Palliative care activity in a medical oncology unit: the implications for oncology training

There has been a nationwide reorganization of cancer services since publication of the Calman-Hine report, which encourages the integration of high-quality palliative care into all areas of cancer provision. Details of the daily clinical care activity for medical oncology inpatients are not collected routinely. A prospective survey of activity was carried out in a large teaching hospital, in order to ascertain the extent to which palliative care is exercised in a medical oncology unit, alongside other aspects of care provision. Almost a quarter (23%) of the admissions were for palliative care, either alone or in combination with another aspect of care. Palliative care activity accounted for 34% (169 bed-days) of daily activity, compared with 32% (163 bed-days) for the administration of chemotherapy. A high proportion of patients receive palliative care on medical oncology wards, consideration therefore needs to be given to the place of formal training in palliative medicine for oncology trainees.