The Department of Health’s Strategy for cancer services sets out an ambitious aim for the NHS to make significant progress in reducing preventable cancers, increasing cancer survival and improving patient experience and quality of life by 2020. The ‘two-week wait’ (2ww) cancer referral system has been in place for more than 10 years to help deliver the best outcome in a stipulated time frame for each patient.

Like many organisations, our team at South Tyneside District Hospital in the north east of the UK, struggle to maintain a compliant performance on a consistent basis despite providing excellent cancer care. As a result, our multidisciplinary team looked at our current pathway and evaluated it against best practices, recent directives and programmes such as the Accelerate, Coordinate, and Evaluate (ACE) Programme. The ACE programme encourages the utilisation of Straight-to-Test (STT) to improve time to diagnosis, and so we challenged ourselves to implement it effectively by appointing a dedicated ‘Pathway Coordinator’ (Band 6 Nurse).

The coordinator receives referrals, triages them with consultants, and then places them either into clinics or directly to investigations (STT). They also conduct a pre-procedure assessment over telephone within 48–72 hours that helps confirm the patient’s indication, fitness and willingness to have a definitive test. By collecting and comparing data on whether patients attend clinic or go directly to scope and how long it takes for them to receive treatment, before and after the new job role, we can accurately assess the new pathways’ direct impact on patients receiving treatment.

Initial Results showed that nearly half of patients went straight to test, with an improved number of days between referral and scope and referral and diagnosis, indicating that adapting this patient centred approach through a targeted role effectively addresses some of the challenges that the 2ww pathway presents.