Background At our trust (Popn 289400, x2 district general hospitals,) the Acute Oncology Service (AOS) began formally in June 2015. The team consists of 6 members, 3 consultants (1 session per week each ; x1 clinical lead at both sites and one clinical lead for metastatic spinal cord compression across both sites,) 2 clinical nurse specialists full time, 1 data coordinator full time. One of the 3 consultants is a chest physician (author.)
In September 2014 a formal expression of need for AOS development was accepted and supported by Macmillan for a 3 year fixed term project.
There was a well supported process of induction for the nurses and introduction of the service to the Health Board prior to becoming clinically available in September 2016.
569 patients have been seen since clinically active (Sept 2015)
Median reduction in length of hospital stay (LOS) from 11 to 5 days for patients with carcinoma of unknown primary (CUP)
Median LOS since introduction of service is 5 days for all cancer diagnoses. This equates to a 1 day reduction in LOS. Median LOS in preceding years 2011–2015 = 6 days
The largest number of refrrals to the service has been for patients with lung cancer (21%) – see Table
Conclusions/personnel reflections An effective AOS service improves quantatative outcomes(reduced LOS, efficient processing of CUP patients,) and enhances qualititative outcomes for patients (advocates for CUP patients,better communication*)
The majority of cancers dealt with by the AOS service are lung cancer
The outcomes above are almost exclusivley down to the AOS nurses but of all medical and surgical specialities,chest physicians (who deal with lung cancer) are ideally placed as clinical leads for this service due to their cancer experience and established links with radiology,pathology and palliative care (Author’s own opinion.)
For present and future AOS services, this team would reccommend that an amenable/enthusisastic chest physician would be a valuable asset to the service
* Patient feedback can be provided on request