‘No right time, no right place’ – conversations in acute cancer care – results of a Macmillan focus group

There needs to be increased recognition of acute admission as a point of transition, often into end-of-life care, for people with cancer. There are significant barriers to conversations in acute cancer care, which include a lack of clear ownership in oncology pathways, and a reticence of all professionals to engage in conversations around prognosis before acute admission or at the time of acute illness. There is a need to develop standardised links between oncology and urgent care providers and for protocols within hospital to allow for access to expertise and assessment and onward sharing of information. Earlier, more transparent conversations may allow patients and families to make clearer choices about care options in the last months of life and, critically, reduce dependence on acute care.