Cathy Hutchison, Cancer Consultant Nurse, NHS Greater Glasgow & Clyde and Beatson West of Scotland Cancer Centre

1. New Acute Oncology Services
Workshop
Cathy Hutchison
Rosie Roberts
Lisa Barrott

2. Session aims: working together
Identify the key challenges encountered
when developing new services
Share lessons learned through mistakes
& successes
Develop ‘Top Tips’ for those setting up
services or expanding existing services

3. Acute oncology in Wales
Established 2011
1 nurse in each DGH
CUP MDT
No DGH: No AOS.
2016:
1 x Band 8 lead nurse
2 x Band 7 nurses
plus consultant sessions
2015: 1x WTE AO SpR
2016: 2 x AOS Band 7 nurses
2017: Admin support
2015: 3 x Band 7 nurses
1 consultant session
Admin support
2016: 1 x band 6
2015: 2 x Band 7 AOS nurses
1 consultant session
2016: Admin support
2016: Band 8 AOS ANP
2015: 2 x band 7 nurses
2 x consultant sessions
1 x radiologist session
Data analyst /admin
VELINDRE CANCER CENTRE
2015: 1 x Band 7 AOS nurse
24/7 AOS Spr
2016: Admin support

4. All Wales Structure
WalesCancerNetwork: 1sessionConsultant
oncologist & MacmillanAO project (1.4WTE)
All WalesAO group with agreedworkstreams
-data group
-professionaleducationanddevelopment
-AcuteOncologystandards
3 regionalgroups:SouthEast,SouthWest&North
AcuteOncologydatabaseusedacrossWales
Pathways and protocolsshared
WelshAOS standardspublished2016

5. What next?
Securing ongoing fundingfor Macmillanfundedposts
andexpansionofservices
ExploringoptionsforAO assessmentunits
Developmentalposts forband6-7nurses
Considerationof7dayworking
AOmobilephoneAPP forjuniormedics July 2017
AOpeerreview2018
Options for Primarycare AO

6. NHS Greater Glasgow & Clyde
Part of West of Scotland
Cancer Network
2 AO service models:
1) Beatson WoS Cancer Centre
Acute Oncology Assessment Unit
& Helpline
2) Queen Elizabeth University Hospitals
AO in-reach

7. Acute Oncology Assessment Unit (AOAU) & Helpline
• Beatson WoS Cancer Centre - Non surgical cancer treatment centre
for West of Scotland (population approx 2.5m)
• AOAU - 8 bedded single rooms, 8am-8pm, mon-fri
• Nurse-led – ANP/NP + Staff nurse/HCSW – access to on-call Reg
• Houses Cancer Treatment Helpline – manned by nurses with access to
patient records, 8am-8pm, 7 days (diverts to national cancer
treatment helpline for urgent calls overnight)
Queen Elizabeth University Hospitals (QEUH) AO in-reach
• QEUH - one of the largest acute hospitals in the UK (14 floors, 1,109
patient rooms)
• Baseline audit screened 9308 patients to identify 749
cancer/suspected cancer unscheduled attendances in 1 month
• Business case for new service – 4 ANPs, 2WTE consultants, Audit
Facilitator, Admin post - Macmillan funded
• Beatson Macmillan Acute Oncology Service –launched 27/2/17

8. Next steps
• Regional AO group – first meeting 10/3/17
• Regional audit
• QEUH - completion of ANP training programme
• Review of new QEUH service after 6-12 months
(?expansion of service hours)
• Development of QEUH AO database
• Development of other DGH-based AO services
within health board (2 sites) and also across the
region

9. Acute Oncology in England:
Brighton & Sussex University
Hospitals NHS Trust experience
• BSUH NHS Trust: one of largest UK teaching hospitals; 2
acute sites; cancer centre, trauma centre, children;
eye; population >1 million; 944 beds
• 2010: draft AO measures. Finalised 2011. AOS
mandated
• Snap shot audit BSUH 2010; AO 5 day/wk service
introduced 2011: consultant led, 1WTE CNS, RSCH
based only
• Peer Review 2012, 2013, 2014: Immediate risks as no
on-site cover at PRH. 2013 change to nurse led service
• 2014: Trust supported expansion of service to 3 WTE
CNS’ & admin to provide cover at PRH and set up CUP
MDM

10. BSUHAO Service
• Nurse Led service, with 0.5 PA consultant @ PRH and 1 PA speciality doctor @
RSCH & 1 PA @ PRH. 1PA each for CUP clinic. MDM coordinator and patient
support worker role
• Macmillan Adoption
• On call consultant support Mon-Fri
• SpR support
• 5 day/wk nurse-led service; SpR cover weekends on-site RSCH only
• Review of patients in all specialities. NS audit, Early Discharge Pathway
• Attendance daily acute medical meeting; email referral system
• Helpline via chemo unit and inpatient wards
• Key workers for CUP service
• On-going collaboration across Sussex Cancer Network footprint- regular
meetings/joint working, inc MSCC
• Somerset Cancer Register

11. Next Steps
• AO national measures review
• Extended roles: expansion of AOS to incorporate ANP roles with
responsibility for chemo units both sites and cancer centre
• 7 day service?
• Collaboration with SECAMB: IBIS, teaching programmes, admission
avoidance
• Community AOS?
• Acute assessment unit!
• Audit of service across the Network