A joint working party report from the Royal College of Physicians and Royal College of Radiologists

When a cancer patient becomes unexpectedly ill during or after treatment, very often they and the health professionals who deal with them are taken by surprise, sometimes with serious consequences. This report identifies the difficulties faced by the health professionals who need to treat them promptly and effectively but may not be familiar with cancer management. It also provides a range of tools and suggestions for better treatment, across the settings where this occurs from the community and general practice to hospital acute care.

The current situation is illustrated by a series of incident reports from the National Patient Safety Agency, showing how life-threatening inappropriate or inadequate interventions can be. The issues are then addressed for each setting and group involved, recommending constructive changes that include:

  • regular assessments of the risk of acute care needs for individual patients
  • emergency contingency planning for people with cancer, covering possible urgent needs
  • availability of key information about cancer patients in all settings at all times
  • training curricula that provide all professionals who respond to patients with cancer with the skills and knowledge to manage acute presentations.

The report also emphasises the role of patients as key participants in their own care, keeping themselves informed about their illness, able to inform doctors, and share in decisions about their care. With the report is an innovative tool for patients – an emergency planning wallet with a series of cards that show them how to plan for an emergency situation, how to recognise a deterioration, and what information to gather that will enable health professionals to help them effectively.

Short and accessible decision aids for use by hospital teams and by community teams pose the right questions to help them assess and plan management of acutely unwell patients.

The report is for all those who deal with acutely unwell people with cancer, for commissioners and providers of services, people responsible for workforce training, and patients and carers. Only a concerted response from all these groups will bring about real improvements where they are so urgently needed.

Contents of report

  • Current problems for patients and professionals
  • Decision making with the patient in the community setting: for primary care teams and other community-based services
  • Decision making with the patient in the acute care setting: for hospital-based teams
  • The patient with cancer in acute care: partners in decision making
  • Managing risk and improving care for acute events in cancer
  • Education and training needs

Patients’ emergency planning wallet

This compact wallet contains ten cards to help people with cancer plan for an emergency situation, and gather all relevant information about their illness and care. It also contains a leaflet where they can fill out all their contacts information. If you would like to order a printed wallet with cards, please email: Publications@rcplondon.ac.uk.

Decision aids

There are two decision aids: one for hospital teams and one for health professionals working in the community. Both ask questions designed to help with the care and management of acutely unwell cancer patients.

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Joint working group reports