Oncologist-led, cardiology-collaborative cardio-oncology clinic in a UK tertiary centre: business case and implementation framework

Cardio-oncology services in the UK remain limited and are frequently cardiology-led, often functioning separately from routine oncology workflows. We developed an oncologist-led, cardiology-collaborative cardio-oncology clinic embedded within the oncology department of a tertiary centre to provide integrated cardiovascular care for patients receiving systemic anticancer therapy. The service incorporates same-day cardiovascular investigations, including echocardiography, electrocardiography, and cardiac biomarkers, alongside protocol-based risk stratification and surveillance aligned with contemporary cardio-oncology guidance. The clinic operates as a fortnightly joint service delivered by oncologists with scheduled consultant cardiology input, supporting baseline assessment, surveillance during treatment, and rapid-access review for new cardiovascular symptoms. A prospective framework was established to evaluate clinical, operational, and economic outcomes, including treatment continuity, unplanned admissions, and healthcare utilization. The model aimed to improve early detection and management of cancer therapy–related cardiovascular toxicity while reducing avoidable interruptions to anticancer therapy and enhancing patient experience through coordinated one-stop care. This integrated oncologist-led model represents a feasible and scalable approach to embedding cardio-oncology within routine cancer care pathways.