1. Developing a NI Acute Oncology Service Round Table Discussions Liz Henderson Advisor to Macmillan Cancer Support

2. Discussion agenda Take note of your concerns and claims about AOS in NI Identify the key issues/questions that emerge Briefly explore these Prioritise what is required

3. Claims What positive statements could you make about current acute oncology arrangements 2 minutes

4. Concerns What concerns do you have about current arrangements for acute oncology 4 minutes

5. Summary CLAIMS Patients are in the system and being managed Regional input and improved NS management in AE’s Collaboration & education in AE Nurse led 24hr helpline standardised with UKONS Unit/centre patient pathways for chemo complications SHSCT AOS Regional collaboration on MSCC Funding approved for Oncologists to support AOS Offer of funding from Macmillan for AOS nurses CONCERNS Current system inadequate – no mechanism for CUP – no coordination for MSCC – palliative care pts admitted to assess, instead of assess to admit – no coordination between departments and oncology Patient safety risk Patient poor experience AE already swamped and demand increasing Gone as far as we can without additional resource Changing context increasing risk of variation in standards Lack of clarity around nursing role Hub and spoke model means haematologists feel ‘put upon’ Commitment and availability of all oncologists

6. Issues emerging An issue is a reasonable question raised through better understanding of claims and concerns

7. Questions 1.What are the essential ingredients of AOS? 2.What is stopping us from delivering an effective AOS across NI? 3.What would enable us to deliver an effective AOS across NI? 4.What are the key priorities to be addressed? 5.What can be done to address these, and by whom?

8. Common elements of all successful models There are many individual models which can be successful in a variety of different settings but essential core components include: Good leadership Representation from all interested parties A good relationship between Medical and Clinical Oncology Specialised advanced nurse role required in order to run a successful service Brian Haylock, Clatterbridge

9. What are the essential ingredients? AOS team with named lead and core membership Assessment Agreed pathways Good IT links and flagging systems Fast track clinics, Referral protocols, 24 hour triage line and on call consultant service, Regular morbidity & mortality meetings and prospective data collection Coordination & communication Cooperation & commitment WHAT MODELS?

10. NI Model (s)? Regionally commissioned model with local flexibility – Regional plan, recruitment, policies, pathways, standards of car e -NI Measures / – Service Specification Team approach: AOS Nurses & AO Consultants ( Units 5 day oncologist present) – Hospitals with A&E but no cancer services – access to AOS nurses as minimum Importance of data collection/ management IT enabled service / communication mechanism Initial focus 5 unit/centre Need continuity of care Buy-in all parties Involvement all stakeholders Sustainability and resilience Leadership present and visible in hospital Multidisciplinary – skills mix / advanced roles nurses Good communication with primary consultant Not 1 size fits all Need be attractive posts

11. Questions 1.What are the essential ingredients of AOS to provide a safe and effective service? 2.What is stopping us from delivering an effective AOS across NI? 3.What would enable us to deliver an effective AOS across NI? 4.What are the key priorities to be addressed? 5.What can be done to address these, and by whom?

12. Questions 1.What are the essential ingredients of AOS to provide a safe and effective service? 2.What is stopping us from delivering an effective AOS across NI? 3.What would enable us to deliver an effective AOS across NI? 4.What are the key priorities to be addressed? 5.What can be done to address these, and by whom?

13. Questions 1.What are the essential ingredients of AOS? 2.What is stopping us from delivering an effective AOS across NI? 3.What would enable us to deliver an effective AOS across NI? 4.What are the key priorities to be addressed? 5.What can be done to address these, and by whom?

14. Questions 1.What are the essential ingredients of AOS? 2.What is stopping us from delivering an effective AOS across NI? 3.What would enable us to deliver an effective AOS across NI? 4.What are the key priorities to be addressed? 5.What can be done to address these, and by whom?