Return cancer test results within 10 days, NHS England tells hospitals

3rd May 2023

NHS England has tasked hospitals with turning around diagnostic test results for suspected cancer within 10 days.

Hundreds of patients who have been referred under the urgent pathway will receive faster news about whether they have cancer or not helping to reduce anxiety and start treatment more quickly, NHS England said.

A letter sent to local health leaders has also asked teams to prioritise diagnostic tests like MRI scans for cancer in community diagnostic centres (CDCs) or to free up capacity within hospitals by moving elective activity into the centres. 

Earlier this month, figures showed more than 42% of patients are waiting more than 62 days for their first cancer treatment from urgent GP referral.

Worst ever cancer waiting times

It follows a report from the Public Accounts Committee in March which warned that cancer waiting times are at their worst ever level and NHS England was unlikely to meet its recovery target of moving back to 85% treated within 62 days of referral.

But the latest figures did show some improvement in two week wait times from the previous month with 86% of people seen by a specialist within a fortnight of urgent referral up from 81%.

In February, NHS England said it achieved the faster diagnosis standard for suspected cancer for the first time, with three quarters of those referred receiving a definitive diagnosis or all clear within 28 days – 171,453 people.

There has been high demand for services with up to one in four GP referrals a month for cancer.

In March 2022 to Feb 2023, 470,000 more people were checked for cancer compared with the same period before the pandemic, the figures show.

There are now 105 CDCs in place and offering a ‘one stop shop’ for tests, NHS England confirmed.

‘Significant progress’

Dame Cally Palmer, NHS national director for cancer, said: ‘It is a testament to the hard work of NHS staff that we are seeing and treating record numbers of patients for cancer, and have made significant progress bringing down the backlog and achieving the target for diagnosing three quarters of people within 28 days – all despite huge demand and pressures on the system.

‘Fortunately, the vast majority of suspected cancer patients waiting for a diagnostic test will not have cancer, but for those waiting it can be a very anxious time, so we are asking trusts to aim for a 10-day turnaround time between GP referral and tests results for patients – so we can get people the all-clear faster, or in some cases ensure patients diagnosed with cancer are able to start treatment sooner.’

Professor Mike Osborn, president of the Royal College of Pathologists, said: ‘We welcome the announcement of support for pathology services which will help our members provide the quicker diagnoses that patients need.

‘Pathologists have long asked for improvements in digital pathology and infrastructure to help them provide better patient care. We fully support this initiative and the fresh focus on pathology which it should provide will, we hope, make a real difference to patients.’

This news story was originally published by our sister publication Pulse.

Study finds that remote consultations in radiation oncology might have greater prominence in future

15th October 2021

More radiation oncology consultations should be done remotely after a study found that few face-to-face appointments were required.

The COVID-19 pandemic has had a major impact on the provision of healthcare across all specialities. In Australia, the government decided that tele-health was to be a weapon against COVID-19 and expanded consultation services available through this medium. According to a study by a team from Canberra Hospital, Australian, in the future, telephone and or tele-health consultations may have a more prominent role in the provision of radiation oncology services. Prior to the pandemic, there was already some evidence that follow-up telephone consultations were able to provide similar outcomes for breast cancer patients and those with stage-I endometrial cancer. 

For their study, the Australian team set out to determine the percentage of telephone/tele-health radiation oncology consultations that led to the need for a subsequent face-to-face consultations during the first wave of the 2020 COVID-19 pandemic. In addition, where face-to-face consultations were required, the authors examined the reasons behind the need for such appointments. The team employed a retrospective design and obtained a de-identified dataset report created from the department’s oncological information system (ARIA) spanning a 10-week period from 23 March to 28 May 2020. Using the information system, the team extracted patient demographic data including the area of residence and diagnoses based on ICD-10 codes and additional data from the clinic appointments such as the appointment type, e.g., initial or follow-up. The patient’s medical records were then reviewed to categorise the reasons for the subsequent face-to-face consultation and these were recorded as frequency counts.

Findings

During the study period, there were a total of 1159 radiation oncology consultations undertaken with 973 patients. Overall, 696 (60%) of all consultations were conducted via the telephone, of which, 649 were for a follow-up appointment and the remaining 47, an initial appointment. However, less than 1 per cent of all (4/696) were conducted using tele-health. Of those who had a telephone/tele-health consultation, only 66 (9% of all telephone/tele-health consultations) subsequently required a face-to-face consultation. Among these 66 patients, the most common reason (45%) was the need for written consent prior to radiotherapy. Other reasons included the need for a clinical examination of a new problem (24%) and for a new investigation (7.5%). For the 16 (24%) patients needing a clinical examination for a new problem, the primary sites of disease were breast (4), mucosal head and neck (3), skin (3), endometrium (2), oral cavity (1), rectal (1), lung (1), and prostate (1).

The authors concluded that “A large proportion of radiation oncology appointments can be completed using telephone/tele-health, with a relatively small number of these requiring subsequent face-to-face appointments.” Nevertheless, they cautioned that “careful patient selection and accounting for multiple variables would be needed to ensure effective and safe healthcare is provided.”

Source. It’s a sign of the times:Our experience with telephone/tele-health consultations for radiation oncology patients in Canberra during the COVID-19 pandemic. The Royal Australian and New Zealand College of Radiologists conference 2021.