Document resource
Aims and Objectives The Physician Response Unit (PRU) provides hospital-equivalent care by emergency clinicians in the community. The PRU Acute Oncology Pathway, established in 2020 in collaboration with the Barts Health NHS Trust Acute Oncology Service, aims to deliver timely assessment and intervention for this vulnerable cohort, often avoiding unnecessary hospital conveyance and supporting care closer to home. We present a 12 month review of pathway compliance, interventions, and patient outcomes.Method and Design Retrospective analysis was undertaken of all patients attended by the PRU between 1 August 2024 and 31 July 2025, where the referral source or pathway was designated as ‘Oncology.’ Data included demographics, clinical interventions, pathway compliance, conveyance rates, re-contact rates, and 28-day mortality.Results and Conclusion Results: 184 patients were identified. Pathway compliance was high, reflecting strong collaboration between hospital and pre-hospital teams. The hospital conveyance rate was 25%, demonstrating effective community management in the majority. Of those conveyed, many were directly admitted to Barts Hospital, avoiding Emergency Department attendance in sites without acute oncology cover.The most common diagnosis was sepsis/infection, followed by side-effects of treatment, and disease progression. Interventions included point-of-care and lab bloods, IV antibiotics, and IV/oral symptom control. Among non-conveyed patients, 23.2% had an unscheduled ED attendance within 28 days, while 58% had no further unscheduled healthcare contact. The 28-day mortality rate was 10%, highlighting the high acuity and vulnerability of this cohort.Conclusion: The results demonstrate that this complex cohort of patients can be safely and effectively managed by a community emergency medicine service in collaboration with their parent team. By reaching frailer, less ambulant individuals, the PRU delivers care aligned with NHS priorities to manage patients in the community, reducing system pressures while improving patient experience.