Please take a look at the latest in our series of SDEC pathways. The Pathway for Cancer Patients (Solid Tumour) Presenting with Low Risk Febrile Neutropenia (LRFN) is a guide to patient assessment and ambulatory management of appropriately identified patients. It includes a detailed assessment and management checklist and pathway record along with a patient information and instruction leaflet   
The pathway has been developed by a clinical working party with involvement of:

• UK Acute Oncology Society (UKAOS),
• Society of Acute Medicine (SAM),
• UK Oncology Nursing Society (UKONS),
• NHS Ambulatory Emergency Care Network 
• NHS Elect.

Introduction

Neutropenic sepsis (NS) has been a core focus of Acute Oncology Services (AOS) since the publication of key NCEPOD and NCAG reports. However, systemic anti-cancer therapy (SACT) has evolved significantly, while the NICE NS guidance has not been updated since 2012. This has led to protocols that do not reflect current clinical realities. There is little new research to support best practice, and the adoption of innovative pathways, such as the Low-Risk Febrile Neutropenia (LRFN) approach, remains sluggish. This SDEC pathway concentrates on the initial management of NS in patients with solid tumours, presenting in the outpatient setting and offers recommendations for risk stratification aligned with the latest sepsis guidance. The goal is to encourage a flexible, locally adaptable approach, and improve patient care and experience.

Background/History

UKAOS and SAM have been eager to support improved management of patients with Low-Risk Febrile Neutropenia and led the Acute Oncology Neutropenia Working Party in the development of the first LRFN pathway published in 2020.

This updated and revised version has been developed following an extensive multi-disciplinary, cross speciality consultation process including a multi-disciplinary workshop the outcomes and recommendations of which are detailed in the recently published UKAOS report Initial Management of Neutropenic Sepsis: A UKAOS Collaborative Workshop Report (2026)