Cancer patients in crisis: responding to urgent needs

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A joint Royal College of Physicians (RCP)/The Royal College of Radiologists (RCR) working party was established in 2010 to review the experiences of patients with cancer who become acutely unwell and need urgent help and advice; to identify the obstacles to good care across all care settings; and to consider how both patient experience and the outcome of care might be improved where indicated.

This work has been undertaken with representation from a wide range of clinical specialties and professional groups, in partnership with patient and carer representatives. It has been developed in conjunction with the important national programmes for acute oncology, emergency and end-of-life care, and transforming inpatient pathways. Although many of the findings and conclusions in this report both echo and endorse the objectives of these initiatives, the report has sought to broaden the context across all care settings and to highlight opportunities to influence the quality of care and reduce the risks for patients. The recommendations are made to:


  • Healthcare professionals in all disciplines who encounter, and share responsibility for, acutely unwell patients with cancer in any setting
  • Commissioners and providers of services
  • People responsible for workforce training and development, including undergraduate and postgraduate curricula
  • Patient and carer representatives, for their endorsement and support in promoting greater patient participation in emergency contingency planning in the future.


The working party wishes to acknowledge in particular the vision and far-reaching impact of the acute oncology measures. Although the present financial climate may continue to limit progress towards full implementation, there is no doubt that these measures are driving considerable improvements in the recognition and management of specific oncology emergencies, including the acute and serious complications of cancer treatments. These will bring about clearer pathways, better-equipped staff with easier access to oncology advice and earlier direct input from oncologists.