Triage Toolkit to improve advice for parents of children with cancer

For parents of children with cancer, knowing when to bring them into hospital during treatment can be very difficult. Now a new tool aims to streamline phone conversations between parents and nursing or medical staff, helping to ensure consistent and accurate advice is provided.

Triage Toolkit to improve advice for parents of children with cancer

During cancer treatment, a child could go through a number of physical changes that could concern a parent, such as catching a fever, bruising, or feeling short of breath.

The Oncology/Haematology Telephone Triage Toolkit provides hospital staff with a clear methodology to follow when a parent calls an advice line with concerns about a child with cancer.

The toolkit was developed by an expert working group from the UK Oncology Nursing Society (UKONS), the Royal College of Nursing (RCN), Children’s Cancer and Leukaemia Group (CCLG), and CLIC Sargent, the cancer support charity for the young.

Parents who call the hospital for advice about their child are often worried and emotional and are in need of clear, concise assessment and information in order to know whether to come in to hospital.

Anecdotal evidence suggests that uncertain advice, which is not accurately recorded, can lead to patients being brought to hospital unnecessarily, or a pattern of symptoms being missed.

Staff in the hospital will be provided with a clear path of questions aimed at assessing the state of the patient. They are then directed to the best advice, while a record of the call is made.

The level of oncology/chemotherapy knowledge and training required to manage a 24-hour advice line is variable nationally, and many practitioners feel unsure and ill equipped to make advanced care decisions. The toolkit works as an education resource and includes a competency assessment framework that all staff would need to complete before being able to take a call.

Jaydene Davies, CLIC Sargent Outreach Nurse Specialist, said: “This service will offer families a more streamlined, individual assessment of their child. It is hoped this will make families feel valued and reassured that their own assessment of the child is being listened to and acted upon appropriately.

“Nurses will be able to quickly assess and ascertain information from parents/carers, which will lead to the patient receiving care that is safe, timely and appropriate.”

Kerry Young, whose eight-year-old daughter Khianna is undergoing treatment for acute lymphoblastic leukaemia, said clarity is crucial in order to help a parent make a decision.

"A lot of the time you can feel like you have to make a judgement call, and that means that you will bring your child in to the hospital. It's better to be safe than sorry.

"We had a time when we waited for more than an hour for a bed and then were told that we didn't need to be there. Everything gets less efficient. This toolkit could really have a good impact."

The toolkit was launched at the RCN CCLG nurses meeting on Tuesday, September 27. All children's cancer principal treatment centres and shared care hospitals will be encouraged to set out their plan for implementation.

Helen Morris, Chair of the Children's Cancer and Leukaemia Nursing Group, said: "This telephone triage tool is being welcomed across the country by nurses in all principal treatment centres as well as many shared care centres. 

"It will give a consistent, validated way of assessing parents' concerns over the telephone, which will lead to the patient receiving care that is safe, timely and appropriate.

"It provides a standardised, competency based method for training staff in this important aspect of care, increasing their confidence and providing an audit trail of advice given as well as improving documentation and communication."

Parents of children and young people with cancer are encouraged to ask their local services about their plans for implementation. For access to the full document, visit