The National Chemotherapy Advisory Group report has recommended that all hospitals in the UK with an Emergency Department should establish an acute oncology (AO) service. Acute oncology, when implemented at a clinical network level, presents significant challenges for informatics, including the requirement for 'onco alerts' - automated notification of admission of potential cancer patients, whose diagnosis may not be recorded on the admitting hospital's IT systems. In this short paper we present a case study and describe an approach to supporting the development of AO services with cross-organisational information systems.