Rapid cancer diagnostics, novel cancer treatment and longer cancer survival have increased the number of patients with cancer and treatment related complications being seen by acute medical services as unplanned admissions.  Almost a quarter of new cancer diagnosesare made following an emergency admission.

The Society of Acute Medicine Benchmarking Audit(SAMBA) in 2022 provided an opportunity for the SAM Acute Oncology (AO) subgroup to review the provision of acute oncology services in the UK via a questionnaire to all participating hospitals with an emergency department. SAMBA 22 demonstrated that acute medical services are not geared to meet the urgent cancer patient care standards set by the National Chemotherapy Advisory Group (NCAG) 2009 following concerns over the care of inpatients receiving cancer treatment.  The NCAG 2009 recommended that all hospitals with an emergency department should establish an acute oncology service (AOS) tasked with managing acute cancer care pathways and implement peer reviewed acute cancer standards. The SAMBA 22 results, from the 128 hospitals responding to the audit questionnaire found that:

• A large proportion of acute cancer presentations were assessed in ED or AMU
• 10 units did not have access to an AOS.
• More than half did not have access to AO hot clinics or Malignancy of unknown origin (MUO) clinics.
• Only 42.3% had an alert system for unplanned AO presentations that was embedded in the patient record.
• 69.5% had no SDEC specific oncology pathways
• Acute oncology patients were less likely to be assessed in or discharged from SDEC, compared to patients with non-oncological presentations.

The SAM AO subgroup is focused on bridging the front door processes in acute oncology patient care with a focus on:

• Acute cancer pathway development linking up cancer services with AMU
• SDEC pathways for acute oncology patient presentations that avoid unnecessary admissions and promote reduction in LOS
• MUO/Hot clinic - diagnostic process for acute medical presentations with abnormal radiological finding suggestive of MUO.
• Immunotoxicities and late effects – early recognition and management pathways
• Patient experience – enhancing patient flow whilst maintaining effective treatment and patient experience
• AOS Liaison/MDT - Development of Acute medicine consultant liaison role in the AOS
• Training – Review of subspeciality training program curriculum for AIM trainees with an AO subspeciality interest.

The SAM AO subgroup has representation in the UK Acute Oncology Society (UKAOS) board which is an exciting opportunity for joint working in establishing national change in acute cancer care, training and research.

The SAM AO subgroup is keen to link with acute physicians at trainee to consultant level to share current practices, knowledge and  training requirements. Please fill the form to lodge your interest.