Component

Agreed Actions

Urgent Referral

Ensure protocols for all urgent referrals agreed based on Scottish Referral Guidance for Suspected Cancers and in place across NHSScotland.

Ensure urgent referrals are processed appropriately and with minimum delay when received in secondary care

Ensure systems in place across NHS Scotland to identify all urgent referrals received – start of tracking system (see also information)

Drive and support electronic transmission of all urgent referrals

Examples of good practice from Cancer Service Improvement Programme include electronic/faxed referral to a single point, referral to a service not a consultant, direct referral to specialist service from diagnostics, no vetting or, as a minimum, daily team vetting of all referrals

Rapid Assessment and diagnosis

Ensure mechanisms established to process urgent referrals within appropriate timescales

Examples of good practice from Cancer Service Improvement Programme include single route of referral and access for endoscopy services, prebooking/scheduling of investigations and appointments, dedicated fast track clinics with rapid reporting, reduce consultant vetting of investigation requests, telephone consultation/communication of results, specialist nurse led clinics, reduce follow up appointments at outpatient clinics

MDT

Ensure Multidisciplinary Team Meetings in place for all cancers to support clinical management decision making and data capture

Examples of good practice from Cancer Service Improvement Programme include clear responsibility for coordination of MDT to ensure all necessary information is available at MDT fro treatment decision making, MDT used to refer on for treatment, timely communication with MDT of GP decision, video conferencing/telemedicine lines to be used where attendance is limited

First Treatment

Reduce delays in first treatment for all urgent referrals through optimal capacity, demand management and scheduling

Examples of good practice from Cancer Service Improvement Programme include coordination of treatment processes across network to ensure optimum use of capacity e.g. theatre time, planned management of annual leave and public holidays, streamlining of booking processes for chemotherapy and radiotherapy, efficient system for appropriate referral to palliative care

Across total care pathway

Information

Redesign

Ensure systems in place across NHSScotland to track all urgent referrals through diagnosis to treatment and produce monthly monitoring information

Ensure changes are implemented to address bottlenecks, reducing time for each step of the pathway within overall target