Ambulatory Care Service

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This page provides an overview of the Ambulatory Care Service for adult patients.

What is Ambulatory Care?

Ambulatory Care (AC) is based on the second floor of the University College Hospital Macmillan Cancer Centre.

It provides the opportunity for many of our patients to receive a variety of treatments without having to stay in hospital overnight. These treatments include high-dose chemotherapy, stem cell transplant or CAR T-cell therapy.

Your healthcare team will assess if AC is suitable for you. If it is, you will receive your care in a daycare setting and stay in a nearby hotel at night. Some patients even stay at home during the night, depending on the type of treatment they are having.

You may be able to stay at home if:

your consultant has agreed to this
you live within a 60-minute travel time to the Cancer Centre (according to Google maps)
you have a family member or a friend available to drive you to the hospital at any time of the day or night
you have a mobile and are contactable at any time.

The AC team will advise you where you will be staying. They will also give you more information about your accommodation if you’re not staying at home.

What advantages does AC offer me?

We hope that staying in a hotel will offer you a comfortable environment to rest in between your daily treatments.
Your partner, relative or carer may stay with you throughout your treatment. This is not always possible in the hospital.
You will receive the same treatment as you would on the ward except that it will be scheduled between 8am and 8pm.
If you are receiving chemotherapy, your treatment may be delivered through a small portable pump. This will allow you to continue with your daily life away from the hospital and enjoy local attractions with your family and friends.
If you are staying at home, we hope that this will add a greater degree of privacy, independence, and normality to your treatment.

'I felt like I was in a community. I liked that you could talk to other patients. There was a relaxed atmosphere, which I think helped my stay.'
Ambulatory care patient

What happens during the AC opening hours (daytime)?

You will be given treatment times to attend each day. This will allow you to plan for visitors, your meals, and your rest time. Please note that you will need to be in the Ambulatory Care Unit by 11am each day.
An AC nurse will assess you daily, take your blood samples and check the medicines you are taking. They will also assess any symptoms you may be having during and after your treatment. These include nausea, vomiting, diarrhoea and fatigue. The nurse will ring you with your blood test results later in the day and advise you if you need to come back to the unit.
If requested by your healthcare team, you may have other tests.
Doctors are available daily. If you have blood cancer, your consultant will visit you twice a week.
You will be responsible for taking your oral medicines. It’s important that you tell the AC nurse if you are running low on any medicines you are taking so that they can order them for you.
Please note that treatments may sometimes take longer than expected, or you may have days when you feel tired or unwell. It’s important that you allow some flexibility for this.
Contact the Ambulatory Care Unit on 07908 356 182 as soon as you begin to feel unwell or if you develop any symptoms listed below. You will be responsible for checking your temperature every four hours when you are neutropenic, and four times a day when you are not.

What happens in AC out of hours (nighttime)?

A nurse in charge on one of the haematology wards will hold the AC mobile at night. They will be able to access your records and assist you if you need any help overnight or out of hours.

Don’t wait until the morning to contact us if you develop any of the symptoms listed below.

Ambulatory Care mobile: 07908 356 182

What if I become unwell during my stay in AC?

It’s important that you contact our team at any time of the day or night if you develop any of the following symptoms:

Temperature near to or above 38 °C
Shivers or hot flushes regardless of temperature
Persistent nausea, vomiting or diarrhoea
Shortness of breath or finding it hard to breathe
A cough, sore throat or flu-like symptoms
Pain and swelling around your PICC (peripherally inserted central catheter) or in the arm where your PICC is
Feeling dizzy or faint
Feeling generally unwell or ‘not right’.

Depending on your symptoms, you may need to come to the hospital to be reviewed by a doctor or nurse. Please bring your medicines with you if this is the case. Your healthcare team may decide to admit you to hospital if you need close monitoring and/or additional treatment that cannot be managed within the ambulatory setting, such as fluids or antibiotics.

You must phone us if you or your companion/carer have:

any infectious symptoms, such as runny nose, sneezing, diarrhoea or vomiting
any symptoms of COVID-19, such as fever (temperature close to or above 38 degrees), continuous cough, or loss or change in taste or smell.

This is especially important before coming to the Cancer Centre. We will advise you where to go for your assessment to minimise the risk of infection spreading to other patients.

If you have any infectious or COVID-19 symptoms and need to be admitted to hospital, you will be isolated from other patients. Often you will need to stay on a different ward than your usual ward but your medical team will remain the same.

Follow the tips below to help you stay well

Take your temperature regularly and as advised.
Avoid people with signs of a cold, such as coughing, sneezing or a runny nose. This also applies to companions/carers staying in the hotel.
Avoid crowded places and ‘smoky’ areas.
Wash your hands regularly and maintain a high level of personal hygiene.
Take good care of your teeth and gums.
Follow food safety advice outlined in our information ‘Safer eating during your cancer treatment’.

What should I do in an emergency?

An emergency is any urgent situation where you need immediate medical and nursing assistance.

If you need urgent medical attention:

press the call button in your room to call for help, or
call 999 immediately and state the treatment you received, your symptoms and location.

If you have a companion/carer staying with you, they should call the AC team on 07908 256 182 to update them.

If you are neutropenic and calling an ambulance, please tell the call handler that you are neutropenic and what your temperature is. If the wait for an ambulance is longer than 10 minutes, call the AC mobile and they will call 999 on your behalf.

What do I need to bring if I’m staying in a hotel?

A thermometer
A mobile phone with charger
Light luggage that can you or your companion/carer can easily transport to the hospital if needed
All medicines you are taking
Books, magazines and gadgets to help you pass the time.

'The hotel was well thought out and perfect for patients who don't need to be on a ward. I was always seen promptly and felt very safe there.'
Ambulatory care patient

Checking into and out of the hotel

Checking into the hotel

You can check into your room after 2pm.
It is very important that you keep your room key safe. You will be charged £50 if you lose the key.
We will cover the cost of your room and breakfast for both you and your companion/carer.
Small portions of microwaveable food are also available free of charge for lunch and dinner. You can request this by filling in a food order form on check-in, which is available at the reception desk.
We will not cover any extra expenses such as bar, restaurant, room service or mini-bar bills, phone calls (excluding calls made to the hospital), or any non-accidental damage to the hotel during your stay. You will need to cover these additional costs when checking out of the hotel.

Checking out of the hotel

On the day you are due to go home, you will need to check out of your room by 11am.
If you are admitted to hospital during AC working hours, you will have to check out of the hotel. If the decision to admit you to hospital is made before 2pm, either you (if you are well enough) or your companion/carer will have to check out by 2pm. The AC staff can help you with this or check out on your behalf. If you don’t check out on time, you will need to pay additional hotel costs.
Please note that we cannot offer hotel accommodation for your companion/carer if the decision to admit you to hospital is made before 2pm.
If the decision to admit you to hospital is made after 2pm, your companion/carer may stay in the hotel overnight. They must check out the following morning by 11am.

Frequently asked questions

1. Are meals provided?

Breakfast and small portions of microwavable food are provided for you and your carer/companion within the hotel.

You can also buy meals at your own expense in any of the local restaurants.

2. Is transport available?

We don’t provide transport from home to AC for everyone. You can find out if you qualify for transport by calling the transport assessment team on 020 3456 7010 between 8am and 8pm, Monday to Friday.

3. What happens if my blood counts are low?

When your blood counts are low and you are neutropenic, you are more at risk of infection. Your AC nurse will check your blood counts daily and let you know when you become neutropenic. You will be able to stay in the AC as long as you remain well.

Follow-up care

When discharged from AC:

You will have dates for blood tests and your next appointment (if this applies to you).
We will organise for a district nurse to visit you for your weekly central line care and blood tests (if this applies to you).
Depending on your treatment, you may need to return to AC when you are neutropenic. The AC staff will arrange this for you.
You will receive a 24-hour urgent advice card in case you become unwell at home.

Macmillan Support and Information Service

The Macmillan Support and Information Service offers advice, support and information to anyone affected by cancer. This includes your friends, family and carers who are supporting you.

It’s located on the ground floor of the Cancer Centre where the support and information specialists can tell you more about the support available. You don’t need an appointment to visit and the team will see you as quickly as possible.

General enquiries: 020 3447 8663

Email: uclh.supportandinformation@nhs.net

Opening hours: 9.30am to 4.45pm, Monday to Friday