Terminally ill cancer patients being referred to Altnagelvin A&E by GPs, MLA warns

Transcript

00:00Oncology and surgical teams who manage cancer patients strive to minimise the need for emergency department visits.

00:07Every hospital trust in Northern Ireland has a 24-hour systemic anti-cancer therapy, or SACT, telephone advice service.

00:15Patients are encouraged to contact their treating unit using this service if they feel unwell,

00:20during or within six weeks of completing SACT treatment, or within 12 months of completing immunotherapy treatment.

00:28Similarly, cancer patients who have undergone recent surgical treatment receive verbal and written discharge advice,

00:35including instructions on how to access the surgical team and under what circumstances they may need to seek emergency care.

00:42When a cancer patient is referred to the emergency department by their GP, they will be triaged, stabilised and assessed by the ED team,

00:50and that will be based on clinical priority within the physical and staffing constraints of the emergency department.

00:58If necessary, the ED team will contact the relevant oncology or surgical team to assess and admit that patient.

01:05In addition, each trust has an acute oncology service that aims to provide a coordinated approach to the care of cancer patients

01:13who are suspected of having a first diagnosis in the emergency setting,

01:17or indeed those admitted acutely ill due to the disease itself or to treatment complications.

01:23Currently, this service operates on a five-day, nine-to-five model across all trusts.

01:29Extending the acute oncology service to seven days working is a recommendation for the Northern Ireland Cancer Strategy.

01:35However, it has not been progressed due to budgetary constraints.

01:39Work is, however, still progressing to assess demand and to develop appropriate pathways,

01:44with costed proposals for extending the service being considered based again on available funding.

01:51Mrs Ferguson.

01:52Can I thank the Minister for his answer thus far?

01:55Minister, I have a number of individuals, particularly elderly, who are terminally ill with cancer,

02:01who are still being referred by their GP to the emergency department.

02:05I have also numerous cases which I have forwarded to the Western Trust,

02:08where they have had to lie on chairs for up to five days before they are treated.

02:14Would you agree with me that urgent action needs to be taken,

02:17particularly for cancer patients who have a suppressed immune system that need priority status,

02:24and we need to look at other options so they are not lying in A&E for sometimes days?

02:31I absolutely agree with the Member.

02:34After Christmas, I visited seven EDs, including Alton and Galvin, which, as the Member knows,

02:39is the oldest of our type 1 EDs.

02:43It is more than ready for a replacement, and one, I hope, will be in place,

02:47although it will be perhaps five years before we get to that point.

02:53When I was up in the ED, I was speaking to people who had been in the same chair for four days.

03:00It is not acceptable under any conditions.

03:04I also met a man who has since passed away, sadly, who had cancer,

03:09who was on a trolley, had been on a trolley for a number of days,

03:15and I think made a hospital bed for his last 24 or 48 hours on this earth.

03:23In terms of GPs referring, I know that the Cancer Network has developed a resource for GPs

03:30to try and assist in managing mild to moderate side effects,

03:35but I think what you are talking about is a much more serious condition.

03:39I can just assure the Member that I am aware that more work needs to be done in this area,

03:45and it will be done.