Aneurin Bevan University Health Board
In Wales, patients in the last year of life with cancer spend 25- 30 days in an acute hospital. Most people who die of cancer will have an emergency hospital admission in their last year of life, one in six will experience three or more admissions.
Around 40 Aneurin Bevan University Health Board (ABUHB) patients a month are referred via Velindre Cancer Centre (VCC) Treatment Helpline to Acute Care within ABUHB Hospitals.
Not all acute patients require immediate care, therefore most patients experience a long wait at the front door of A&E/Medical/Surgical Assessment Units (MAU/SAU) before being referred to by Oncology Specialists for further review.
Our aim is to develop a triage tool, working between Acute Oncology Services in ABUHB and the treatment help line at VCC. We have learnt through development of Same Day Emergency Care (SDEC) at VCC that same day review is appropriate for many cancer patients however current triage services are set up to send patents directly to front door of local hospital. We suggest these pathways could enable around 50% of patients directly referred to acute care to be seen in SDEC. This would enable specialist needs to be addressed more quickly and reduce time spend in acute care, thus improving patient outcome and experience.
A steering group with clinical experts from oncology, acute care and Treatment Helpline staff will assist in the development of a triage tool and pathways, ensuring the tool is taken through a pilot and audit to ensure its appropriate for use.
With improved access to data and education and the development of a leaner pathway, patient experience will improve and there will be reduced pressure at the MAU setting. Developing this pathway will ensure that regionally ABUHB and VCC continue to build strong relationships through improved communication routes for both staff and patients.