Emergency admissions for patients with cancer remain problematic, despite the development of acute oncology. According to a new report by the Royal College of Physicians (RCP) and Royal College of Radiologists (RCR), more could be done to improve their care and subsequent experiences and outcomes.
The Cancer patients in crisis: responding to urgent needs report found that patients and their carers do not receive enough information about what to expect and who to contact if their condition suddenly worsens and requires urgent medical attention. More proactive care would ensure that patients, their carers and health professionals are better equipped to respond when a person becomes acutely unwell. When the patient is admitted to hospital there is also a need to improve decision-making, coordination of care and communication between professionals and with patients themselves. In unplanned and urgent situations, patients can receive confusing or conflicting information or feel less able to assert their concerns and wishes. Patients often receive fragmented care, being seen by multiple healthcare professionals and sometimes multiple medical specialties during an admission. This can result in some patients being treated suboptimally, especially where the cancer diagnosis clouds other considerations in their management. Others, especially nearing the end of life, may undergo repeated investigations and interventions that are not to their benefit. Finally, some admissions, especially among patients already approaching the end of life, may be avoidable. The report goes on to offer decision making tools for health professionals working in hospitals and the community, to help improve the care of cancer patients in crisis and proposes standards of good practice in each care setting which should reduce risk and improve outcomes.
