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Understanding the challenges of providing acute oncology care

Wales, Northern Ireland and Scotland have separate and distinct health boards from those of NHS England. The geography of each country brings its own challenges to providing acute oncology services to their respective populations.

Northern Ireland has five health and social care trusts serving a population of 1.8 million people; each trust provides oncology services. Two of the trusts, Belfast and the Western, provide cancer care similar to that provided in cancer centres in England, and both also deliver radiotherapy. The remaining three trusts have cancer units; provision of oncology services in each of the units is by visiting medical and clinical oncologists from the Belfast trust to ensure local provision of chemotherapy treatment for patients across Northern Ireland.

Scotland has three regions in which cancer care is organized for a population of 5.44 million: West of Scotland Cancer Network, South East Scotland Cancer Network and the North Cancer Alliance. The largest is the West of Scotland Cancer Network which embraces four NHS boards: Ayrshire and Arran, Forth Valley, Greater Glasgow and Clyde, and Lanarkshire. The region has one cancer centre: the Beatson West of Scotland Cancer Centre, which is part of NHS Greater Glasgow and Clyde. The West of Scotland Cancer Network serves a population of 2.5 million people (approximately 46.5% of the Scottish population) and provides some specialist services for patients from other areas of Scotland including the Western Isles and Dumfries and Galloway. NHS Greater Glasgow and Clyde board serves a population of 1.14 million and employs around 39,000 staff. It has five acute hospitals and is the largest NHS organization in Scotland and one of the largest in the UK.

Wales has seven health boards and one NHS trust providing healthcare to a population of 3.1 million. There are three cancer centres providing specialist cancer care including radiotherapy. The Wales Cancer Network works with and supports health boards across Wales to meet the requirements of the Welsh government’s cancer delivery plan and undertakes a regular programme of peer review of cancer services.

When were acute oncology services in the devolved nations first developed?

The first acute oncology service in Wales was established in 2011 in North Wales; services in South Wales were set up between 2013 and 2018. In Northern Ireland, the first acute oncology service began in 2010 in the Southern Health and Social Care Trust. It provided the basis for the development of acute oncology services across the remaining four trusts, which began in 2014. In Scotland, the philosophy behind acute oncology services began in 2009 with the provision of unscheduled care in inpatient wards during weekdays. Since 2012 there has been service development both within cancer centres (creation of acute oncology assessment units) and new acute oncology services in acute and district general hospitals (outreach or at the point of admission). For ...

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