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Acute Oncology Service (AOS)

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)

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  1. Acute Oncology Service (AOS) Monday – Friday 8am – 4pm Bleep: 946 T: 020 8401 3000 x5726 F: 020 8401 3513

  2. 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

  3. Diagnostics Disease sites • Lung • Upper GI • Lower GI • Breast • Gynaecology • Urology • Skin • Haematology Cancer MDM Treatment Cancer MDM Palliative care

  4. AOS referrals

  5. GP referrals • 61 GP practices • 6786 urgent referrals suspected cancer (2012/ 2013) • Conversion rate 9.82 (4th highest LCA) • 1678 new cancer registrations (2011)

  6. 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

  7. 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

  8. What we can offer • Cancer expertise • Diagnostics • Treatment complications • Disease complications • Liaison with Cancer Center where necessary

  9. Job plan

  10. 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

  11. 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)

  12. Treatment: • IV fluids and bisphosphonates • Biopsy to confirm metastatic cancer • Referral to RMH for ongoing outpatient management

  13. 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

  14. Treatment • High dose steroids to reduce swelling • Referred to respiratory for stenting • Discussion at CUH MDT (video-linked to RMH) • Offered radiotherapy

  15. Case Study 3 • 22 year old man • Admitted with back ache • Investigations • Examination and blood tests reveal no abnormalities • CT scan - large retroperitoneal mass

  16. 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

  17. 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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