Acute oncology in small and rural hospitals
Editor – The theme of the February 2020 issue of the Future Healthcare Journal, small and rural hospitals, is timely and it is generally positive in discussing the contribution such facilities can make to the service and to training. However, the issue of oncology in such settings is barely touched upon. Smith states that they provide a service to patients who are unable to access oncology and other services directly.1 Fox and colleagues state that a number of specialties, including oncology, are often not co-located with acute medicine.2 The implication is that in the more remote hospital they might be so co-located.
In reality, there will often be some non-surgical oncological work in such a hospital, at least the delivery of chemotherapy, and it is to be hoped that full medical oncology services for common epithelial tumours will be developed there. What is certain is that complications of cancer and its treatment will present in this setting. This was recognised by the National Chemotherapy Advisory Group in 2009 and the need for hospitals taking acute admissions to provide an acute oncology service.3
Airedale General Hospital serves a large rural area in the Craven district of North Yorkshire. Its total catchment population is around 200,000. It has had a medical oncology service for several decades. The acute oncology service provided as part of that has been described in a textbook on the subject.4 It has the important function of ensuring that acute aspects of cancer and its treatment receive optimal management in the setting of the general hospital. The continuing and increasing importance of this function is emphasised in the second edition of that textbook.5
This discipline is a clear example of how up-to-date, accessible services can be extended throughout the UK.
- © Royal College of Physicians 2020. All rights reserved.
References
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- Smith E
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- Fox K
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- National Chemotherapy Advisory Group.
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- Crawford SM
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- Board RE
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