Most countries in the British Isles (except for Northern Ireland) offer a hub and spoke model of care with a regional children’s cancer principal treatment centre working with local hospitals who are designated to provide ‘shared care.’ This enables some families to have care closer to home when possible.
Most countries in the British Isles (except for Northern Ireland) offer a hub and spoke model of care with a regional children’s cancer principal treatment centre working with local hospitals who are designated to provide ‘shared care.’ This enables some families to have care closer to home when possible.
The regional principal treatment centres for children 0-16 years can be found here. Specialist Hospitals.
Map of shared care units
(With thanks to the Tessa Jowell Brain Cancer Mission - Paediatric Academy, who created this map)
Each country has a slightly different way of describing the scope of services which are offered in shared care.
England
In England a national service specification (2021) outlines the services that are commissioned to offer shared care. A set of national standards are linked to the level of designation outlined below.
Each POSCU will offer either ‘Standard’ or ‘Enhanced’ services:
- Standard POSCUs: Provide the full range of supportive care but will not provide systemic anti-cancer therapies (SACT) services;
- Enhanced POSCUs: Provide the same services as Standard POSCUs and, in addition, will also provide SACT services. Enhanced POSCUs will be sub classified into two groups:
- Level A Enhanced POSCUs who provide out-patient and daycare bolus or infusional chemotherapy; and
- Level B Enhanced POSCUs who also provide in-patient chemotherapy.
Wales
The service specification for Wales (2024) describes the value of shared care but does not describe levels of shared care. However, the three POSCUs in North Wales link with the two principal treatment centres in England (Liverpool and Birmingham) and thus utilise the same levels of service described for England.
There are two shared care services in South Wales which link with the Cardiff PTC.
Northern Ireland
Due to the relatively small geography of Northern Ireland, all children with cancer are cared for by the principal treatment centre in Belfast.
Scotland
Children’s cancer services in Scotland are delivered through a coordinated, national model centred on three designated PTCs, each providing comprehensive specialist oncology and haematology care for children and young people. While Scotland’s approach to shared care is not structured as formally as the system in England, shared‑care arrangements are nevertheless well established. Across the country, a network of POSCUs supports the PTCs by offering elements of treatment (including SACT) and supportive care closer to home, reducing travel burdens for families and improving access to local services.
Ireland
Ireland has 16 POSCUs which work with the principal treatment centre in Dublin.
All POSCUs provide Standard Services which includes emergency care (including febrile neutropenia), outpatient care (including blood testing, blood component transfusions, and dressing changes), and initial management of oncological emergencies (including tumour lysis syndrome and spinal cord compression).
POSCUs may then offer one of three options for additional systemic anti-cancer therapy (SACT) services.
No SACT
Low level SACT
Moderate level SACT
Page last updated: March 2026