South East Cancer Network (SCAN)

The South East Cancer Network   (click here for the network website) 

What is currently happening with Acute Oncology (AO) across the  SCAN network:

• Systemic Anti Cancer Therapy (SACT) is delivered, where possible, nearest to the patients home or at the Edinburgh Cancer Centre (ECC).
• Radiotherapy is delivered at the ECC.

• Acute oncology team

NHS Lothian - The ECC have an on call team who manage acute oncology unscheduled care. Initial referrals or calls for advice are made via a direct telephone number. A senior nursing team triage calls during working hours and the specialist registrar out of hours. In turn this allows the clinical team to assess acute oncology patients either in the dedicated oncology assessment area (OAA) or via locally agreed pathways at their local hospital either by the local acute oncology team or medical team. The aim is to provide rapid (or specialist) oncological assessment for patients with complications relating to their cancer treatment or disease in a safe clinical area. As a result they are able to provide an assess to admit model of management rather than admit to assess one.

West Lothian – At St John’s Hospital, Livingston a new Acute Oncology Service (AOS) was established in March 2020 to support the expansion of the local SACT unit. This outreach service accepts referrals Monday-Friday 9-5pm and is a consultant led model overseeing a team of two speciality doctors and a trainee ANP. The service is aiming to establish more integrated working between acute medical and surgical specialties by early access to speciality oncology input as well as promoting education and awareness. The team also has input from a palliative care consultant with AO experience embedding an enhanced supportive care approach aiming to avoid over treatment and maintain or improve quality of life 

• Dedicated oncology assessment area - Following a pilot of an Oncology Assessment Area (OAA) within an Oncology ward at the Edinburgh Cancer Centre (ECC) a new dedicated facility was launched at the end of 2013. The aim was to provide rapid (or specialist) oncological and haematological assessment for patients with complications relating to their cancer treatment or disease in a safe dedicated clinical area. The facility is open 24 hours a day, accommodating trolley bays, isolation rooms and a procedure room. It is supported by a dedicated multi disciplinary team; nurses, doctors, administration staff and pharmacists.
• Malignant Spinal Cord Compression (MSCC) - Patients with suspected MSCC are investigated via locally agreed referral pathways. The pathways promote local investigation with prompt transfer to the specialist ECC if positive for radiotherapy, and consistent management using locally developed MSCC guidance.
• Cancer of unknown primary/Malignancy of Undefined Origin (CUP/MUO) - Patients presenting with malignancy of undefined origin (MUO)/metastatic cancer of unknown primary (CUP)  are investigated and managed through locally agreed pathways across the region. NHS Lothian has a designated multidisciplinary CUP team and infrastructure in line with all site-specific tumour groups. The CUP team provides a service to the population of Edinburgh and the Lothian’s as well as providing advice/MDM review /patient review to NHS Fife, Borders and Dumfries on referral. The service provides a streamlined diagnostic pathway to ensure early patient review by members of a designated multidisciplinary team, improved oncological treatment selection and symptom control and support for patient and carers. For patients with less favourable subsets of CUP, time is limited, and an early focus on supportive care is crucial.

NHS Borders –  awaiting information

NHS Dumfries and Galloway –  awaiting information

Future plans for AO

Acute oncology services are evolving within SCAN. A number of initiatives started on a project basis. Outcomes from such projects have demonstrated their worth with some able to expand with additional funding and some discontinued due to lack of funding. SCAN health boards acknowledge, as demand on for oncology services expands, further development of the AO services will be a priority.

Key contacts in the region:

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