Guidelines endorsed by RCPCH - Oncology

The College reviews high quality guidelines and standards produced and published by other organisations against the RCPCH Standards for Endorsement. We believe the following publications will be of interest to paediatricians working in oncology.

The following have been endorsed by the College.

Endorsed guidelines

Antimicrobial stewardship (NICE QS)

This quality standard covers the effective use of antimicrobials (antibacterial, antiviral, antifungal and antiparasitic medicines) to reduce the emergence of antimicrobial resistance (loss of effectiveness of antimicrobials).

It covers all settings, all formulations of antimicrobials (oral, parenteral and topical agents) and is for health and social care practitioners, organisations that commission, provide or support the provision of care, as well as people using antimicrobials and their carers.

RCPCH notes:

The College endorses the quality standards and notes that the document would have benefitted from specifying the route of administration and by adding a reminder that sometimes more than one microbiological sample (or none) might be need to be collected. The option of offering back-up (delayed) prescribing in Primary care would have been preferred to be suggested as a last resort and only in situations where the doctor has a clear opinion as to a likely bacterial cause of an illness that may not be self-limiting.

Date of Publication: April 2016 
Endorsed on: August 2016

Full Quality Standard (PDF, 177KB, 39 Pages)

Children and Young People with Cancer (NICE QS)

This quality standard covers the provision of all aspects of cancer services for children and young people with cancer. For this quality standard, children are defined as aged 0–15 years and young people as 16–24 years, though this is not a formal upper age limit because the needs and circumstances of individuals will vary, including their need to access age-specific services.

Date of Publication: February 2014
Date of Endorsement: August 2014

Full quality standard (PDF, 248KB, 46 Pages)

Blood transfusion (NICE) 

Blood transfusions are common in clinical practice. In 2014/15 NHS Blood and Transplant issued 1.7 million units of red blood cells, 275,000 units of platelets, 215,000 units of fresh frozen plasma and 165,000 units of cryoprecipitate to hospitals in England and North Wales. 
An estimated 430,000 patients received a red blood cell transfusion in 2002; a further study has not been conducted, but given the reduction in blood use since 2002 the number of patients who have had a transfusion is likely to be 10–20% lower than this figure. Despite considerable efforts to ensure the safety of blood transfusions, they are associated with significant risks.
This clinical guideline contains recommendations about general principles of blood transfusion, and applies to a range of conditions and different settings. 
Date of Publication: November 2015
Endorsed on: February 2016
NICE clinical guideline (PDF, 142KB, 26 Pages) 
NICE full clinical guideline (PDF, 3,531KB, 351 Pages)

Feverish illness in children (NICE QS)

This quality standard the assessment and initial management of unexplained feverish illness in infants and children (from birth to 5 years).
Feverish illness is very common in young children (under 5), with between 20 and 40% of parents reporting such an illness each year. Fever is the most likely reason for a child to be taken to the doctor and the second most common reason for a child being admitted to hospital.
The quality standard is expected to contribute to improvements in the following outcomes:
  • Mortality in infants and children under 5 years
  • Morbidity in infants and children under 5 years
  • Number of emergency admissions to hospital of infants and children under 5 years
  • Parent and carer experience of services.
Date of Publication: July 2014
Endorsed on: February 2015
Full quality standard (PDF, 196KB, 32 Pages)

Haematological cancers (NICE QS) 

This quality standard covers diagnostic reporting and the organisation of haematological cancer services for people of all ages (children, adults and young people) and managing haematological cancers in adults and young people (aged 16 and over). It describes high-quality care in priority areas for improvement.

Date of Publication: June 2017
Endorsed on: June 2017

Full quality standard (PDF, 111KB, 19 Pages)

Melanoma - assessment and management (NICE CG) 

Melanoma is the fifth most common cancer in the UK, with 13,348 cases diagnosed in the UK in 2011. In males and females separately, melanoma is the 6th most common cancer (4% each of the male and female total). The age-standardised incidence rate of melanoma in the UK in 2012 was higher for men (25.0 melanomas per 100,000 men) than for women (22.1 melanomas per 100,000 women). 
The incidence of melanoma is rising rapidly and is predicted to increase by 50% in the next 15 years. This is the fastest projected increase in incidence for any cancer. Most melanomas occur in white skinned people. The risk factors are skin which tends to burn in the sun, having many melanocytic naevi, intermittent sun exposure and sunburn.
This guideline covers children, young people and adults with suspected melanoma, and who have been newly diagnosed with cutaneous melanoma, including vulval and penile melanoma.
The guideline is relevant to all healthcare professionals who come into contact with people with melanoma, as well as to the people with melanoma themselves and their carers. It is expected that the guideline will be of value to those involved in clinical governance in both primary and secondary care to help ensure that arrangements are in place to deliver appropriate care to this group of people.
Date of Publication: July 2015
Endorsed on: August 2015
Full clinical guideline (PDF, 2297KB, 246 Pages)

Mouth Care for Children and Young People with Cancer (UKCCSG-PONF)

This guideline covers oral care for children and young people who have undergone or are receiving chemotherapy and/or radiotherapy for a malignancy (including head and neck cancers) or stem cell transplant (including bone marrow and peripheral blood stem cell transplants).

The guideline includes a quick reference guide and a one page "at a glance" document.

Date of Publication: March 2005
Date of Endorsement: June 2007

Full guideline (PDF, 840KB, 65 Pages)

Pathways to Diagnosis: The Diagnosis of Brain Tumours

The guideline covers the symptoms and signs that may occur in all children aged 0-18 years with brain tumours, the assessment of children, and indications and waiting times for imaging these children. Recommendations were formulated using the evidence that supported them. Where no substantial clinical research evidence was identified, formal consensus methods (modified Delphi technique) were used to formulate recommendations.

The guideline is accompanied by an algorithm and quick reference guide and includes key audit criteria and an algorithm.

Date of Publication: June 2008
Date of Endorsement: June 2008

Full guideline (PDF, 808 KB, 43 Pages)
Quick reference guide (PDF, 566KB, 16 pages)

The HeadSmart programme (formerly The Brain Pathways project) aims to reduce the length of time it takes to diagnose brain tumours in children. Click here to find out more about the HeadSmart project and how you can get involved.

Practical Guidance for the Management of Palliative Care on Neonatal Units

This guideline covers all aspects of the management of palliative care on neonatal units and focuses on practical aspects of infant care. It includes details on pain relief, symptom relief, comfort and dignity, the management of prognostic uncertainties, and the provision of support.

Developed by members of the multidisciplinary neonatal medicine team at Chelsea and Westminster NHS Foundation Trust, in collaboration with the Royal College of Paediatrics and Child Health, this guideline, which complements existing resources, equips staff working on a neonatal unit with a clear set of principles to underpin the care they provide to babies in life-limited situations and support parents.

The project is supported by a wide group of stakeholders including ACT, APPM, BAPM, BLISS, RCM, RCN, SANDS and the UK Neonatal Networks.

Date of Publication: February 2014
Date of Endorsement: February 2014

Full guideline (PDF, 714KB, 40 Pages)
Supporting documents are available from the Chelsea and Westminster Hospital

Transition from children’s to adults' services for young people using health or social care services (NICE CG)

Transition occurs during the period when young people and their families are thinking about their hopes for the future. If people are likely to have care and support needs when they are 18, they need information and advice so that they can make the necessary plans. Despite this, there is evidence that the transition process is variable, with previous good practice guidance not always being implemented.
This clinical guideline focuses on young people passing through transition to adult services with health and/or social care needs. 
It covers the period before, during and after a young person moves from children's to adults' services, and aims to help young people and their carers have a better experience of transition by improving the way it’s planned and carried out.
Date of Publication: February 2016
Endorsed on: March 2016
Full Clinical Guideline (PDF, 1,710KB, 218 Pages)
NICE Clinical Guideline (PDF, 173KB, 31 Pages)