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Thursday, 31 July 2014

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Cumbrian hospitals trust must rectify cancer unit problems

The trust which runs hospitals in Carlisle and Whitehaven has been ordered to take action after serious problems were found in its cancer services.

It has until January 2 to address the concerns relating to “immediate risks” and “serious issues” identified in an external review.

The review into chemotherapy and acute oncology services was carried out by doctors, patient representatives and the National Cancer Action Team (NCAT).

An “immediate risk” is said to be something that may cause harm to patients or have a direct impact on patient outcomes and requires immediate action. A “serious concern” is an issue that could seriously compromise the quality or outcome of patient care and requires urgent action.

As a result the North Cumbria University Hospital Trust, which runs the Cumberland Infirmary and West Cumberland Hospital, has to respond to NCAT with an action plan to address all concerns by January 2. All the issues are currently being or have already been addressed by the trust, say health chiefs.

Two of the immediate risks relate to chemotherapy services at the Cumberland Infirmary, at Carlisle.

One risk was that a drug fridge on the hospital’s chemotherapy day unit was not dedicated for storage of chemotherapy drugs and was unlocked, there was also a food fridge within the clinical area.

The other was that a drug fridge on Larch D ward was not dedicated for chemotherapy drugs, was unlocked and contained drink supplements.

A third risk, however, which related to West Cumberland Hospital, was a result of a misunderstanding, says the trust. The visiting team thought there was no ‘extravasation’ kit on the chemotherapy day unit with equipment to help if there was a leak from a tube delivering to or removing fluids from a patient.

The kit is in its right place but, they say, a member of staff thought the team was referring to something else when asked about it during the visit.

Serious concerns regarding chemotherapy were that there is no lead chemotherapy nurse which has contributed to a lack of leadership and development of the service – something which is now being addressed – and an electronic prescribing system has not been implemented.

There were seven serious concerns highlighted including; no assessment and communication pathways to ensure patients are identified, assessed, referred and followed-up appropriately; no dedicated staff for regular patient review; no patient flagging system which means patients with complications may experience delay in their assessment and no robust programme for the service to address gaps in the service.

Corinne Siddall, the trust’s director of operations, told Tuesday’s board meeting that it was a positive visit and they had assurances that a number of concerns have already been dealt with and other issues are being dealt with.”

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