Paediatric oncology service

The paediatric oncology service has been developed from scratch over the past ten years and now has a dedicated team and three dedicated oncology cubicles on Outwood Ward, the children’s inpatient ward at East Surrey Hospital. Patients cared for in the paediatric unit up until they are 16, however, the team will look at each individual case to see if they can continue to be managed in the paediatric department after the age of 16.

It is one of the busiest Level 1 Paediatric Oncology Shared Care Units in the South East and works closely with the Royal Marsden Hospital in Sutton, which is the principle treatment centre in the area for children with cancer. Between 15 and 20 new cases are seen every year and the team actively treats 30 patients at any one time. Around half of the patients have leukaemia, a third have brain tumours and the rest have solid tumours elsewhere in the body.

The Trust’s service provides supportive inpatient care for children who suffer a febrile neutropenia, intercurrent illness or need a blood transfusion. There is an outpatient chemotherapy clinic which is run by a dedicated Paediatric Oncology Nurse with support from the consultant.

There is also a community nursing team which does the weekly blood tests and central line care in the patient’s own home setting. In the most recent peer review, in late 2011, the paediatric oncology service was commended for its work.

Most children diagnosed with cancer either attend via the emergency department or are referred through the urgent pathway with non-specific symptoms. Pick-up rate through the two week rule is extremely low. Once the diagnosis is suspected or confirmed, the patient is referred to the Royal Marsden for further investigations and initiation of treatment plan. Children under one are referred to Great Ormond Street Hospital.

If a GP suspects a child has a serious condition, they can refer them to the Rapid Access Clinic on Wednesday afternoons at East Surrey Hospital.

Children with suspected cancer should be referred under the two week rule – the paediatric oncology service has 100% compliance with the two week rule. However, because patients mostly come to the service via the Emergency Department, they are invariably seen much more quickly.

All GP Referral Letters, except those referred though the Choose & Book System or Two Week Rule method, should be sent direct to the Outpatient Booking Office, East Surrey Hospital, Canada Avenue, Redhill RH1 5RH. Please do not send these direct to a consultant, medical secretary or any other department.

You can of course make the actual outpatient referral letter out to a specific consultant. The Outpatient Booking Office is responsible for processing all referrals for outpatient appointments which then initiates the patient’s 18 week RTT status.

Outpatient Referrals made under the Two Week Rule method should be faxed immediately to 01737 231733.

The ethos of the service is to provide safe chemotherapy as close to the patient’s home as possible. The number of visits to Royal Marsden is kept to a minimum, and some of the chemotherapy takes place at East Surrey Hospital. There is an outpatient paediatric chemotherapy clinic situated on the paediatric assessment unit.

Community Children’s Nursing Teams, based both at West Sussex and East Surrey Primary Care Trusts, visit the family in their home every week, to carry out routine bloods tests and reviews.

From the point of diagnosis, the paediatric oncology team takes care of all the patient’s health needs, even if not directly linked to the cancer, until six months after completion of chemotherapy.

Paediatric oncology patients have direct access to Outwood Ward and open access if they need a blood transfusion. Outwood Ward telephone number is 01737 768511 x 6415.

Children with brain tumours will be operated on at St George’s Hospital, Tooting, but cared for under the Royal Marsden team for chemotherapy. Where necessary, children may be referred to the Trust’s physiotherapists.

The community nurse team will refer families to The Olive Tree Cancer Support Centre, based at Crawley Hospital, for complimentary therapy. The Trust’s support group for parents of paediatric oncology patients is also held there once a month.

Once a child has finished their treatment – up to two years in girls and three years in boys – they will have long-term follow-up clinics to treat late effects of chemotherapy. The paediatric oncology consultants will hold the follow-up clinic near where the patient lives – this could either be at East Surrey, Crawley, Horsham, or Dorking Hospital.

If a child patient is going on holiday, either in the UK or abroad, the oncology nurses will contact the local paediatric oncology centre to help support the child while they are away. Similarly, the Trust’s paediatric oncology team will support visiting children to the area.