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Same Day Emergency Care Cancer Pathways

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Same Day Emergency Care Cancer Pathways - Cancer Patients Presenting with Unsuspected Pulmonary Embolism

Urgent and Emergency Care (UEC) is a fundamental aspect of the Cancer patient journey with a high frequency of Emergency Department (ED) attendance and conversion to unplanned admission. For many Cancer patients, the admission pathway may be distinct from the primary treating oncology team and often into a different organisation.

Up to 50% of Cancer patients currently have a short hospital admission (≤ 3 days) often complicated due to a lack of locally available information or agreed clinical pathways and leading to an approach of ‘admit to assess’ rather than ‘assess to admit’.  This short-term hospital admission can be viewed as a missed opportunity for some patients to undergo a more coordinated same day assessment and discharge via evolving Same Day Emergency Care (SDEC) services.

UKAOS working in partnership with the Society of Acute Medicine (SAM), UK Oncology Nursing Society (UKONS)  and NHS Elect are developing an initial 5 Cancer Ambulatory Pathways to support alternatives to ED and admission for cancer patients who fulfil the criteria and where locally agreed pathways have been implemented.

As a first publication, UKAOS and partners have now developed an evidence-based summary guideline to support organisations and clinicians in offering a standardised ambulatory pathway for cancer patients who are diagnosed with an unexpected Pulmonary Embolus.

The guidance recognises that Cancer patients may present via a number of routes and the supports the key principles for ambulatory management across a range of clinical pathways that might include Medical Same Day Emergency Care (SDEC), Cancer Assessment Units, Outpatient services, Community and Primary Care.

Clinicians are encouraged to work with key partners in implementing local solutions that reflect service configuration and varying links between Oncology and the UEC System.

The expert working group aims to further publish ambulatory guidance by March 31st 2026 including:

  1. Metastatic Spinal Cord Compression
  2. Low risk Febrile Neutropenia
  3. Suspected brain cancer
  4. Malignant Hypercalcaemia

 

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