West of Scotland Cancer Network (WoSCAN)

 Acute Oncology: West of Scotland Cancer Network

The West of Scotland Cancer Network is a collaborative embracing the four NHS Boards in the West of Scotland. Together with the WoS regional Managed Clinical Networks (MCNs), Speciality Networks (Pharmacy and Nursing) and hosted National Managed Clinical Networks, WoSCAN serves a population of 2.5 million people (almost half of the Scottish population) and provides some specialist services for patients from other areas of Scotland including the Western Isles and Dumfries & Galloway.

NHS Greater Glasgow & Clyde

The Beatson West of Scotland Cancer Centre is part of NHSGGC and has been progressing a number of acute oncology initiatives, including:

• Acute Oncology Assessment Unit (AOAU) established at the Cancer Centre in October 2013. This unit is ANP led with a combination of specialist cancer nurses and ANPs from acute medicine. Medical input as required is mainly from the on call registrar and consultant. Patients come to the unit via the Beatson Cancer Treatment Helpline or from clinic, or treatment areas if they present unwell, or become unwell during treatment. Includes oncological emergencies, consistently meeting door to needle time for Sepsis.
• An in-reach Acute Oncology service from the cancer centre was established in February 2017 at Queen Elizabeth University Hospital (QEUH) which is one of the largest acute hospitals in the UK (1109 patient rooms).  This is delivered through consultant medical sessions and on-site acute oncology ANPs. We are currently looking at the other acute hospitals with a view to implementing a similar AO model.
• A new MDT and clinic was established as part of the QEUH AO development, and is now an established service at the cancer centre with a CNS, medical sessions, designated clinic and weekly MDT.
• Alert cards for patients at high risk of developing MSCC and pathways into acute services for review
• Beatson Cancer Treatment Helpline – 7 day service for all patients on treatment at the Cancer Centre, delivered by oncology nurses in the AOAU, supported by regional pathways and access to patient records. Triage nurses taking calls will advise the patient, arrange for them to be seen in acute care or by GP, send written communication to place seeing patient, undertake follow up calls as appropriate and liaise with the patient’s own clinical team. Diverts to National NHS24 CTH overnight only - from 8pm. Beatson nurses follow up the NHS24 CTH calls every morning including at weekends.

NHS Ayrshire & Arran

• Patients receiving/within 6 weeks of receiving treatment at the Beatson contact the Beatson Cancer Treatment helpline
• Patients receiving/within 6 weeks of receiving treatment within NHS Ayrshire & Arran contact NHS 24 Cancer Treatment Helpline.  Call handlers triage patients in hours (Mon-Fri 08.00-16.30) with double amber/red calls being transferred to a CTH page holder who refers to speciality CNS for enhanced assessment/intervention or arranges admission to the local clinical end point.   Out of hours call handlers triage patients to the local clinical end point for assessment.  GP and clinical teams are informed of CTH patient contact and outcome.

NHS Lanarkshire

• Patients receiving/within 6 weeks of receiving treatment at the Beatson contact the Beatson Cancer Treatment helpline
• Patients receiving/within 6 weeks of receiving treatment within NHS Lanarkshire contact NHS 24 Cancer Treatment Helpline where call-handlers triage patients to local clinical end points for further assessment as indicated. Clinical teams are informed of CTH patient contact and outcome with the addition of clinical teams calling the patient back to ensure the initial management suggested or undertaken as been effective. This gives the opportunity to move unscheduled care into planned care.
• Development of Lanarkshire Primary Care pathway to enable the safe stratification of care within the wider Healthcare Professional remit supporting a person centred, safe and effective Integrated Health and Social care model (Monday to Sunday).
• 2 Acute Oncology ANPs are based at Monklands site and provide telephone advice/support to Wishaw and Hairmyres
• In addition to this the ANP can also review patients with less acute symptoms within the Oncology Day Units as a planned AO review to clinically assess and prescribe appropriate medication.
• Development of NHS Lanarkshire CUP pathway with testing of this underway at Monklands Hospital with the support of the Medical Oncology Advanced Nurse Practitioners and the Palliative Care Team.

NHS Forth Valley

• Patients receiving/within 6 weeks of receiving treatment at the Beatson contact the Beatson Cancer Treatment helpline
• Patients receiving/within 6 weeks of receiving treatment within NHS Forth Valley contact NHS 24 Cancer Treatment Helpline where call-handlers triage patients to local clinical end points for assessment as indicated. GP and clinical teams are informed of CTH patient contact and outcome
• In addition to above, the Oncology/ Palliative Care Nursing Team based in Forth Valley Royal, on a rotational basis liaise with the Acute Receiving unit daily to ensure any patients admitted with a cancer diagnosis or with palliative care needs are reviewed within one working day by the appropriate cancer team.

Future plans for AO in West of Scotland

• Further expansion of in-reach from cancer centre, within NHS GGC.
• Regional approach to Acute Oncology

Key contacts in the region

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