Poster abstracts of the 15th Annual BTOG / Lung Cancer 103S1 (2017) S1–S81 S9 18 How has including “unexplained haemoptysis” in 2015 NICE lung cancer referral guidelines changed referral and diagnosis rates? S. Dobson 1 , R. Miller 2 , L. Fuller 2 1 Respiratory, South Tyneside General Hospital, South Shields, United Kingdom; 2 Respiratory, South Shields General Hospital, South Shields, United Kingdom Introduction: NICE guidance (published June 2015) advises referral of patients aged 40 and over with unexplained (rather than persistent) haemoptysis under the ‘two week wait’ (2WW) system. The aim was to improve early detection of cancer. It was estimated this would cause 5–20% increase in referrals. We wished to determine if our department had experienced an increase in 2WW referrals following the new guidelines and review whether unexplained haemoptysis is an indicator for lung cancer in clinical practice. Methods: A retrospective case note review of patients presenting with haemoptysis as a 2WW referral from October to December 2014 and the same period 2015 was conducted. Data was collected on referral source, demographics, investigations, final diagnosis and number of follow up appointments. Results: 20 cases from 2014 cohort were reviewed; 6 (30%) female, median age 64.4 years, 8 (40%) current smokers. In 2015 there were 14 cases; 5 (36%) female, median age 61.2 years, 2 (14%) current smokers. Infection was the commonest diagnosis made in 2014 (50% patients), with only 1 malignancy. In 2015, 5 patients (36%) were diagnosed with definite or suspected malignancy (Table 1). Table 1 (abstract 18) Diagnosis of patients referred with haemoptysis 2014 (%) 2015 (%) Confirmed lung cancer 1 (5) 3 (21.4) Suspected lung cancer 0 1 (7.1) Other malignancy 0 1 (7.1) Infection 10 (50) 3 (21.4) Bleeding from alternative source 2 (10) 3 (21.4) Unclear 5 (25) 2 (14.3) Other 2 (10) 1 (7.1) Conclusion: Our department did not experience an increase in referrals following the new guidance. A greater proportion of patients referred in 2015 had evidence of malignancy (36 vs. 5%), suggesting early referral was appropriate. Higher referral rates may occur at peak incidence of respiratory infections within the community, which may explain the diagnosis of infection in 50% of 2014 referrals. Haemoptysis is an important symptom which should prompt urgent referral to a respiratory specialist. Further audit over a prolonged period is needed to further establish the impact of these guidelines on referral practices and diagnosis. Disclosure: All authors have declared no conflicts of interest. 19 Intra-operative frozen sections – is video-link technology equivalent to an on-site service? J. French 1 , D. Betney 1 , U. Abah 1 , N. Bhatt 1 , R. Daly 2 , E. Internullo 1 , G. Casali 1 , R. Krishnadas 1 , T. Batchelor 1 , D. West 1 1 Thoracic Surgery, Bristol Royal Infirmary, Bristol, United Kingdom; 2 Pathology, Southmead Hospital, Bristol, United Kingdom Introduction: Thoracic surgery frozen section histopathology in our institution changed from on-site to video-link service on 28/4/16. Specimens are now dissected in theatre by the operating surgeon, frozen and cut in the lab, and then sent via video-link to a centralised unit. This reflects a trend across the NHS with regards to centralisation of key services. We audited our service to see what impact this move has had upon surgical practice. Methods: Cases were collected over an 8 month period from the prospectively logged thoracic theatre specimen book at our institution. Demographics, operation, sample type, time taken from theatre, time received by lab, time reported by lab, frozen section diagnosis, paraffin diagnosis, and final TNM staging were recorded. Results were analysed using statistical software SPSS, and a p value of <0.05 was considered significant. Results: In total 63 samples from 60 patients were recorded, 28 female 32 male, age range 40–83 years. Samples included 49 wedges, 6 lymph nodes, 3 bronchial biopsies, 3 chest wall, and 2 pleural biopsies. Overall time from specimen arrival to report ranged from 12–59 minutes, with a mean time of 28.8±10.9 minutes. Mean time for on-site service was 28±10.5 minutes, whilst the mean time for the video-link service was 29.6±11.3 minutes. This difference was not statistically significant (p=0.57). No diagnoses were changed between frozen section and paraffin section microscopy. Conclusion: There was no significant increase in time taken using video-link technology compared with an on-site service. Although this is an early study with insufficient power to fully test accuracy of diagnosis, these results are encouraging for the provision of this technology over a number of specialties. Disclosure: All authors have declared no conflicts of interest. 20 Pattern of lung cancer referrals to a newly established Acute Oncology Service L.E. Mulholland 1 , C. Quin 1 , C. McCoy 1 , K. Foden 1 , S. Spring 1 , S. Rowan 2 1 Cancer Services, The Ulster Hospital, Dundonald, United Kingdom; 2 Medicine, The Ulster Hospital, Dundonald, United Kingdom Introduction: The Acute Oncology Service was established in the Southeastern Health and Social Care Trust (SEHSCT) in January 2016 and is part of a regional service being developed simultaneously across the five Health and Social Care Trusts in Northern Ireland. Our team consists of 1.5 WTE Band 7 CNS and 1 Consultant Oncologist. This service is provided Monday–Friday 9am–5pm and is supported by a chemotherapy helpline which operates 24 hours a day. The aim of the service is to provide timely expert oncology advice to patients with a new cancer diagnosis or who present with complications of their disease or treatment. We decided to look at the impact of the AO service on the lung cancer population. Methods: We collected data prospectively, from January 2016 to September 2016 using our regional AOS database. Results: Since the advent of the service until end September 2016 we have had 386 referrals, 69 of which were patients with a lung cancer diagnosis (Table 1). Average age was 65 years (range 25–82 years); 52 patients (75%) were seen within 24 hours of referral; average length of stay was 8.5 days (range 1–36 days); 13 were new cancer lung referrals, of which 9 went on to have systemic anti- cancer treatment. Table 1 (abstract 20) Reason for admission Number of patients Symptom control 38 Neutropenic sepsis 8 Non-neutropenic sepsis 8 New presentation of lung cancer 13 Metastatic SCC 1 Thrombocytopenia 1 Conclusion: Initial results show that the acute oncology service is being well utilised and that in particular the lung cancer population