Doncaster CCG funded the recruitment of two additional acute oncology specialist (AOS) nurses to pilot an 8am-8pm, 7 days a week, including bank holidays, service at Doncaster Royal Infirmary. Bassetlaw Hospital continues to have a 9am-5pm service and telephone advice is given by the AOS Nurse after 5pm and during the weekends. The hours 8am-8pm were chosen in line with the hours that other professionals work, for example the 8-8 walk-in centre. 306 patients were seen during the pilot period of October – March and of these 151 were seen in the new working hours.
National reports identified serious concerns about the quality and safety of services for cancer patients presenting to acute hospitals as emergencies. Hospitals were therefore required to develop an Acute Oncology Service (AOS) and set up an Acute Oncology Team (AOT). Poor communication between teams, especially from primary to secondary care, was found and a need for specialist presence out of hours highlighted. There were also concerns from the Doncaster CCG around the number of emergency admissions related to a patient cancer diagnosis.
The current service operated from 9am-5pm, so only a third of patients were seen. A need to extend working hours to include weekends and bank holidays was identified. Funding was obtained from Doncaster CCG for a six-month pilot.
The project aimed to provide an out-of-hours service for cancer patients presenting as an emergency to Doncaster Royal Infirmary. Bassetlaw Hospital would continue to have a 9am-5pm service Monday to Friday, with telephone advice out of hours from the AO clinical nurse specialist (CNS) at Doncaster.
Objectives included saving patients from unnecessary tests and emergency admission to hospital, ensuring rapid assessment and triage of cancer patients presenting as emergencies, and improving the quality of patient and carer experience.
The team also wanted to support generalist staff when oncological expertise is required.
The project required the AOT to provide education sessions to staff in emergency receiving areas (A&E/MAU) and community staff such as nurses and GPs.
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