A service at The Clatterbridge Cancer Centre for people who need intensive chemotherapy for acute myeloid leukaemia (AML) and related blood cancers is reducing the need for patients to stay in hospital for weeks at a time.
Acute myeloid leukaemia (AML) is an aggressive blood cancer that usually develops very quickly and affects white blood cells. Both AML and the chemotherapy used to treat it can severely affect people’s immune systems, leaving them vulnerable to infection.
Treatment usually involves patients staying in hospital for long periods while they have intensive chemotherapy and allow their immune systems to start recovering.
The Clatterbridge Cancer Centre’s Ambicare (ambulatory care) service means they can come into hospital as day patients for their treatment and then go home, where they are closely monitored by their hospital team. Patients can get immediate help from their hospital team if they become unwell, need urgent cancer care or have any concerns.
Bill Shimmins is just one of the patients who has benefited from the Ambicare service. He had his first round of chemotherapy as an inpatient, staying in hospital for several weeks, and was initially unsure about whether to opt for Ambicare for his second round of treatment.
“I was a bit concerned about what would happen if I got another infection,” says Bill. “The team at Clatterbridge are so good at fixing any problems you have and the inpatient rooms are very good but it’s a drag being in hospital, not just for you but for your family.
“I decided to give it a go and trusted the team and it went really, really well. There was an emergency Hotline that I could call if I had any problems and they would make sure I got the care I needed.
“The care at Clatterbridge is phenomenal but there’s nothing like having your home comforts. You just feel better at home if you can manage it and being able to get outside for a stroll is really good for your mental health.
“It also meant my family didn’t have to come to hospital every day or worry about practical things like bringing laundry in. Food in your own home always tastes better than hospital food. I was also able to get up and about more at home, which really helps your recovery.”
Aaron Purle, from Aintree, also chose to have part of his treatment through the Ambicare service so he could enjoy more time at home with his young daughter. Aaron believes that not being in hospital all the time helped him recover more quickly physically and mentally.
“I think patients benefit greatly from it,” he said, “just to get outside and to be able to spend time with the family. It’s so much better than sitting in hospital waiting for them to visit. Your mental health can go down when you’re in hospital and being able to get home in between gives you light at the end of the tunnel. It’s just that bit of normality.
“The team in Clatterbridge are worth their weight in gold and, if you have any problems at all, they’re only a phone call away. If you feel unwell, you just call them and they can bring you back into hospital straight away to be seen. I’d recommend the ambulatory care to anyone who is able to do it.”
Since launching in 2023, the Ambicare service has meant AML patients spent more than 1,000 fewer nights in hospital. Feedback has been overwhelmingly positive, with people saying they feel much better at home and know they can get immediate help from their hospital team if needed.
Consultant Haemato-Oncologist Dr Muhammad Saif, who specialises in leukaemia and is also Director of The Clatterbridge Cancer Centre’s Stem Cell and Cellular Therapies service, said:
People with AML can suddenly become very unwell because their immune systems are so weakened. Traditionally, patients stayed in hospital to receive transfusion support, reduce infection risk and in case they needed urgent care for infection and other complications that can happen after intensive chemotherapy but we know that long hospital stays aren’t necessarily that good for people.
Our Ambicare ambulatory care service offers the best of both worlds. Patients don’t have to stay in hospital overnight but they are very closely monitored at home with regular blood tests and monitoring calls from their hospital team. They also have rapid access to urgent specialist cancer care if needed. We can bring them straight into hospital for urgent assessment and treatment.
Now Ambicare is being extended to other patients including Catherine Holloway, from Wirral, who has a rare blood cancer called blastic plasmacytoid dentritic cell neoplasm (BPDCN).
Catherine was diagnosed in August 2024 and, when she began chemotherapy, her immune system was so fragile that she spent around four months in hospital. She has been in and out of hospital ever since and recently had a stem cell transplant.
“In between, though, I’ve had weeks when I could be at home and just come into the day ward for my treatment,” says Catherine. Being able to have some of her treatment as a day patient instead of having to stay in hospital has made a world of difference to her.
“I have two drips which take about two hours in total. The nurses are all really lovely and you forget you’re there after a while. You get to know each other so well that the nurses almost feel like your friends, although obviously it’s in a professional way.
“I’m not really well enough to do a lot but, when you’re at home, you get to walk around the block and enjoy the weather which is really nice. If I feel unwell, I’ve got a big list of numbers to call for advice including my own nurses.”
The nursing team supporting Bill, Aaron and Catherine includes Advanced Nurse Practitioner Janine Collins and Myeloid Clinical Nurse Specialists Aoife Brennan and Faye Finneran.
The Clatterbridge Cancer Centre is also working on plans to extend the Ambicare service to other patients having intensive chemotherapy.
