SP 3.05 Utilisation of a Community Diagnostic Centre to Improve Colorectal Urgent Suspected Cancer Pathway Performance
Jack Carter, Yan Li Goh, Jon Lacy-ColsonAbstract
Background
Hospitals struggle to cope with the large number of patients referred on the urgent suspected cancer (USC) pathways. Diagnostic/treatment targets outlined in the NHS Long-Term Plan are often not met, resulting in long patient waiting times, increased staff workload, and high costs.
Method
We analysed a reinvented colorectal USC pathway, utilising nurse-led, consultant-supervised clinics delivered in a community diagnostic centre (CDC). All patients received a standardised face-to-face assessment by a nurse specialist to determine the diagnostic investigation and further management. We compared the delivery of the CDC clinics with the traditional pathway in terms of time from USC referral to first outpatient appointment (OPA), time until investigation, proportion of patients meeting the Faster Diagnosis Standard (FDS), cost of pathway delivery, and time to first OPA for routine referrals.
Results
The time to first OPA for USC referrals reduced from 14 to 3 days. The time to colonoscopy reduced from 16 to 11 days whilst the time to CT reduced from 17 to 6 days. FDS performance increased from 51% to 75%. The CDC pathway was cheaper, £373,222 per annum compared to £414,420. Additionally, time to first OPA for routine referrals reduced from 65 to 6 weeks following greater consultant availability.
Conclusion
We demonstrated that nurse-led clinics in a CDC can safely deliver the colorectal USC pathway with several benefits for both patients and hospital trusts. Standardising and streamlining the USC pathway in a CDC setting delivered benefits to both the USC and routine referral pathways.