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The Acute Oncology Project

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

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The Acute Oncology Project

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  1. The Acute Oncology Project Mrs Jenny Almond Project Lead for Acute Oncology

  2. 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

  3. Vision 2020 Steering Group Chair: Silas Nicholls MCCN Clinical Advisory Group Chair: Ged Corcoran Acute Oncology Project Steering Group Chair: Jenny Almond Project Management Structure • An Acute Oncology Project Steering Group established with representation from MCCN

  4. 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)

  5. 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 N A  T  C  A  N  S  A  TThe National Cancer Services Analysis Team

  6. 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

  7. 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

  8. Collaboration • Acute oncology requires collaboration between: • Oncology • Palliative care • Acute Medicine • ED • Haematology

  9. 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

  10. Acute Oncology Patient admitted via ED or AMU ‘Onco Alert’ to AOT Portfolio of protocols / pathways Oncologist / CNS review Diagnostic & Treatment Plan

  11. 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

  12. 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

  13. 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)

  14. 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

  15. 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

  16. Thank you for your attention Any questions? Further information: jenny.almond@ccotrust.nhs.uk

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