Colorectal Cancer Straight to Test Pilot Mr Dimitrios Pissas Mr Praminthra Chitsabesan Adam Spray Ben Douglas Suzanne Bennett
Context • Preparation for 28 day faster diagnosis standard • Requirement to work towards national best practise pathways
Analysis of Current Pathway & Performance Referrals increasing since 2014 – from 2500 for the trust to 5000
Current 28 Day Performance Current 62 day performance
Where we need to be by 2020
Overall Results of STT Pilot
Decision Making Analysis • 50 triaged 0-1day (65%) • 27 triaged 2-4 days (35%) FT Clinic 22 patients STT Endoscopy Referrals Consultant Diagnosis 45 Patients Triage 77 Patients 68 Patients Attrition STT CT Scan 6 patients 7 Patients Admitted prior to first contact 3 Patients
Overall Results: Control Sample vs STT Clock Start to First Clock Start to Clock Start to Old pathway Diagnosis (28 Contact Endoscopy Done CT Report day standard) Old Pathway 11 20 36 50 Median Clock Start to First Clock Start to Clock Start to New Pathway Diagnosis (28 Contact Endoscopy Done CT Report day standard) Total Pilot Median 14 13 33 33
Straight to Test (STT) Pilot
Implementation in the future • The current trial will involve a telephone triage of the patient to assess what information is missing from the form and to see if the form is fit for purpose • Pnts will be triaged STT or to a fast track clinic • (CT/ Ctcolon/Colonoscopy/Flexible sig)
GP Support GP Referral Form
New Referral Proforma
Referral Proforma – Patient Demographics Essential to ensure correct identification of patient. Please ensure Contact Telephone numbers are up- to-date.
Referral Proforma – Patient Suitability Confirmation ***Referring GP required to assess patient suitability for telephone assessment at time of referral and confirm on proforma.*** • Is the patient able to independently answer questions regarding their PMH and presenting symptoms/complaint? • Does the patient have a disability which may be a barrier to telephone assessment?
Referral Proforma – Reason for referral In accordance with NICE Guidelines for recognition and referral of suspected lower GI cancer.
Referral Proforma – Clinical Examination Please use tick boxes provided if examinati on findings normal. Please record any abnormal findings, in as much detail as possible, using the tick box diagrams and spaces provided. ***Comprehensive abdominal and digital rectal examination by GP essential as patient may not be assessed in person by a senior clinician following referral***
Referral Proforma – Referral Checklist GP or Surgery admin clerk must ensure this section is fully completed and corresponding information is included in the referral. ***Missing information will result in patient not being recruited to pilot and potential delays to investigations, diagnosis and treatment.***
Any Questions?
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