Acute Oncology Service (AOS) in NHS Scotland: principles

Appendix 2 - High Level Training Summary

Medical Training – UKONS Competency Level 4

The medical and clinical oncology curricula (2020) include a shared capability in practice 8 (CiP 8) that requires trainees to develop the ability to manage oncological emergencies and work within the AOS team as appropriate to their stage of training. To provide training that meets the competencies outlined in the latest curriculum trainees need exposed to the following:

• Designated inclusion in an AO team within a cancer centre
• Designated inclusion in an AO team in a hospital that has unselected emergency medical admissions
• Evidence of trainees in-reaching into acute admissions units and medical wards
• Evidence of trainees having ongoing exposure to patients experiencing complications of cancer and anti-cancer treatment
• Experience in common AO scenarios including MSCC and neutropenic sepsis
• Review, management and treatment of patients with new diagnosis of cancer admitted as an emergency
• Satisfactory completion of miniCEX/CBDs, alongside a new Acute Care Assessment Tool, to demonstrate learning
• Regular involvement in all activities to improve service quality – clinical audits, mortality and morbidity reviews, serious incident reviews and relevant research activity

Advanced Practice Training – UKONS Competency Level 4

The training requirements for advanced nursing practice are on a Masters level pathway and, dependant on the experience of the individual, can take up to 2 years to complete. There is an educational commitment required in addition to organisational support - a practice supervisor is required for each trainee ANP from existing ANP staff and, dependant on the experience of the supervising ANP, a maximum of 1-2 trainees can be supported at any one time. Medical team investment, and managerial support, for education and protected time to facilitate role development and studying, are also key to enabling ANPs to evolve fully into their role.

In addition to the existing UKONS competencies, added benefit would be specific to the particular role area and department, for example:

• MSCC recognition and management
• Neutropenic sepsis
• Immunotherapy related presentations
• CUP/MUO

The above are broad examples, however, a generic acute oncology competency-based portfolio would be required to be devised. Additionally, within that competency strategy there should be generic ANP competencies such as management of surgical and medical emergencies.

The ANP should have a record with documented evidence of the following:

• Case based discussions (approximately 1 per month)
• Mini CEX’s, CBD, NMP, ALS
• Scenario based clinical OSCEs biannually (this is the gold standard)
• Approximately 12 hours CPD monthly (as per advanced practice guidance)
• Attendance at 1 advanced practice or non-medical prescribing conference a year
• Dedicated clinical supervision with ANP peers a minimum of 4 times per annum
• Monthly team education
• Service development and audit

(Examples of accepted evidence of ongoing professional development are: publication of research; additional clinical learning – i.e. Adults with Incapacity certification, Advanced Life Support).