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Local Cancer Centre: Mission to provide emergency cancer care

Despite more people than ever before recovering from cancer, or living longer as a result of improved treatment methods, doctors are still seeing an increase in the number of people being admitted to hospitals with cancer-related emergencies.

The Clatterbridge Cancer Centre NHS Foundation Trust and Merseyside and Cheshire Cancer Network have been leading the way nationally with an acute oncology service improving the care of people with cancer who need emergency hospital assessment or treatment. The acute oncology teams are cancer professionals who support non-cancer specialists in hospitals across the region.

Dr Ernie Marshall, one of the UK’s leading experts in acute oncology and a consultant in medical oncology at The Clatterbridge Cancer Centre, has recently developed some national guidance for non-cancer health professionals involved in emergency care. He has also co-authored an acute oncology medical textbook for cancer specialists.


Dr Marshall tells us more about this potentially lifesaving acute oncology service and how it’s currently working across Merseyside and Cheshire:

1. What is the acute oncology service?

Acute oncology is a service designed to improve the care of patients who present with urgent medical problems related to their cancer or the treatment for their cancer. The service aims to improve access to specialist teams by increasing oncology provision in hospitals across the region and developing effective methods for doctors to implement. The service is delivered by oncologists from The Clatterbridge Cancer Centre, partnered with nursing and administration teams in the local hospitals.

2. When did it launch in Merseyside and Cheshire?

Acute oncology was first recommended as part of a national review of patient outcomes. It was revealed that one in five cancer-related emergencies are due to cancer being suspected or confirmed for the first time, while half are related to cancer complications and around 30 per cent are related to cancer treatment complications. As a result, a team of oncologists at The Clatterbridge Cancer Centre used their local experience and knowledge to develop a plan to roll the service out across the region.

The service officially launched in 2010 and The Clatterbridge Cancer Centre became the first site in the UK to implement it across all of its networked sites in the region. The service saw the creation of new consultant posts at The Clatterbridge Cancer Centre and the development of seven acute oncology teams based in the local acute trusts with A&E departments.

3. How does the acute oncology service work?

The Clatterbridge Cancer Centre acts as the hub of expertise and partners with the Merseyside and Cheshire Cancer Network in coordinating all aspects of the service. The Clatterbridge Cancer Centre employs all of the consultant staff and, in addition, it has developed its own in-house acute oncology service that reviews and supports all emergency admissions to the Centre.

The Centre is also leading on aspects of acute oncology education with an e-learning module running in partnership with Liverpool University. The Clatterbridge Cancer Centre is at the heart of the developments and, as a result, I’m currently chairing a new national acute oncology committee, tasked with developing a new national service specification. The Centre’s role in education has also been consolidated with the publication of the first ever acute oncology textbook.

4. How many patients have benefited from the service since it launched?

The analysis of data shows that each unit team sees approximately 500 patients per year, with the majority of patients being reviewed one working day after referral. We also know that the teams have saved approximately three bed days per admission, freeing up thousands of hospital bed spaces.

The teams also provide expert support and communication to this vulnerable group of patients who were previously managed by general physicians who were pressed for time and may not have had the information and expertise to counsel patients.

5. What are the future plans for the service? Do you see a need for the teams to grow?

The teams have been successful in reducing bed days and improving safety and care, which was the initial objective. The next phase is intended to focus on admission avoidance so that we can support patients and professionals in the community and reduce the need for hospitalisation.


The acute oncology teams can be found at seven of The Clatterbridge Cancer Centre’s networked sites: Aintree University Hospital, Countess of Chester Hospital, Royal Liverpool Hospital, Southport and Ormskirk Hospital, St Helens and Knowsley Hospital, Warrington and Halton Hospital and Wirral University Teaching Hospital.

To support the fight against cancer, the Action on Cancer campaign aims to keep local residents up to date over the coming months with the latest cancer-related news and plans to improve services over the coming years, including the new Clatterbridge Cancer Centre site in central Liverpool.

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