# Formal shared-care agreements between oncology and family doctors, with same-day e-consult

Source: https://onco.cc/ideas/idea-acc-primary-care-shared-care-agreements/  
OnCo record `idea-acc-primary-care-shared-care-agreements` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Family doctors often do not know who is responsible for a cancer patient's blood pressure, diabetes or new symptom. Written agreements plus a same-day electronic question line to the oncologist would fill the gap.

## Summary

During active treatment, primary care is often sidelined; after treatment, oncology withdraws and primary care is unclear about what to monitor. Formal shared-care agreements defining who manages what, combined with electronic consultation channels with a same-day response target, have improved coordination in other chronic diseases. Applying them systematically in oncology would reduce emergency visits and duplicated or missed care.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Practices under shared-care agreements with e-consult access will reduce unplanned emergency attendances of their cancer patients by at least 15% and increase management of comorbidities to target.
- Rationale: Ambiguity of responsibility is a documented cause of missed care in cancer; explicit agreements resolve it at low cost.
- Proposed test: A cluster-randomised trial across 60 primary care practices with emergency attendance, comorbidity control, and clinician satisfaction as endpoints.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Fragmented care and guideline gaps): Hanna et al., Mortality due to cancer treatment delay: systematic review and meta-analysis (BMJ 2020): https://doi.org/10.1136/bmj.m4087

## Connected records

- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Older and multimorbid patients are excluded and undertreated](https://onco.cc/bottlenecks/b-aging-comorbidity/)
- key papers: [Mortality due to cancer treatment delay: systematic review and meta-analysis](https://onco.cc/key-papers/paper-hanna-bmj/)

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