Health experts to evaluate new fast-track cancer diagnosis scheme

University of Stirling health experts are to study the success of a new Cancer Research UK-funded scheme which aims to reduce cancer diagnosis waiting times in Scotland. 

The projects based in NHS Forth Valley and NHS Fife, are part of a new programme called Test, Evidence, Transition (TET), which hope to enable patients to access treatment more quickly - providing the best chance of tackling the disease successfully.

The TET pilot schemes in NHS Forth Valley will see patients who contact their GP after finding a lump in their breast, referred directly to a breast assessment clinic without the need for an initial GP appointment and subsequent wait for a referral appointment. 

The aim is to free up GP time, improve the patient experience and prevent delays in diagnosis which is crucial in tackling the disease when it is most treatable.

Meanwhile, in NHS Fife, the project will see advanced specialist nurses leading the diagnostic process for those with prostate cancer symptoms to allow consultants to focus on more complex cases.

Once patients are referred to the specialist team, they will then be in the care of a dedicated nurse-led team and patient navigators who will assess patients, arrange scans, book biopsies and refer patients quickly to a cancer care team for treatment where necessary.

Cancer waiting times in Scotland are currently amongst the worst on record. In April-June 2023, only 73.7 per cent of patients on an urgent referral for a suspicion of cancer started treatment within 62 days. This is well below the 95 per cent standard and is the third worst performance on record since 2012.

Dr Erica Gadsby, of the University of Stirling’s Faculty of Health Sciences and Sport, and lead on the project, said: “In NHS Forth Valley, we hope this new patient pathway will remove the need for that initial GP appointment, therefore freeing up valuable GP time, reducing inconvenience to the patient and speeding up the referral to the breast clinic.

“Currently, the prostate diagnosis pathway is one of the more complex ones and patients are experiencing delays. By using consultant time in the most effective way, we hope to be able to reduce waiting times at the treatment end. 

“This nurse-led approach is used in other NHS health boards but hasn’t yet been fully evaluated. By collecting data and feedback, we will be looking closely at the impact of the new pathways on waiting times, patient experience and also on health inequalities.”

Current diagnosis pathway is complex

Currently in Forth Valley, people who find a breast lump are asked to contact their GP for an initial appointment who will then decide whether to refer the patient to a specialist breast clinic at Forth Valley Royal Hospital, Larbert.

Under the new procedure in NHS Forth Valley, on calling their GP practice the patient will be asked screening questions by the GP’s receptionist who can then refer them directly to the local breast clinic at Forth Valley Royal Hospital.

Currently, the prostate diagnosis pathway is complex and often requires multiple appointments and waits for investigations and monitoring.

Under the new system in Fife, the diagnostic process will be undertaken by advanced nurse practitioners who will be dedicated to prostate diagnosis, hopefully speeding up the process and freeing up consultants.

Both projects will be evaluated by researchers at the University of Stirling who will work with the NHS clinical teams to evaluate and develop the pathways over the next 18 months.

If successful, the new pathways could be adopted permanently in Forth Valley and Fife as well as elsewhere in Scotland and the rest of the UK.