Acute Oncology Service (AOS) in NHS Scotland: principles

7. Service and Outcome Evaluation

7.1. Outcome Measures

To improve outcomes through seamlessly delivered AO optimal pathways and supportive care protocols to achieve the following:

• Improved experience and outcomes for individuals;
• Equity of access to acute oncology services and expertise for all cancer patients in Scotland;
• Timely and effective management of patients presenting as an emergency with complications of their cancer and cancer treatment, including: early recognition, improved treatment, rapid referral back to specialist teams, early involvement of specialist palliative care teams, and early discharge;
• Appropriate investigation and management of patients presenting to an AOS with a new cancer diagnosis or oncological emergency in line with the local and/or regional guidelines;
• Preventing unnecessary admission
• Improved outcomes for staff with a highly skilled, competent workforce.

National comparative reporting against agreed outcome measures should be established, these are currently under development. Meeting these outcomes will provide a service that is fit for the future, has sufficient flexibility to provide emergency care, ambulatory care, specialist supportive care, and to withstand pressures. It is recognised that in some remote and rural areas, to achieve these measures of care there will be a need to adapt to local services and resources.

7.2. Service Measures

In addition to meeting the outcome measures, the following metrics will also be utilised to demonstrate successful implementation of specialist AO services:

• Prompt review of new cancers presenting as an emergency;
• Improved performance in the management of neutropenic sepsis;
• Earlier detection and management of suspected and confirmed malignant spinal cord compression (MSCC)/impending MSCC;
• Reduction in average length of stay for patients meeting the AOS criteria;
• Reduction in attendance to admission conversion rate
• Reduction in unnecessary and inappropriate investigations, outpatient appointments and admissions for this patient group to optimise operational capacity.
• Regular collection and publication of patient feedback.
• Adherence to agreed pathways and standard operating procedures.

7.3. Data and Information Requirements

An AOS will maintain the required minimum dataset and have an explicit data and information strategy in place that demonstrates performance against required service and outcome measures, and covers GDP/GDPR data protection, confidentiality, accessibility, transparency, analysis use, dissemination and risks.