+ENorth Tyneside General Hospital A+EHexham General Hospital ECUBerwick InfirmaryAlnwick Infirmary

Visiting Oncologists:Clinics only

Specialist Cancer Nurses:Haematology, Breast, Lung, Urology, Colo-rectal

Haemato-Oncologists:Clinics and daily presence in hospital

No dedicated IP facilities. We depend on linking with NCCC.

Patient report a high satisfaction rate with the existing service. In the National Cancer Patient Survey the Trust scored 6/158 in patient satisfaction.

We identified our oncology day units as the place to develop and implement changes required to meet the measures. NTGH are already seeing 196 cases/year as emergencies in office hours and admitting 46.

The patients are familiar with the staff and the setting.

Nurses band 6 and above working in the day units have attended or will attend the NACAN (Northumbria Advanced Clinical Assessment Course) to develop the Acute Oncology Assessment service.

The team have piloted the Triage Tool during working hours in preparation.

They will work with the Acute Oncology Management Guidelines.

The Oncology nurses will man the 24 helpline and be ready to work with MAU and A+E in dealing with Acute Oncology problems, assessing patients on the ward as required.

They will see patients referred from A&E in a triage setting in the day units and liaise with the appropriate consultants to ensure patients are then booked into the correct clinic within one week.

They will share and build up their already considerable expertise in Acute Oncology.

Their existing jobs will need backfilled to allow them to take up this new role. The business case is submitted but not yet approved and so we fail to meet some of the measures at present.

Other changes underway:

Acute Oncology Group are meeting regularly.

Accommodation for the day units is changing as larger, more suitable premises are required -especially at NTGH.

RAPA (patient alert system) training completed and IT installing in October.

We need to use the NCCC acute oncology consultant service and MSCC service.

Measure Compliance:

11-3y-301 to 311 = 80%11-3y-401 to 404 = 0%11-3y-101 to 106 = 17%

Challenges:We are awaiting a decision with regards to the funding to allow us to implement all the plans that we have prepared.

We are confident that once funding is identified we will meet many of the measures.

We do not have oncologists every day on site and so will not meet this measure.

Due to our geographical size we will not be booking directly into clinics from A&E in the first instance, but trial a different model, through our acute oncology nurses, that will provide us with details on activity and help us to monitor the referrals for further discussion.