Faster Diagnosis

The Faster Diagnosis Framework (the Framework) sets out the strategic approach to delivering faster diagnosis of cancer and the associated cancer waiting times standards.

Read more about the Faster Diagnostic Framework here.

The below illustrates the Faster Diagnosis Principles which should underpin thinking, planning, review and implementation of actions for any pathway or service work.

There are key areas of focus as part of the Framework which includes:

Nationally developed best practice timed pathways (BPTPs)

Within WCA we use the nationally published BPTPs to support us in developing or re-designing our cancer pathways to optime pace of diagnosis and importantly patient experience.

As part of any pathway work or review the BPTP, where available, is used to compare best practice approach with locally designed pathways to ensure we are optimising our pathways wherever possible.

This includes looking at things such as approaches to triage, one stop clinics and how we use our workforce most effectively at different stages of the pathway.

Non-specific Symptoms Pathways (NSS)

NSS pathways have been introduced from 2020 to fill a previously un-met need to people who have symptoms suspicious of a cancer who however do not meet the NG12 criteria for a site specific suspected cancer referral.

The WCA are committed to strengthening and sustaining the Wessex Non-Specific Symptoms pathway which is delivered by the Rapid Investigation Service, run by University Hospital Southampton on behalf of the Wessex geography.

The core objective for 23/24 for the pathway is to work with ICB partners in both Dorset and HIOW systems to commission the service in a sustainable way.

Community Diagnostic Centres (CDCs)

The CDC programme was developed following Professor Sir Mike Richard’s review of NHS diagnostic capacity.

The vision for CDCs is to both increase and optimise capacity and access to diagnostics and improve patient outcomes and experience.

CDCs are ICB led programmes which are required to consider and include cancer pathways as part of their overall make up of service and diagnostic offer which spans wider than cancer.

We are working closely with CDC programmes in both Dorset and HIOW systems to ensure the opportunities for development and support of cancer pathways are clearly within CDC plans.

In particular we are working together to look at opportunities to enable some of the GP direct access guidance, additional capacity for diagnostics and also to release activity on acute sites where diagnostics are clinically more appropriately delivered there.

The Framework is supported each year through the detail within the Operational Planning Guidance and Alliance Planning Guidance.

For 23/24 this contains the two below metrics for Faster Diagnosis:

  • Continue to reduce the number of patients waiting over 62 days
  • Meet the cancer faster diagnosis standard by March 2024 so that 75% of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have cancer ruled out within 28 days

It also contains the below key actions for Faster Diagnosis:

  • Implement and maintain priority pathway changes for lower GI (at least 80% of FDS lower GI referrals are accompanied by a FIT result), skin (teledermatology) and prostate cancer (best practice timed pathway)
  • Increase and prioritise diagnostic and treatment capacity, including ensuring that new diagnostic capacity, particularly via community diagnostic centres (CDCs), is prioritised for urgent suspected cancer. Nationally, we expect current growth levels to translate into a requirement for a 25% increase in diagnostic capacity required for cancer and a 13% increase in treatment capacity.

The planning also describes key actions with are linked with Faster Diagnosis which also sit with our ICB and Diagnostic Network partners:

  • Maximise the pace of roll-out of additional diagnostic capacity, delivering the second year of the three-year investment plan for establishing Community Diagnostic Centres (CDCs) and ensuring timely implementation of new CDC locations and upgrades to existing CDCs
  • Increase GP direct access in line with the national rollout ambition and develop plans for further expansion in 2023/24

Wessex Cancer Alliance Faster Diagnosis Pathway Focus 23/24

For 23/24 the WCA has planned the following pathway focused activities to start/continue in Q1 and 2:

  • NSS: development of the service offer to include consideration of referral routes from ED and for Teenager and Young Adults.
  • Lumps and Bumps Pilot: this pilot is for a specific cohort of NSS patients. The focus for 23/24 will be the sustainability of the current live pilot with UHD and further roll out to DCH
  • Breast self-Referral: workforce recruited to support a second phase of the pilot which will see the introduction of a face to face clinic for symptoms and an integrated approach to workforce. Alongside this we will be looking at how we can work with system partners to sustain the service.
  • Gynae: review of pathways to be offered for all Trusts to look at the current offer alongside the national BPTPs to identify opportunities for development.
  • UGI: review of provision across both Dorset And H&IOW systems to identify an approach for sustainable provision of this pathway.
  • Prostate: deep dive of this pathway to be undertaken with all Trusts, diagnostic network and ICB partners.
  • Brain: review of the front end of the pathway to consider how we can optimise resources and support GP direct access.
  • Sarcoma: pan Wessex review of this pathways from presentation in primary care through to treatment.
  • Teledermatology: the objective is to have access to teledermatology for all practices across Wessex by the end of March 2024, and for these pathways to be increasing in uptake.

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