With cancer services facing an ever growing number of urgent suspected cancer referrals, achieving national waiting time standards is challenging. Accurx’s Sarah Garner, Market Director for Acute Trusts, looks at how starting with a few simple steps to improve communication with patients can improve performance against the 28 day Faster Diagnosis Standard.
2023/24 saw record demand for cancer services. In November 2023, the number of urgent referrals for suspected cancer seen each month was at 126% of pre-pandemic levels.
This increase in demand coincided with the worst year on record for industrial action. So, NHS trusts should be applauded for meeting the national NHS objective for the 28 day Faster Diagnosis Standard (FDS) in February.
75% of patients urgently referred by their GP for suspected cancer to be diagnosed or have cancer ruled out within 28 days
While national performance has been trending in the right direction, huge variation still exists at both provider and pathway level. The latest data shows vast differences between NHS trusts, with figures ranging from ~55% to ~90% of patients receiving their diagnosis within 28 days, and performance for eight of the 16 suspected cancer pathways still not meeting the 75% target.
As we move into 2024/25, the performance target has increased to 77%. Providers will need to find further efficiencies within their pathways, but particularly for those patients who are most likely to wait longer than 28 days.
Being held back
When we meet teams on the ground responsible for delivering the FDS, we often hear about common challenges holding them back. Many of these challenges stem from an inability for staff to effectively and efficiently communicate with patients and each other.
Referrals don’t contain the information required to instantly triage patients to the correct diagnostic procedure. Nurses struggle to collect this from patients or their GP practices. The process of generating and posting letters to patients is too slow and unreliable for a timed cancer diagnostic pathway. Patients are unprepared for the procedures they might need at the clinic - to mention just a few examples.
Communication needn’t be hard, but we know change is
At Accurx, we firmly believe that solving these challenges needn’t be rocket science. Clinicians and their teams just need simple and intuitive tech that enables them to easily and instantly communicate with everyone involved in a patient’s care.
From speaking to NHS colleagues on the frontline every day, we know that the more challenging part is finding the time and head space to design and implement change.
That is why when meeting with cancer services we generally suggest starting with at least one of the following three simple, but effective, steps and offer boots-on-the-ground implementation support.
1. Use text messages to replace discharge letters for the ~96% of referred patients who do not have cancer
In the Colorectal Cancer Service at George Eliot Hospital NHS Trust in the Midlands, the process of confirming non-cancer diagnoses, generating discharge letters and posting them to patients was slow and resulted in unnecessary delays. This meant that patients were waiting longer than they needed for confirmation that they did not have cancer, and performance against the 28 day FDS was not reflecting the true speed at which diagnoses were established.
The team redesigned this part of their discharge process, ensuring that consultants review diagnostic scans in a timely manner and texts are sent via Accurx to patients within a day of confirmation of their non-cancer diagnosis. This also creates a clear audit trail for the wider team managing reporting and next steps for the patients.
Time taken to report non-cancer diagnoses has fallen on average from 6.5 days to 1 day and their performance against the 28 day FDS improved from 56.1% to 71.5% in 3 months.
2. Ensure patients are engaged and informed about their pathway at the point of referral
Preparing patients for their urgent suspected cancer pathway is important as they may need to undergo a number of scans and tests in a short period of time. In the case of one-stop shop clinics, that could mean both an MRI and biopsy within a matter of hours.
Accurx enables teams to instantly share information with patients at the point that a referral is received, letting the patient know what to expect and emphasising the importance of prioritising these appointments. This can improve patient experience and reduce the potential for DNAs.
3. Use digital questionnaires to quickly and asynchronously collect information from patients to enable timely referral triage
Referrals with incomplete information are unfortunately all too common. Contacting the patient or their GP practice by telephone to collect missing information can be inefficient and delay the service booking a patient in for the appropriate diagnostic test.
The Prostate Cancer Clinical Nurse Specialists at University Hospitals of Leicester NHS Trust are now using an Accurx digital questionnaire to quickly collect missing information directly from patients and avoid the need for time consuming telephone tennis. With the patient’s response, the nurse is able to quickly determine whether they’re suitable for an MRI or not, which influences next steps for that patient’s diagnostic pathway.
The nurses have reported a time saving of 15 minutes per patient who responds to the questionnaire and a 90% response rate. This time can be reallocated back towards direct patient care activities within the diagnostic pathway.
We’re here to support your service
Need support improving your 28 day Faster Diagnosis Standard performance? Or, want to find out more about how Accurx can support your trust? You can visit this page or get in touch at enquiries@accurx.com.