The aim of the acute oncology service is to provide a systematic approach to dealing with cancer related emergencies in order to optimise the care of patients presenting to hospital potentially suffering from the acute complications of cancer treatment or from emergencies caused by the disease process itself. While for cancer centres this service is perhaps most logically placed within the oncology department, alignment of the service in trusts without oncology services is possibly less clear. The vast majority of these organisations have, however, a specialist palliative care team who have clinical contact with most patients admitted with complications of cancer or its treatment and who are already familiar with managing many of the clinical conditions that fall within the remit of acute oncology. The aim of this pilot project was to establish an acute oncology service model within a teaching district general hospital which has on-site palliative care and haematology services but is not a cancer centre. The service commenced in autumn 2011 and comprised several elements: (1) the acute oncology team chaired by the consultant in palliative medicine as trust acute oncology lead (2) the acute oncology assessment service staffed by palliative care clinical nurse specialists with medical support from oncologists based at the local cancer centre (3) fast track referrals for patients needing rapid access into clinics for diagnostic or review purposes facilitated by the acute oncology administrative support, an extended role for the hospital palliative care team administrative support (4) audit, to quantitatively and qualitatively assess the service (5) education, to train acute medical and nursing staff in the use of the acute oncology service. In conclusion, an acute oncology service can be placed successfully within a specialist palliative care team with cancer expertise in trusts that do not have oncology services which are based on-site.
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