Acute Oncology Service (AOS)
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Acute Oncology Service (AOS). Monday – Friday 8am – 4pm Bleep: 946 T: 020 8401 3000 x5726 F: 020 8401 3513. Croydon Healthcare Services. Population of 346,000 65 years and over (13.8%) 85 years and over (1.9%) 61 GP practices Croydon University Hospital 572 beds

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Acute Oncology Service (AOS)

Monday – Friday

8am – 4pm

Bleep: 946

T: 020 8401 3000 x5726

F: 020 8401 3513


Croydon healthcare services
Croydon Healthcare Services

  • Population of 346,000

  • 65 years and over (13.8%)

  • 85 years and over (1.9%)

  • 61 GP practices

  • Croydon University Hospital 572 beds

  • Member London Cancer Alliance


Diagnostics

Disease sites

  • Lung

  • Upper GI

  • Lower GI

  • Breast

  • Gynaecology

  • Urology

  • Skin

  • Haematology

Cancer MDM

Treatment

Cancer MDM

Palliative care



Gp referrals
GP referrals

  • 61 GP practices

  • 6786 urgent referrals suspected cancer (2012/ 2013)

  • Conversion rate 9.82 (4th highest LCA)

  • 1678 new cancer registrations (2011)


Muo cns
MUO CNS

  • To provide support and information to patient

  • To improve coordination of diagnostic pathway

  • To speed time to diagnosis

  • Source of expertise for GPs and

    colleagues


Consultant oncologist job plan
Consultant Oncologist Job plan

  • Started in the Trust in November 2012

  • Joined in December 2012 by Dr Jill Noble

  • Work between RMH (Breast Unit) and CUH (Acute Oncology Service and Breast Unit)

  • RMH employed- similar consultant posts at Kingston Hospital and Epsom and St Helier


What we can offer
What we can offer

  • Cancer expertise

    • Diagnostics

    • Treatment complications

    • Disease complications

  • Liaison with Cancer Center where necessary



Our aims
Our aims

  • Earlier diagnosis

  • Correct management quicker

  • Shorter inpatient stays

  • Ambulatory pathways

  • Closer to home

  • Referral to cancer center where necessary

  • Referral to palliative care where appropriate

  • IMPROVED PATIENT EXPERIENCE

  • Education

    • Patient

    • Staff-hospital and community

  • Research

    • CADIAS


Case study 1
Case Study 1

  • 55 year old lady

  • History of breast cancer

  • Presents with nausea and vomiting

  • Results:

  • Calcium level is elevated at 3

  • Imaging show she has new bone and liver metastases (secondary breast cancer)


Treatment:

  • IV fluids and bisphosphonates

  • Biopsy to confirm metastatic cancer

  • Referral to RMH for ongoing outpatient management


Case study 2
Case Study 2

  • 70 year old man

  • Admitted with a cough and a swollen face

  • Results:

  • CXR - widened mediastinum

  • CT - lung mass, enlarged lymph nodes obstructing superior vena cava


Treatment

  • High dose steroids to reduce swelling

  • Referred to respiratory for stenting

  • Discussion at CUH MDT (video-linked to RMH)

  • Offered radiotherapy


Case study 3
Case Study 3

  • 22 year old man

  • Admitted with back ache

  • Investigations

  • Examination and blood tests reveal no abnormalities

  • CT scan - large retroperitoneal mass


Differential diagnoses include sarcoma, lymphoma, germ cell tumour (amongst others)

Treatment

  • His imaging is IEPed to RMH to be discussed at the sarcoma meeting

  • He is transferred as an inpatient to have surgery


Future developments
Future developments

  • Ambulatory care facility to avoid admission

  • Outpatient clinic

  • Trust wide dissemination protocols and pathways

  • Trust wide education programme

  • Joint teaching with CUH and RMH


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