Introduction Emotional distress (ED) is a significant unmet need experienced by up to a third of cancer patients. Many oncologists are reluctant to broach these issues perhaps due to (i) lack of awareness of referral pathways and (ii) a perception that it may increase the length of the consultation length. We propose that a clearly defined referral pathway to services and interventions to manage ED would help to overcome these barriers.

Aims To develop brief, accessible, evidence based guidelines for oncologists outlining local interventions and services to support the management of distress.

Methods Guidelines were developed using the National Institute of Clinical Excellence stepped psychosocial care and support model. This constituted a consensus based iterative approach involving:

• ▶ literature review

• ▶ local information gathering on services

• ▶ consultation with both professionals and patient groups.

Results Evidence based guidelines have been produced which reflect the range of interventions and services available and provide oncologists with clear pathways for management of ED. They and are now being disseminated for independent review and the resulting feedback will be incorporated to make further improvements.

Conclusion It has been possible to incorporate the views of professionals, service users and existing information services within the guidance. The efficacy of the guidelines will be evaluated via an audit of referrals to services, consultation analysis, assessment of patient centeredness and completion of outcome measures.