Integrating cancer care in a district general hospital


Developed from the existing specialist palliative care team, to encompass the acute oncology service and subsequently the cancer of unknown primary service, the integrated cancer care team at Basildon Hospital strives to provide a personalised, effective and responsive service that puts patients at the heart of decision-making. The service provides seven-day face-to-face contact and assessment for patients, wherever they are in the hospital, supporting them to receive the right care in the right place and in a timely manner.


The National Chemotherapy Advisory group specified in 2009 that all hospitals with an emergency department should provide an acute oncology assessment service. In 2010, the trust piloted an acute oncology service, resourced by nurse specialists within palliative care. A substantive Acute Oncology Service was launced in 2012.

In England and Wales over 10,000 cases of cancer of unknown primary (CUP) occur annually. It is  the fourth most common cause of cancer death, but 2010 NICE guidelines identified a lack of specialist nurses.

A CUP service was established at Basildon Hospital in 2013. The trust identified the need to financially invest in a Clinical Nurse Specialist. A CUP CNS started in October 2013, based in the Specialist Palliative Care Team.


The team aimed to improve patient experience and pathways by working between both primary and secondary care and across divisions and specialities.

By embedding the AO service and the CUP service within the specialist palliative care team, AO admissions gained access to immediate specialist pallaitive care input. Having a CUP CNS within the specialist palliative care team gave patients direct access to specialist palliative care advice.

Both the AO service and specialist palliative care team provide seven-day cover. They weekend cross-cover for the CUP service, guaranteeing prompt holistic patient assessment.

Ensuring staff across the trust are aware of the integrated cancer team, and the support and advice it provides across seven days, will increase accessibility to the team’s specialist services.

Back to the top

QiC Oncology Commended 2014
Cancer team of the year
Integrating cancer care in a district general hospital
by Basildon and Thurrock University Hospitals NHS Foundation Trust


Dawn Patience

Job title:
Head of nursing and quality for division of medicine – service unit manager
Place of work:
Basildon and Thurrock University Hospitals NHS Foundation Trust
01268 391632


Supported by: