Table 1 Comparing pathway modifications: changes and adaptions made to diagnostic pathways
Site 1 | Site 2 |
|---|---|
Lung | |
• Remove minimum time threshold for referral • Introduction of RATs as reference tool • For persistent high risk symptoms OR suspicious CXR patient referred simultaneously to 2-week wait pathway 2WW clinic AND CT scan 2WW | • Formal use of RATs alongside existing national NICE guidelines including a recommended risk assessment threshold of 2% • Option to do 2WW and simultaneous CXR for highly suspicious symptoms • Radiology given initiative to initiate 2WW referral and CT scan following suspicious CXR |
Pancreas | |
• RAT introduced as reference tool • Built on previous pilot by secondary care trust • Splits jaundice into a separate pathway (recognition of high risk) • Fast track for jaundice and suspicion of cancer • Simultaneous referral for CT and 2WW on non-jaundice pathway for high risk symptoms • Fast track route in for GP generated ultrasound referrals w/suspicion of malignancy | • Formal use of RAT and threshold score for 2WW • High risk symptoms go direct to CT scan followed by consultant review • Below national NICE guidance and RAT threshold consider abdominal US scan, if suspicious into 2WW |
Colorectal | |
• No change to national NICE guidelines | • Formal introduction of RAT with lower threshold than national NICE guidelines • For high risk symptoms and patients that meet the safety criteria GPs given a direct access to colonoscopy option |