We will support equitable access for people and ensure they receive a timely and definitive diagnosis of cancer. Confirmation or exclusion of a cancer diagnosis should take a maximum of 28 days from referral to diagnosis for at least 85% of people by 2030.

Below, we have described specific aims to realise our ambition:

1. Improve appropriate diagnostic testing and shared decision making for people.
2. To provide clear information and offer decision support tools for some common cancers, to support health seeking behaviour; applying the latest technology (wearables, self-testing, artificial intelligence (AI)), genomics and cancer blood tests.
3. To continue to develop community diagnostic services, ensuring access is as close to home as possible.
4. Work with teams delivering diagnostic services to help predict the changes in cancer-related demand and ensure there is enough equipment and workforce to meet the needs of our population.

Aim: Improve appropriate diagnostic testing and shared decision making for people.

 Objective: To develop integrated pathways between health and social care settings, with a focus on frailty.

In order to achieve this we will:

• Continue to develop our Wessex imaging, pathology, histopathology and endoscopy networks (working with training academies) to ensure integrated systems and an appropriate digital/physical workforce are in place to support clinical teams.
• Agree which tests are needed, in which order, for each pathway to ensure quality, equity of access and reduce duplication and variation, in line with nationally prescribed best practice timed pathways where they exist.
• Build clear governance and accountability frameworks to enable staff to work across organisational boundaries to flex capacity to where it is most needed, prioritising remote image reporting across organisations at a Network level.
• Invest in and develop IT and digital integration within and between systems to allow reliable and rapid data sharing (in collaboration with the Southern Counties Pathology and Wessex Imaging Networks), for primary, community and secondary care diagnostics (including community diagnostic centres).
• Develop shared waiting lists across service providers to improve equity of access.
• Be at the forefront in the use of AI, where it has been proven to assist accurate and rapid reporting of all images. Where possible, we will use automation to improve efficiency and accuracy in administration processes.
• Include frailty assessment, when required, in discussions ahead of referrals for diagnostic testing for cancer. We will develop guidance and support for clinical teams and patients and their families to make informed decisions about the right time to refer and the options around diagnostic testing.
• Further develop shared decision making to support patients and their families to make informed choices about accessing diagnostic testing that is right for them.

Aim: To provide clear information and offer decision support tools for some common cancers, to support health seeking behaviour; applying the latest technology (wearables, self-testing, artificial intelligence (AI)), genomics and cancer blood tests.

Objective: To implement innovative solutions to allow more patients to confirm or rule out a cancer diagnosis.

In order to achieve this we will:

• Seek opportunities for technological developments and processes where patients are empowered to self-monitor and triage, if they wish to, particularly if disease recurrence is suspected.
• Collaborate with Central and South Genomic Medicine Service Alliance, to proactively invest in and develop genomic testing to ensure a personalised approach to diagnostic pathways for patients and their families.
• Co-design effective communication that addresses barriers to participation in technology and genomic solutions, so these innovations are taken up by diverse populations across Wessex.
• Utilise population health data to seek to offer information and support to people with increased cancer risk.
• Ensure emerging tests, for example Multi Cancer Blood Tests, Cytosponge, Colon Capsule Endoscopy and others are scaled and implemented at pace where evidence supports effectiveness.

Aim: To continue to develop community diagnostic services, ensuring access is as close to home as possible.

 Objective: Utilise community diagnostic centres to create one-stop or shortened pathways, including self-referral and walk-in facilities near to communities.

Particularly for our rural and Island population we will ensure access to diagnostic pathways is close to home and easy to get to, utilising shared data, modelling, and population health information to plan services around need.

In order to achieve this we will:

• Work across systems with people and communities to design access to diagnostic services around people and communities, locating services close to people, promoting accessible pathways for diagnosis.
• Continue to review processes to eliminate duplication, to promote same day testing and diagnosis where feasible.
• Ensure alignment between change in demand of diagnostic pathways and capacity in laboratory, imaging, and endoscopy services, utilising proven technological innovations (including AI) as they emerge.

Aim: Work with teams delivering diagnostic services to help predict the changes in cancer-related demand and ensure there is enough equipment and workforce to meet the needs of our population.

Objective: Ensure we have the right people with the right skills, in the right place to deliver diagnostic services.

In order to achieve this we will:

• Through Networks and Academies, develop demand and capacity modelling for the future diagnostic workforce to meet the increasing need.
• Build plans in partnership across commissioners and providers to ensure sustainable recruitment and training for current and future service requirements.
• Increase opportunity through joint and rotational roles to help retain our workforce.
• Support the development of advanced communications skills in the diagnostic workforce to provide supportive patient care.

We will support systems to help predict the changes in cancer-related demand linked to:

• Demographics.
• Survivorship.
• New tests and approaches to identifying or monitoring cancer.
• New or extended screening services.

This information will help develop an overall demand and capacity tool for workforce, training, physical capacity, and equipment.