Needs of Cancer Patients in Acute Care
Prompted by the findings of NCEPOD reports into deaths within 30 days of systemic anticancer treatment, and also deaths within 96 hours of admission to hospital, a joint RCP/RCR working group is now developing a framework that would enable timely and appropriate decision making for patients with cancer who present to emergency care services. This work will support the development of acute oncology services and the end of life care initiatives. Expertise within the group is drawn from oncology, haematology, internal medicine, emergency medicine and critical care; primary care and palliative medicine; nursing and patient/carer representatives.
Existing pathways for patients with cancer who present to A&E, and are then admitted to hospital, are often very inadequate. Care can be adversely affected by a number of issues; poor communication between professionals, variable access to specialist oncology and palliative medicine advice (and indeed a general lack of palliative care skills and knowledge in acute care settings); both nihilism and inappropriate intervention in the context of advanced disease; difficulties in the transition between ‘life saving care’ to supportive end of life care, and poor recognition of the individual patient’s preferences.
Given the vital importance of this work I hope you will consider your own experiences of managing a person who presents as an emergency with a pre-existing or new cancer diagnosis, and how this influenced subsequent management. The Working Group is gathering a range of insights and perspectives from as many professionals – and patients and carers - as possible to assist in their report preparation. They would welcome your thoughts and views on what should be improved and what would enable this to happen.
This could be in relation to
- A particular situation that presented challenges in decision making for the teams concerned
- Areas that could be addressed through education
- Examples of tools and good practice that have demonstrably helped the teams and empowered patients
- Any relevant evidence, published or unpublished, that you would be willing to share.
The working party is chaired by Dr Wendy Makin Consultant in Palliative Care.
Any questions and in particular any input into the above can be done by contacting: