When should I consider referring a patient experiencing severe side effects from chemotherapy to a specialist?

You should consider referring a patient experiencing severe side effects from chemotherapy to a specialist immediately, particularly if neutropenic sepsis is suspected NICE CG151. Neutropenic sepsis should be suspected in patients undergoing anticancer treatment who become unwell NICE CG151. Patients with suspected neutropenic sepsis require immediate referral for assessment in secondary or tertiary care NICE CG151. This condition must be treated as an acute medical emergency NICE CG151. Patients and their carers are typically provided with information on how and when to contact 24-hour specialist oncology advice and how and when to seek emergency care for chemotherapy-related complications NICE CG151. For patients receiving high-intensity chemotherapy, especially those in ambulatory care, there should be clear pathways for rapid hospital assessment in the event of neutropenic sepsis or other chemotherapy-related complications or toxicities NICE NG47. Haematology units caring for patients receiving high-intensity chemotherapy should ensure consultant-level specialist medical staff are available 24 hours a day NICE NG47.