This document discusses implementing a national telephone triage service for cancer patients in Scotland. It aims to provide consistent triage using the UKONS tool and refer patients to secondary care if needed. The service would involve NHS 24 call handlers triaging patients who call a dedicated number with concerns after cancer treatment. Patients referred for further assessment would be seen by an acute oncology team within each region. The benefits cited include safe and reliable triage, timely access to care, and audit capabilities to support quality. Next steps include developing training programs and further planning electronic health integration between NHS 24 and secondary care services.

1. Improving Outcomes by
Implementing a National
Telephone Triage Service
Dawn Orr, Nurse Consultant, Clinical Decision
Making

2. National telephone triage service for
patients receiving or recently completed SACT or
radiotherapy
 Aim of the session…
 Share….Background, Context, Future
 Describe work carried out so far
 Describe the next steps
 Raise the profile and sense check

3. Background
• Nationally consistent telephone triage
service
• Reports/Policy/Publications/ Directives
• Short life working group

4. Front End: NHS 24 – Cancer Team Model V 0.2 – 05.03.12
On commencement of treatment every patient is issued with an ‘alert card’ based on the template set out within the NPS BPS
which advices the patient to call NHS 24 – Cancer Team if the patient has a healthcare concern
Patient at home NHS 24 – Cancer Patient is Patient is managed
has a healthcare Team answer Triaged using according to
concern UKONS Tool triaged alert
Patient or carer NHS24 – Cancer Call Handler takes Green – Advice
follows the ‘alert Team – Call the patients details. given
card’ and calls the Handler asks the Call Handler talks Amber – Follow up
dedicated number NHS24 standard the caller through after 24hrs by NHS
for the NHS 24 – initial questions. If the UKONS Triage 24 – Cancer Team
Cancer Team serious health tool. Double Amber or
concern advices Completed tool is Red – Assessment
caller to Dial 999 electronically auto - required within
shared with the secondary health
prescribing team. care setting.
Call Hander [Band 2 AfC] supervised at all
times by Senior Staff [Band 6 AfC] on a
maximum 5:1 basis. It is the responsibility of each
All Cancer Team staff complete competence NHS Board to determine and
based training. share with NHS 24 how that
All call are monitored and audited. assessment will be managed

5. Referral On: Management Within Secondary Care Model V 0.2 – 05.03.12
On commencement of treatment every patient is issued with an ‘alert card’ based on the template set out within the NPS BPS
which advices the patient to call NHS 24 – Cancer Team if the patient has a healthcare concern
Patient triaged Patient referred to Patient attends Initial treatment / Patient managed
using UKONS secondary care secondary care management plan by Prescribing
Tool by triage service for assessment implemented Team
Double Amber or Each NHS Board Receiving Service Initial treatment / Patients ongoing care
Red – Assessment has responsibility assess the patient management is transferred to the
required within to have an identified and develop an options: Prescribing Team
secondary health Receiving Service initial treatment / • discharge with
care setting to accept referrals management plan agreed follow up
• admit to general Effectiveness of
medical ward of model will be
attending hospital reviewed:
There is national Receiving Service provided by NHS Board will: • admit to cancer • Audit
consistency with all • Meet a set of minimum clinical standards that centre • Patient Experience
front door services match the NPS BPS(2011), the future CEL • admit to ITU • M+M Review
using the UKONS (2012) and the UKONS (2012) AO Guidelines
traige tool: • Have capacity to manage multiple referrals
• NHS 24 Receiving Service model could be:
• Primary Care • Acute Oncology Team Priority is for at the earliest point all treatment
• Emergency Care • Oncology Emergency Assessment Area / management transfers from the Receiving
• Other? • Emergency Medical Assessment Team Service to the patients Prescribing Team

6. Benefits
• Safe reliable triage tool
• Dedicated phone number/ cancer
• Dedicated Secondary care
• Audit trial to support quality and demand
• Robust governance framework
• C ost effective
• Timely access to Acute Oncology Service

7. Next steps
• Preparation of training programme
• PID development
• E health input
• Sharing electronic records

8. Thank you
Dawn.orr@nhs24.scot.nhs.uk
scott.taylor@scotland.gsi.gov.uk