How this fits in

Unscheduled care use is common in people with advanced cancer, but previous research has focused largely on accident and emergency (A&E) attendances only; this has led to an underestimation of the frequency of unscheduled care use as use of general practice out-of-hours (GPOOH) services is significantly more common than A&E use. This study demonstrates that the percentage of people with cancer who use unscheduled care is significantly higher than previously shown, that demographic factors have relatively little influence on unscheduled care use, that unscheduled care attendance was linked to clinical factors including pain and palliative care symptoms, and that people who are ‘frequent users’ were a small proportion of the cohort but accounted for over half of unscheduled care consultations. This concentration of unscheduled care use at the end of life and among a small number of users implies that any unscheduled care use should trigger in-hours care review and anticipatory care planning. Identifying factors that affect unscheduled care use will enable clinicians to identify people at high risk of (frequent) unscheduled care use and appropriately target resources and interventions to these individuals in order to optimise care and minimise avoidable unscheduled care use.