Nurse-led protocols are an effective, safe, and sustainable method for achieving early antibiotic administration in patients with suspected febrile neutropenia. This is a key component of ensuring improved outcomes for this cohort of patients.

There is increasing recognition of the need for collaboration between oncologists, acute physicians and specialists to improve the quality of care and outcomes of acutely unwell patients with cancer. At The Christie, a tertiary oncology hospital, a model has been developed to deliver acute medical and specialty support services. This delivers, among many things, a consultant-led acute medical ward round on weekdays. There has been a signifi cant increase in the number of patients admitted to the oncology assessment unit (OAU) since its introduction, in part due to an increased number of direct discharges from the unit. Collaborative working between oncologists and acute physicians with a shared vision for highquality care for patients has ensured that this change has been implemented smoothly. This has included development of patient fl ow models to optimise bed usage, so that a higher number of patients can access these specialist services.