Haematology Symptom Urgent Review Clinic

A pilot project developing a Haematology Symptom Urgent Review Clinic (Haem-SURC) utilising a decentralised model

Monash Health Haematology has a large malignant haematology portfolio and providing a comprehensive haematology services including delivery of complex chemoimmunotherapy regimens, autologous stem cell transplantation and CAR-T therapies. One of the unique challenges faced by Monash Haematology is ensuring adequate and equitable provision of care to all patients living within Monash Health’s large catchment area.

One of the key gaps in our malignant haematology model-of-care is the absence of a dedicated Symptom and Urgent Review Clinic (SURC) for our patients with blood cancers. Currently there are no streamlined pathways for patients who develop symptoms from their anti-cancer treatment to seek urgent review. Patients either present to their closest Emergency Department or contact the on-call haematology registrar or haematology nurse coordinator, with limited ability to perform ad hoc reviews. We also recognise that it is not practical or patient-centred to expect all patients to travel to MMC in Clayton when they
develop symptoms requiring urgent assessment.

The aim is to establish a dedicated SURC clinic for patients with blood cancers receiving anticancer treatment (Haem-SURC), with a focus on patient safety, implementing a decentralised model-of-care, enabling broader reach and more equitable access for patients living within the Monash Health catchment area.

Project outcome

This project addressed a critical service gap in symptom management for patients with blood cancers particularly those managed in outpatient and decentralised care settings. Prior to implementation, patients frequently lacked a consistent and accessible point of contact for emerging symptoms. Operating primarily through telehealth and leveraging existing haematology, HITH, and digital infrastructure, the clinic delivered rapid triage and coordinated escalation across a large and diverse patient population. Between April and December 2025, Haem-SURC managed 685 patient encounters, safely resolving the majority of symptoms without the need for Emergency Department presentation. Patient feedback confirmed high satisfaction, increased confidence in symptom management, and a clearer understanding of escalation pathways.

The evaluation of Haem-SURC demonstrated strong feasibility, acceptability, and integration within routine haematology workflows, laying a compelling foundation for ongoing funding and service expansion.