1133P - Non-elective admissions in cancer care - A review of acute oncology services (AOS) implementation in a north-west region of England

Abstract

Background: Parallel to advances in cancer therapeutics in the clinics, high quality and patient-centred management of cancer or treatment-related complications during non-elective attendance especially to a non-specialist hospital is crucial in achieving excellent patient outcome. AOS was innovated in the UK to meet this need and has rapidly expanded in recent years. Here, we describe findings of an on-going audit of this expanding networked service within Greater Manchester and Cheshire East County consisting of 10 district general hospitals in collaboration with a regional specialist cancer centre (The Christie NHS Foundation Trust). Methods: Information related to any hospital episodes warranting AOS input was collated from all participating hospitals using standardised proforma and analysed. Results: Between Jan 2015 - Sep 2016, 7638 non-elective hospital attendances were recorded of which 58% occurred within working hours. Common cancer sites were lung 16%, breast 15%, lower GI 12%, urology 12%, upper GI and HPB 9%, haematology 7%, gynaecology 6%, cancer of unknown primary(CUP) 6%, and others 7%. Majority were related to cancer complication 40% (Type III), treatment - related 32% (Type II), new cancer diagnosis 10% (Type I) and others 17%. 94% of AOS involvement occured within 24hr of attendance. Level of intervention by AOS was considered major in 60% while 30% and <10% was intermediate or minor respectively. Median length of stay (LOS) is 4 days, 20% of episodes lasted <24hr (11.2% admission avoidance), 50% 1-7 days, and 30% 2-6 weeks (predominantly type I and III). Conclusions: This large multi-sites audit documented the service delivery pattern of a growing oncology subspecialty at the same time provided a glimpse into the healthcare implication of unplanned admission in the current era of advancing oncology lanscape. Excellent median LOS in this region compared to national average likely a reflection of pertinent AOS team involvement in a timely manner. AOS is now an integral component to the cancer care in the UK and its role in the non-elective setting serves to ensure excellent patient experience as well as providing far-reaching potential in healthcare efficiciency. Legal entity responsible for the study: not applicable Funding: None Disclosure: All authors have declared no conflicts of interest.