The Department of Health has asked all hospitals with emergency departments in England to establish acute oncology services following a recommendation from the national chemotherapy advisory group.

The DH estimates that the vast majority of oncology consultants are clustered at the country’s 49 cancer centres.

But centralisation is increasingly seen as being at odds with both the way patients receive their chemotherapy - which is increasingly in the community or at local hospitals - and with the 10 per cent increase in chemotherapy patients triggered by the 2005 decision to fund Herceptin on the NHS.

A DH report, published in 2008, also concluded that the deaths of a quarter of 1,415 chemotherapy patients who died within 30 days of their treatment might have been caused or hastened by the chemotherapy itself or by poor care of side effects. Emergency patients often experienced delays in being seen by an oncologist at a specialist centre.

The national chemotherapy advisory group has said the 121 trusts with accident and emergency departments that are not cancer centres should establish oncology services consisting of at least two oncologists and two specialist nurses.

A DH impact assessment says that will cost the trusts £15.2m a year between them, but it estimates the cost will be more than offset by reductions in patient length of stay.

NHS Confederation director of policy Nigel Edwards said DH estimates about cost savings often did not emerge in reality so the requirement would be a “cost pressure” for some, but recommendations on improving outcomes for cancer patients were welcome.