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Found 28 results
  1. News Article
    A culture of "avoidance and denial" allowed a breast surgeon to perform botched and unnecessary operations on hundreds of women, an independent inquiry has found. The independent inquiry into Ian Paterson's malpractice has recommended the recall of his 11,000 patients for their surgery to be assessed. Paterson is serving a 20-year jail term for 17 counts of wounding with intent. One of Paterson's colleagues has been referred to police and five more to health watchdogs by the inquiry. The disgraced breast surgeon worked with cancer patients at NHS and private hospitals in the West Midlands over 14 years. His unregulated "cleavage-sparing" mastectomies, in which breast tissue was left behind, meant the disease returned in many of his patients. Others had surgery they did not need - some even finding out years later they did not have cancer. Patients were let down by the healthcare system "at every level" said the inquiry chair, Bishop of Norwich the Rt Revd Graham James, who identified "multiple individual and organisational failures". One of the key recommendations from the report is that the Government should make patient safety a the top priority, given the ineffectiveness of the system identified in this Inquiry. Read full story Source: BBC News, 4 February 2020
  2. Content Article
    Talking openly about cancer and our experiences makes a huge difference in increasing understanding, overcoming stigma and reducing fear. This page give you access to numerous stories from around the world from people living with and have experience of living with cancer.
  3. Content Article
    Managing neuropenic sepsis My role as an acute oncology CNS is to improve cancer services. Part of my role is the treatment and management of neutropenic sepsis. Neutropenic sepsis is an oncological emergency following chemotherapy, whereby the patient’s immune system has been depleted by the treatment for their cancer. The body’s natural defense system has been wiped out from the cytotoxic drug, making the patient more susceptible to infections and, therefore, sepsis. The national standards for treatment of neutropenic sepsis are: Early warning symptoms: call the chemotherapy 24-hour hotline, manned during the day by the chemotherapy nurses and out of hours by the oncology ward nurses who are trained in giving advice to patients on chemotherapy. A high or low temperature is normally the worrying symptom. The UKONS 24 Hour Triage Tool: an algorithm used to support the nurses' advice. The patient is then advised to attend A&E or, if acutely unwell, call an ambulance. Once the patient arrives in the emergency department, the national standard 'door-to-needle time' is to receive antibiotics for suspected infection within 1 hour. How we improved cancer patient safety Monthly audits showed that for 65% of all patient's suspected to have neutropenic sepsis, none received appropriate treatment. This was usually because of contra-indicating admission i.e., came in with left flank pain, or poor triage. An alert card is given to every patient receiving cancer treatment for them to present to the emergency department, alerting everyone that the patient is receiving cytotoxic drugs and advice on how to manage this. The audits I performed highlighted that the patients who presented to the emergency department out of hours did not receive appropriate antibiotics in time. This correlated to no acute oncology nurse present. These findings led to us changing our practice to a nurse-led service. We asked the chemotherapy hotline to alert us to anyone they had advised to attend the emergency department. This allowed us to meet the patient at the front door, and to support and arrange for doctors and nursing staff to give the correct management in time, expediting and eliminating error. The errors I speak of were never incompetence; they were human error. One nurse to 20 unwell patients in the emergency department is unsafe. The emergency department is the frontline in all acute trusts. In the trenches, fantastically skilled but overworked and under-valued. This was noticed by the acute oncology team. I derived that we as a team needed to change our working hours. 10 hours days, 4 days a week. Excluding weekends, where the oncology registration would stand in for the acute oncology service. This worked on days where neutropenic sepsis admissions were many, but still did not support the out of hours admissions. Teaching and training were my next focus. I set up a trust-wide acute oncology conference where I invited all trust staff to attend, inviting guest speakers, experts in their field, to teach and train nurses, doctors, the receptionist, anyone who would meet a patient on cancer treatment. We trained emergency department nurses to be able to prescribe and administer the first dose of antibiotics to ensure the door-to-needle time less than 1 hour was adhered to. Training empowered the emergency staff. Training is investing not scolding. Following these changes, our monthly audit numbers went from 65% to 80–90% over the course of 3 months, which showed a huge success. However, then January came, ambulances queuing down the hill from the emergency department. 345 admissions with only two beds within the trust. 25 staff shortage. Door-to-needle times became 3 hour rather than 1 hour. Our team consisted of three CNS to cover the acute hospitals with emergency departments. 50 referrals a day predominately for new diagnosis of cancer. Door-to-needle times on audit were at an all-time low of 25%. The worst I had seen it. Look at the contributing factors: 25 staff nurses down, huge demand on admissions and beds, limited capacity to review patients. During this month, acute oncology CNS predominantly lived in the emergency department, prescribing and administering the antibiotics ourselves to ensure safe practice. This did not come at a cost to the rest of our service and ensured patient safety. It dramatically improved our door-to-needle times. Acute oncology CNS are a necessity and, I personally think, the unsung heroes of an acute trust. We can prevent hospital admissions and avoid delayed discharges, freeing up beds and supporting and advising doctors to investigate patients appropriately and safely. Why I love my role I enjoy my role. It is a rewarding role. I have had the privilege to meet and work with the most beautiful people in the most harrowing of times. The worst times. But it is worth it. Meeting someone who has been in pain and suffering for 3 months at home who has come into hospital because the pain had got to much. They are aware something is wrong but isn’t sure what. Breaking the bad news that this is a cancer and having the time and resources to support that patient and their family. Knowing I am making a difference. Even when the outcome is that this person is not fit enough for further investigations or would not be safe enough to have chemotherapy, but advising them that the main focus of care should be symptom management and palliative care to ensure quality of life. To feel that I have made a difference and, more importantly, to hear that I have. Ensuring patient safety through diagnosis to treatment and to the end of life care. Something we must not overlook the importance of. Although acute oncology CNS is not as well-known as critical outreach nurses or heart failure nurse specialists, it is equally important and necessary. A case study I would like to end this blog with a case study of a patient named Brendan*. Brendan was a 24-year-old man who presented with a 3-day history of right upper quadrant pain. Clinically jaundice. 10/10 pain. Unable to move. He had an ultrasound in the emergency department on Wednesday pm. He was referred to acute oncology in light of suspicious radiological diagnosis of cancer. Within 48 hours, acute oncology had reviewed him and broken the bad news to him that he had cancer. Cancer of unknown primary. The young man was discharged from hospital. We ensured a support service in system (given him our CNS number), managed his pain, arranged further investigations and discussed in a multidisciplinary meeting the best site for biopsy. We booked the biopsy and arranged a clinical appointment 1 week later with our acute oncology consultants. We called this young man every day for symptom reviews and holistic support for him and his family. He received chemotherapy within 3 weeks of diagnosis and is alive to this day, with a cancer that is rare and difficult to treat. Having only had six hospital admissions. This is why acute oncology are a necessity to any hospital and community service. *Name has been change to ensure confidentiality.
  4. Content Article
    Watch Professor John Radford's interview with Sky News, explaining the importance of research at The Christie:
  5. Content Article
    The Primary Care Cancer Toolkit has been developed by the Royal College of General Practitioners (RCGP) in collaboration with Cancer Research UK as part of our partnership to raise awareness and knowledge of the role of primary care in cancer control. It is designed for use by primary healthcare professionals in the UK. If you are accessing these resources from outside the UK, bear in mind that guidelines and systems may be different. Resources are split into professional and patient sections. Professional resources consist of guidelines, information and tools aimed at those working in primary healthcare. Those within the patient section are websites, information leaflets and other resources aimed at a public audience which a healthcare professional can signpost patients to during or post consultation.
  6. News Article
    Trainee oncologists at a major cancer centre covered clinics and made “critical” decisions without senior supervision, including for cancers they were not trained for, HSJ has revealed. A Health Education England (HEE) reviews aid: “The review team was concerned to hear that trainees were still expected to cover clinics where no consultant was present, including clinics relating to tumour sites that they were unfamiliar with.” Guy’s and St Thomas’ Foundation Trust’s trainee clinical oncologists felt “they could only approach 50–75% of the consultants for critical decision-making”, the document said. The HEE “urgent concern review” report said: “The trainees also reported that there was a continued lack of clear consultant supervision for inpatient areas in clinical oncology, which meant that they were not able to access senior support for decision-making.” A trust spokesman said: “We recognise that senior support to the clinical team is a vital part of keeping our patients safe.” Read full story (paywalled) Source: HSJ, 16 January 2020
  7. News Article
    Artificial intelligence is more accurate than doctors in diagnosing breast cancer from mammograms, a study in the journal Nature suggests. An international team, including researchers from Google Health and Imperial College London, designed and trained a computer model on X-ray images from nearly 29,000 women. The algorithm outperformed six radiologists in reading mammograms. AI was still as good as two doctors working together. Unlike humans, AI is tireless. Experts say it could improve detection. Sara Hiom, director of cancer intelligence and early diagnosis at Cancer Research UK, told the BBC: "This is promising early research which suggests that in future it may be possible to make screening more accurate and efficient, which means less waiting and worrying for patients, and better outcomes." Read full story Source: BBC News, 2 January 2020
  8. News Article
    Cancer patients are being pushed to “breaking point” because of a lack of support from overstretched nurses and carers, a leading charity has warned. Almost half of specialist cancer nurses have told the Macmillan Cancer Support charity that their high workload was having a negative impact on patient care, while one in five people diagnosed with the disease say the staff responsible for their care have unmanageable demands. Now the charity says this is affecting patients, with thousands calling its specialist support helpline in distress and worried because they feel they can’t get answers from their health workers. Read full story Source: The Independent, 31 December 2019
  9. Content Article
    The following four initiatives were selected to receive the HQCA’s 2019 Patient Experience Awards: NowICU Project, Neonatal Intensive Care Unit (NICU), Misericordia Community Hospital Rapid Access, Patient Focused Biopsy Clinic; Head and Neck Surgery, Pathology; University of Alberta Hospital Edmonton Prostate Interdisciplinary Cancer Clinic (EPICC), Northern Alberta Urology Centre Transitional Pain Service, South Health Campus Take a look at their presentations and find out more about these great initiatives.
  10. News Article
    Patients are facing a week of disruption, with more than 10,000 outpatient appointments and surgeries cancelled in Belfast. Some people referred by their GPs on suspicion of cancer could have their diagnosis delayed, the head of the Belfast Trust has said. The trust apologised, blaming industrial action on pay and staffing. Martin Dillon said outpatient cancellations "could potentially lead to a delay in treatment" for cancer. The Department of Health said the serious disruption to services was "extremely distressing". Read full story Source: BBC News, 2 Decmeber 2019
  11. News Article
    A mobile app designed by a patient is helping people with breast cancer prepare for the start of radiotherapy. The treatment requires them to raise their arm above their head, but patients often find that difficult or painful after breast surgery. Exercises are important but Karen Bonham said leaflets giving details did not help her enough. So she helped create the app to offer exercise videos and medics say it is helping more women be ready on time. Staff at Velindre Cancer Centre in Cardiff say they have noticed fewer patients needing urgent referral for physiotherapy ahead of the treatment since the "Breast Axilla Postoperative Support app", or BAPS App, was launched in February. Kate Baker, clinical lead physiotherapist at Velindre, who helped devise the app, said: "Previously, we've always handed out information on exercises in a leaflet, that patients would be given by a physiotherapist and taken home. But often these pieces of paper get lost and they're not followed through. "What we wanted to do was provide exercises, physical activity advice and further information in an app format, which would allow individuals to have it with them at all times." Donna Egbeare, breast surgeon at Cardiff and Vale University Health Board, who was also involved in developing the bilingual app, said the impact of being able to start radiotherapy on schedule was significant. Read full story Source: BBC News, 27 November 2019
  12. Content Article
    Key findings The investigation identified that there: are multiple opportunities for error in the processes used to communicate unexpected findings are many steps that have to be completed successfully before the patient is informed is variance in how clinicians receive findings and how they acknowledge receipt of them.
  13. Content Article
    Findings Participants’ perceptions regarding their engagement as a patient safety strategy were expressed through three overarching themes: the word 'patient' obscures the message safety is a shared responsibility involvement in safety is a right. Themes were further defined by eight subthemes. Conclusions Using direct messaging, such as 'your safety' as opposed to 'patient safety' and teaching patients specific behaviours to maintain their safety appeared to facilitate patient engagement and increase awareness of safety issues. Patients may be willing to accept some responsibility for ensuring their safety by engaging in behaviours that are intuitive or that they are clearly instructed to do. However, they described their involvement in their safety as a right, not an obligation. Interpretation Clear, inviting communication appears to have the greatest potential to enhance patients’ engagement in their safety. Nurses’ ongoing assessment of patients’ ability to engage is critical insofar as it provides the opportunity to encourage engagement without placing undue burden on them. By employing communication techniques that consider patients’ perspectives, nurses can support patient engagement.