Saoirse Olivia Dolly1, Geraint Jones2,3, Paula Allchorne2, Daniel Wheeler4, Sunnyath Ali4, Yaseen Mukadam4, Sifan Zheng4, Loay Rahman4, Jan Sindhar4, Charlotte Louise Moss5, Danielle Harari2,6, Mieke Van Hemelrijck5, Anthony Cunliffe7, Luigi Vincenzo De Michele2. 1. Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, UK. saoirse.dolly@gstt.nhs.uk. 2. Guy's and St Thomas' NHS Foundation Trust (GSTT), Medical Oncology, London, UK. 3. South East London Cancer Alliance, London, UK. 4. King's College London, Faculty of Life Sciences and Medicine, London, UK. 5. King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), London, UK. 6. King's College London, Geriatric and Acute Medicine, Department of Ageing and Health, London, UK. 7. Joint National Lead Macmillan GP Adviser and Joint Clinical Chair, South East London Cancer alliance, London, UK.
Abstract
BACKGROUND: Rapid Diagnostic Clinics (RDC) are being expanded nationally by NHS England. Guy's RDC established a pathway for GPs and internal referrals for patients with symptoms concerning for malignancy not suitable for a site-specific 2WW referral. However, little data assessing the effectiveness of RDC models are available in an English population. METHODS: We evaluated all patients referred to Guy's RDC between December 2016 and June 2019 (n = 1341) to assess the rate of cancer diagnoses, frequency of benign conditions and effectiveness of the service. RESULTS: There were 96 new cancer diagnoses (7.2%): lung (16%), haematological (13%) and colorectal (12%)-with stage IV being most frequent (40%). Median time to definitive cancer diagnosis was 28 days (IQR 15-47) and treatment 56 days (IQR 32-84). In all, 75% were suitable for treatment: surgery (26%), systemic (24%) and radiotherapy (14%). Over 180 serious non-neoplastic conditions were diagnosed (35.8%) of patients with no significant findings in two-third of patients (57.0%). CONCLUSIONS: RDCs provide GPs with a streamlined pathway for patients with complex non-site-specific symptoms that can be challenging for primary care. The 7% rate of cancer diagnosis exceeds many 2WW pathways and a third of patients presented with significant non-cancer diagnoses, which justifies the need for rapid diagnostics. Rapid Diagnostic Centres (RDCs) are being rolled out nationally by NHS England and NHS Improvement as part of the NHS long-term plan. The aim is for a primary care referral pathway that streamlines diagnostics, patient journey, clinical outcomes and patient experience. This pilot study of 1341 patients provides an in-depth analysis of the largest single RDC in England. Cancer was diagnosed in 7% of patients and serious non-cancer conditions in 36%-justifying the RDC approach in vague symptom patients.
BACKGROUND: Rapid Diagnostic Clinics (RDC) are being expanded nationally by NHS England. Guy's RDC established a pathway for GPs and internal referrals for patients with symptoms concerning for malignancy not suitable for a site-specific 2WW referral. However, little data assessing the effectiveness of RDC models are available in an English population. METHODS: We evaluated all patients referred to Guy's RDC between December 2016 and June 2019 (n = 1341) to assess the rate of cancer diagnoses, frequency of benign conditions and effectiveness of the service. RESULTS: There were 96 new cancer diagnoses (7.2%): lung (16%), haematological (13%) and colorectal (12%)-with stage IV being most frequent (40%). Median time to definitive cancer diagnosis was 28 days (IQR 15-47) and treatment 56 days (IQR 32-84). In all, 75% were suitable for treatment: surgery (26%), systemic (24%) and radiotherapy (14%). Over 180 serious non-neoplastic conditions were diagnosed (35.8%) of patients with no significant findings in two-third of patients (57.0%). CONCLUSIONS: RDCs provide GPs with a streamlined pathway for patients with complex non-site-specific symptoms that can be challenging for primary care. The 7% rate of cancer diagnosis exceeds many 2WW pathways and a third of patients presented with significant non-cancer diagnoses, which justifies the need for rapid diagnostics. Rapid Diagnostic Centres (RDCs) are being rolled out nationally by NHS England and NHS Improvement as part of the NHS long-term plan. The aim is for a primary care referral pathway that streamlines diagnostics, patient journey, clinical outcomes and patient experience. This pilot study of 1341 patients provides an in-depth analysis of the largest single RDC in England. Cancer was diagnosed in 7% of patients and serious non-cancer conditions in 36%-justifying the RDC approach in vague symptom patients.
Authors: Simon Erridge; Georgios Lyratzopoulos; Cristina Renzi; Andrew Millar; Richard Lee Journal: Br J Gen Pract Date: 2021-10-28 Impact factor: 5.386
Authors: Pamela Smith; Gwenllian Moody; Eleanor Clarke; Julia Hiscock; Rebecca Cannings-John; Julia Townson; Adrian Edwards; Harriet D Quinn-Scoggins; Bernadette Sewell; Daniel Jones; Christina Lloydwin; Sara Thomas; Dawn Casey; Catherine Lloyd-Bennett; Helen Stanton; Fiona V Lugg-Widger; Dyfed Huws; Angela Watkins; Gareth Newton; Ann Maria Thomas; Grace M McCutchan; Kate Brain Journal: BMJ Open Date: 2022-10-12 Impact factor: 3.006